Generation Public Health: Top 8 Tips for Government Health Departments to Hire New Grads
by Heather Krasna and JP Leider
The Biden Administration’s announcement that they will spend $7.4 billion on the public health workforce is big news for the woefully underfunded, short-staffed, overstretched, and burned out public health professionals working in our nation’s local, state, tribal, territorial (and even federal) health departments. There could be thousands of new hires in public health. While much appears temporary, Biden has laid out a Presidential budget that, if adopted, could move the United States toward a sustained and sustainable (large) public health workforce.
Even before COVID-19, nearly half of public health workers said they expected to retire or were considering leaving. Before COVID-19. Now, with 250+ health department leaders (and an untold number of front-line staff, supervisors, and managers) leaving due to COVID-19 related burnout or harassment, there may be many opportunities for these new hires to find permanent positions. This could make the Biden funding a once-in-a-generation opportunity to reinvigorate the workforce—if it’s done right.
These new hires will need a range of skills and backgrounds, including epidemiology, program management, administration, leadership, health education, policy, nursing, and more. For those specialized occupations, where will all those new hires come from?
There are a few options, including trying to poach people from the private or nonprofit sector (if you can manage to get them to leave); attempting to hire people without specialized training and training them on the job (if they can get any time off for training); hiring through temp agencies (if you don’t mind spending money on their exorbitant fees, and don’t want to bother building a long-term talent pipeline); or recruiting new college graduates. Since we both work in academia, we’ll admit some bias towards this last one—but there’s a good argument to be made that it’s the best way to build the workforce for the long term.
JP’s number of the day: Thirty five thousand
There are now more than 35,000 public health graduates in the USA each year, and their degree programs have been designed specifically with the public health workforce in mind (Figure 1).
Almost half of these students are undergraduates. But what will they do with that degree — will there be competition between bachelor’s and master’s grads for jobs that used to be master’s-only, like we saw happen in K-12 education? Possible, though somewhat unlikely (for now). Why not? Only 19% of master’s grads and 10% of undergrads find their first job in government—leaving a lot of room to expand. Besides public health students, many other majors are needed in health departments, ranging from nursing to environmental science, accounting to IT.
There are a number of reasons that schools and programs of public health are training a generation of students that largely won’t work in governmental public health. Employer demand has been steady from other sectors, many of which pay better (at least at the master’s level), and are likely easier to get hired into. One other reason may be less obvious – a diverse “marketplace” of degrees WITHIN public health with different target markets. Consider that in 2010 approximately 10,000 master’s degrees were awarded by 234 schools and programs, increasing to 18,000 degrees and 372 schools by 2019. The “top 10” US News & World Report schools (2021 ranking), awarded 28% of all degrees in 2010 to 21% in 2019. New programs and otherwise “unranked” schools constituted 11% of master’s degree conferrals in 2010 (from n=81 schools) up to 20% in 2019 (n=191 schools). It seems clear that there are many more public health graduates, from a broader range of schools and programs, than before. It would seem logical, then, that in such a crowded marketplace, more schools or programs would focus on filling a clear need – governmental public health. But most clearly do not. So, what gives? (Figure 2)
Benefits and Challenges for Government in Recruiting College Students
Hiring new college graduates benefits employers because it can connect them to an untapped talent source; Gen Z, being “digital natives,” can be adept at new technologies and communication strategies; new grads are often full of excitement, and those who have chosen public health are generally deeply committed to the cause.
However, there are several challenges for health departments in recruiting new grads. From a health department’s viewpoint, campus recruiting can be labor-intensive, recruitment timing may not align with students’ graduation dates, and each university has its own career services office to reach out to. Smaller health departments may not have capacity to build their own recruitment efforts due to time and cost. Onboarding and training can be time-consuming.
From the student’s view, while public health students are attracted to government due to the meaningfulness of the work and good benefits, they are worried about lower pay and lack of career growth and innovation. It’s harder for government to hire students because of the slower time to recruit—98.3 days in the federal government, while the national average is 35-41 days.
There’s also the competition—for instance, of 33,563 job postings for master’s level public health graduates which were posted from 7/1/19 to 6/30/20, only 12% of job postings for master’s level public health grads were from government agencies. And many sectors are growing fast, like “healthcare and social assistance,” which is projected to grow [bls.gov] in employment by 1.4% annually from 2019-2029, while federal government is projected to decline by 0.7% and state and local government is only growing by 0.2%; and “statistician”—an occupation which can include epidemiology and biostatistics graduates—is the fifth-fastest growing occupation in the country, while “medical and health services managers” is eighth. So there are lots of employers looking to hire graduates with the same skills that health departments need.
So, what can you do to lasso the energy of new college graduates, and snag these grads before someone else does?
Heather’s Tips for What Health Departments Can Do Right Now:
As a university career services professional for the last 22 years (with 8 of those years at a school of public health), I’ll admit I’m biased, but I’m a big fan of public health organizations hiring new grads. And as someone who talks to public health students and the employers looking to hire them every single day, I have some opinions to share.
