ADVICE FOR BUILDING A CAREER IN PUBLIC HEALTH

DOES ANY OF IT REALLY WORK ANYMORE?

The public health workforce is not okay. In this series of articles, I will share what it has been like to work on the public health frontline during the COVID-19 pandemic and how these experiences have changed me forever. I will share the lessons I have learned and what I want the people around me to know, both inside and outside of the public health sector.

This post was originally published at JPHMP Direct.

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I’ve been silent for a long time and I am finally finding my voice. Since I started to speak out on LinkedIn about what it has been like to be a public health professional during a pandemic, I have received a lot of questions from public health professionals in the early stages of their careers seeking out advice for how to move ahead. But I’m not sure whether I have any of the answers. More accurately, I’m no longer even sure if there are any answers.

Throughout my career, I have been a supervisor and mentor for junior public health professionals, so I have had a chance to explore the received wisdom for career advice in public health. I’ve made it my business to attend a variety of public health career advice sessions offered by employers, nonprofit agencies, professional affinity groups, and private consulting groups, with the goal of better informing myself to respond to my direct reports and mentees, and — let’s be honest — to see whether maybe I can even glean some career advice for myself along the way.

Ha! How very naïve I was. I have been so thoroughly disappointed by what I have been hearing out there, and how little it connects to current experiences on the #publichealthjobs market. It makes me wonder how many of these so-called experts actually have recent experiences of job-hunting!? Shall we examine some of the advice I have picked up along my way?

“Think outside the box.” 

“Get out of your comfort zone.”

Let’s get one thing out of the way: advice for developing a career in public health that hauls out the same tired old tropes that didn’t even work before COVID-19 reshaped our job market is certainly not going to work now. At best, it is a well-intentioned waste of time. 

“Believe in yourself!” 

“Follow your passion.” 

“Just be flexible.”

At worst, it is gaslighting and victim-blaming to encourage public health professionals to believe that the obstacles to job security lie on their shoulders alone and might be fixed by a change in attitude.

“Volunteer!” 

“Demonstrate your interest by going above and beyond.”

Encouraging public health professionals who are already overworked and underpaid to volunteer for something new opens up new routes of exploitation for an already marginalized workforce.  

“Accept a job at a lower pay grade and work your way up.”

“Do a great job and someone will notice you and offer you a great opportunity.”

Perhaps this used to be the way things worked, but under the current financial pressures facing public health, I haven’t seen any evidence of any employers voluntarily choosing to pay a member of staff more when they can get away with paying less. I haven’t even seen any possibility of getting a lower level job without being turned away as overqualified. And if that somehow works out for you, good luck finding a manager who is open to hearing constructive suggestions from public health underlings lower down the food chain: I have found the hierarchies within Health Departments to be rabidly competitive. The only time that I have actually seen a public health professional credited for their ideas is right before they are thrown under the bus in front of senior leadership. (I refer you to my earlier column where I addressed the prevalent problem of toxic management in public health.)

No, the problem does not lie with the applicants seeking public health jobs, or even (dare to dream) actual careers. The problem is with the public health job market. Our field is currently in flux and still shamefully underfunded. Telling candidates that they have to adjust does not honestly reflect the enormous structural barriers determining the supply side of employment opportunities. 

Remember Sheryl Sandberg writing Lean In back in 2013? She advised women that if we would just apply ourselves harder at home and at work, we would overcome the barriers facing us in sexist workplaces, and readily demonstrate that we were just as worthy as our male counterparts and as deserving of promotion to the C-suite. Well, that didn’t go well for Sandberg, and by 2018 Michelle Obama spoke out powerfully to undermine Lean In’s individualistic mantras that placed all the blame on women themselves, rather than the structural and society-wide obstacles holding us back from career advancement. (Even Serena Williams at the top of her career has been forced to make a choice between career and family goals.) It turns out that there’s no amount of self-empowerment that can overcome pervasive inequalities, gendered burdens of care, and a paucity of family leave.  

Similarly for public health professionals, I argue that there’s no amount of re-formatting your resume that can fix the structural barriers to finding a secure job in public health, one that will compensate appropriately and offer opportunities for training and development. It’s not fair to lead new MPH grads to believe that if they just take one more YouTube training course and tweak their LinkedIn profile they will magically find the public health job of their dreams. Our field has been starved of funding for so long that raising expectations like this becomes unfairly tantalizing. I implore career advisors and experienced public health professionals to stop doling out advice like the phrases above that do not relate to the current reality.

So, what is the advice that public health professionals actually find to be helpful? Obviously, this is a much more important question, and one that is much harder to answer. Next week I will explore contextual changes in the public health career market, in order to set the stage for helpful career advice in a future column. Meanwhile, please reply in the comments or through LinkedIn to share any advice that you have genuinely found to be helpful in building a career in public health, and let’s work towards developing some guidance that actually reflects reality.