Tip #1: Market Your Mission
According to the Universum “Most Attractive Employers in the United States” survey of 52,738 college students, the top five values of respondents from Gen Y (born 1981-1996) are secure employment, work-life balance, professional training and development, inspiring purpose, and an employer with respect for its people. For Gen Z (born 1997-on), key values are high future earnings, secure employment, inspiring purpose, clear path for advancement, and professional training and development (emphasis mine). According to Universum’s Chief Strategy Officer, Richard Mosley, “Young people want to be part of companies and industries that are making the biggest impact on society and daily life.”
Considering that “inspiring purpose” is in the top 5 values for both groups, health departments should focus on their mission. Don’t hide your light under a bushel. Choose some real-life examples and short stories, illustrating a time when one of your staff did something that saved lives at scale. Use the “Fauci Effect.” Students are fired up by COVID-19. Think of some unsung “public health heroes,” and start singing about them. Wear your heart on your sleeve and show your passion. Remember, too, that most students still don’t understand the difference between public health and individual health care, so start with the basics–focus on the millions of lives that are saved through prevention, protection, and promotion.
Figure 3: Public Health, a lifelong job. Source: Library of Congress
And know that some public health organizations have reputations you might be able to latch on to–for undergraduate natural science majors in the Universum survey, the NIH and CDC were in the top 3 employers, ahead of “sexy” companies like Apple, Walt Disney, and Google.
Tip #2: Train Your Recruiters to Be Marketers
As a career services professional, I have helped organize hundreds of employer presentations. There’s a stark contrast between most government employer presentations and those of the consulting firms, nonprofits, hospitals, pharma companies, and tech startups that are fiercely competing to hire my grads. For non-government employers, in an hourlong recruiting presentation, about 45 minutes of the content is about the meaningfulness of the company’s work, the exciting company culture, the opportunities for training and career progression, how new hires are treated, and what the actual substance of a day on the job entails. Usually, there’s a very recent grad—generally an alum of the school—who excitedly talks about their job. Then, there’s one PowerPoint slide, and maybe 5 minutes, about how to actually apply and interview for the job.
I find the ratio is reversed when government agencies do presentations. There’s often no more than 5 minutes on the agency mission, nothing about “day in the life”; and at least 45 minutes trying to explain the civil service hiring process. According to a respondent of a recent survey of career services providers of public health students, “Government program recruiters tend to be less polished and have fewer resources to devote to speaking with students. They are more likely to cancel information sessions, not have the budget to travel to schools outside large cities, etc.”
But another respondent stated, “The governmental career path becomes more attractive when a former student or other current employee interacts with the students and describes the hiring process, giving suggestions about how to navigate the annoying and drawn-out parts but highlighting the many benefits, including the impending retirement wave which will provide lots of advancement opportunities.”
Tip #3: Market Your Benefits, Training, Mentoring, Career Opportunities—and Loan Forgiveness
Many 22-year-olds have never heard of a retirement plan. If they’ve always been on their parents’ health insurance, they may have no clue how having good benefits can favorably impact their financial bottom line. In your outreach, be sure to explain the cash value of benefits and retirement.
Especially at the undergraduate level, some students may never have heard of some of the unique job functions that exist in health departments. A “day in the life” of an epidemiologist, public health laboratory professional, health educator or environmental health specialist can open students’ eyes to jobs that only exist in health departments.
With an impending retirement wave, there is a chance for new grads to move up the ladder faster—market that opportunity to advance.
While there is only a beginning movement toward a robust, special loan repayment program for public health students who work in government, many students still can use Public Service Loan Forgiveness, and for clinicians and for certain health departments, the National Health Service Corps may work.
Tip #4: Get Creative
Maybe you won’t have a big recruiting budget to give away fancy swag items at career fairs, but you can still be creative. Try having your current interns create a Student Ambassadors Program where part of their job is to excite fellow students about your organizations. Use social media, hashtags, videos and other media. Try contests, competitions, and challenges. Some famous examples of creative recruiting campaigns include Google using a billboard with a website: “first 10-digit prime found in consecutive digits of e.com”—leading to a hiring website only math geniuses could find (Figure 4).
Reverse psychology could work, too; Ernest Shackleton apocryphally recruited people for his polar expedition by advertising a “hazardous journey, small wages, bitter cold, long months of complete darkness, constant danger, safe return doubtful… honor and recognition in case of success.”
Tip #5: Play the Long, Long Game
To do college recruiting right, you can’t just do “drive-by recruiting.” You need to identify target schools, and show up at them consistently, over the long haul. Engaging on campus includes campus recruiting, career fairs, site visits, practicum or internships, guest speaking on campus, employer information sessions, “coffee chats” or “recruiter in residence days,” and alumni panels or socials; but it also includes building a positive “employer brand.” Students talk to each other, so treat students respectfully and remember you are competing against corporations that can hire faster and pay more. Partner with universities, and find out who the right career services providers are.
Build an internship program—the most evidence-based method of hiring new grads into health departments. Recruiting new staff from internships is one of the most cost-effective hiring methods, and interns who “convert” to permanent hires are often more loyal; but you have to treat them well to make it happen.
Very soon, there will be $400 million to hire people through the Public Health Americorps program. This program offers the opportunity to expose thousands of people to public health careers. I’m hoping this program might focus on the undergraduate public health majors, only 6% of whom find their first job in state or local health departments, and 9% of whom remain unemployed after graduation. I’m hoping the alums of these programs might find permanent jobs at health departments, and a conversion to permanent employment will be intentionally designed for them. Or, we can think of them as a new generation of public health fans. Perhaps they can join an alumni community, be provided scholarships to public health and other related schools, and eventually be encouraged to try for other “pipeline” programs like PHAP, PMF, and even the EIS.
Tip #6: If You Can, Speed Up Your Process, or At Least Demystify it
If you can, use special hiring authorities, grants, external hiring mechanisms, or other ways to get new hires on board more quickly. A respondent to the survey of career advisors stated, “Many DOH job postings are highly specific and the HR policies can be strict, so I spend quite a bit of time helping students understand how to tailor their applications to ensure they have a fair shot based on archaic requirements.”
Remember, students have never heard of civil service exams, a “certificate of eligibles,” “special hiring authorities,” competitive vs. non-competitive appointments, GS-levels and so on. They have no idea how prestigious a fellowship like the Presidential Management Fellowship is, or how hard it can be to get their foot in the door in certain government agencies. If you have to spend time training students to apply for your jobs, at least make it sound like an exciting challenge. My “Secrets of the Government Job Search” workshop gets good attendance!
Tip #7: You Don’t Know What You’ve Got Till It’s Gone–Retention
With younger hires being more likely to quit public health, and with a significant generation gap in the workforce, it’s important to ensure your workplace is welcoming. Consider creating affinity groups for new hires, buddy programs, training opportunities, job shadowing, or rotational programs. Throw a little “welcome party” for new hires. If your whole workforce is burned out, try to use public health measures to avoid contagion! Prevention of burnout is key, and promotion of a positive work culture is also important.
Tip #8 – National Support Is Needed
This last tip isn’t for the local, state, tribal or territorial health departments. It’s for the Biden Administration itself. If you want this $7.4 billion to be well-spent, you need a longer-term game plan. Because so many health departments are short-staffed and burned out, they may lack capacity to do all this hiring on their own. They need external support—a national public health recruitment campaign. Each health department needs a recruitment and retention strategy, and they will need extra help to build and implement them. A national strategic recruitment and retention effort—built either by a federal agency, a consultancy, or a consortium/ work group with HR, organizational development, recruitment, and college career guidance experts at the table—needs to happen, and fast. It should be focused on data-driven projections of future recruitment need by occupation or skill set, and the long-term development and training of a diverse, highly-trained group of professionals that match these occupations, and reflect the demographics of the communities they serve.
There could be better “one-stop shopping” for public health jobs, like a website which auto-directs job seekers to the job boards of the health departments near their zip code or an “indeed.com” for health departments. This website should have quick tips (written in layman’s terms) for civil service hiring, dazzling recruitment videos, easy-to-find lists of fellowships, connections to loan forgiveness programs. For college recruiting, use tips from experts in college recruiting like Partnership for Public Service and Peace Corps, and even the UK’s National Health Service recruitment page, to get ideas for the site.
Similarly, health departments can use help figuring out where to look to find the right schools to target and to get in front of students at these schools. That’s where organizations like the Association of Schools & Programs of Public Health (ASPPH) Career Services Assembly can help (eg, visit the CEPH site to find a list of accredited schools, post to Publichealthcareers.org, or email me to learn more); or become involved with the National Association of Colleges and Employers (to connect with college career services providers), or connect with the Graduate Career Consortium, for career advisors to those at the PhD level; or Consortium for Career Development in Social Work Education and so on. To save on costs, use webinars and virtual career fairs. And remember, career services providers in colleges and universities have a key job—helping their grads find employment—and so we are here to help. Career services providers like me actually listen to public health students and the employers who want to hire them on a daily basis, and we can be key partners to establishing better connections between public health organizations and new grads.
External support and capacity building is needed for health departments to design an outstanding internship experience. Public Health AmeriCorps members will need training, which could be designed by entities like PH-TRAIN or others. To be strategic, an intentional plan to convert interns and AmeriCorps members to new hires will be key.
And of course, if the Biden funding is a one-time, temporary “shot in the arm” for the workforce, it might have wonderful short-term benefits, but could leave these health departments in even worse shape in a few years when the new hires leave. Legislation like the Public Health Infrastructure Saves Lives Act could be a longer-term game-changer. Even if it doesn’t happen, we still have a chance to harness the energy of an entire generation into public health careers. Let’s not throw away our shot.
Heather Krasna, MS, EdM, is Assistant Dean of Career Services at Columbia University Mailman School of Public Health and the co-author of 101+ Careers in Public Health, 3rd Ed. The opinions expressed here are her own, strongly held ones. She is available at hk2778 (at) cumc (dot) Columbia (dot) edu.
JP Leider, PhD, is the Director of the Center for Public Health Workforce Development and Applied Practice at the University of Minnesota School of Public Health, and a member of the JPHMP Editorial Board. He is available at leider (at) umn (dot) edu.