A discussion on the public health workforce, with Assistant Dean and Director of Career Services at Columbia University Mailman School of Public Health Heather Krasna

Heather 0:00
So my hope is that the outcome is people will read this. People who are studying public health will have a clearer idea of the different directions they could go into, and be equipped to pursue those opportunities. And also, people that never thought about public health have no idea what it is even today, that they will pick up this book and be inspired to go into the field.

Sujani 0:23
Welcome to PH SPOTlight, a community for you to build your public health career with. Join Us Weekly right here. And I’ll be here too, your host Sujani Siva from PH SPOT.

Everyone, thank you for joining me today on another episode of PH SPOTlight a space for you and me and everyone else in public health to share our stories and inspire each other. My name is Sujani Siva, the host of PH SPOTlight, and I’m here to help you build your public health career. Today’s episode is a topic that I have been very much fascinated about. And it’s also related to why PH SPOT was started. And on today’s episode, we are exploring the public health workforce. The conversation that I’m having today on this episode is with Heather Krasna, who is the Assistant Dean and Director of Career Services at Columbia University’s Mailman School of Public Health. And it’s one of multiple episodes that I will be sharing on the PH SPOTlight podcast on this topic of the public health workforce with different professionals who have spent some time thinking about or researching this area. With Heather specifically, we chat about the landscape of the public health field how COVID-19 is and will impact the labor force for new grads and how to make yourself more competitive in the field as well as career advice and a bit about Heather’s book that’s going to be coming out. So you’ll notice that I get super excited with this topic, hence the length of the episode. And I just want to keep speaking to Heather. So I do hope to bring her back at some point to continue our discussion. But until then, here’s this chat with Heather Krasna.

Hi, Heather, welcome to the PH SPOT podcast. And thank you so much for joining us today.

Heather 2:19
Thank you so much. It’s an honor to be here. And thanks for inviting me.

Sujani 2:23
We just chatted a little bit before we started recording, and you’re just south of the border, and I’m up here in Canada. So it’s always nice to collaborate with our colleagues in the US. And I’m really excited about the topic that we’re going to be chatting about today.

Heather 2:37
Same here and I’m honored to be invited to a program based up in Canada, I have great admiration for the country.

Sujani 2:46
Thank you. Yeah, I think when I discovered the work that you were doing it, it just kind of was a natural match for what PH SPOT is also doing because you’ve been involved in just researching and doing some great stuff for the public health workforce. So this discussion should be quite valuable. And I don’t think it’s going to be the last one that we’re both going to collaborate on. So really looking forward to the the future potential that the two of us are going to embark on.

Heather 3:18
Same here.

Sujani 3:19
So I thought maybe we could start off by letting our listeners know a little bit about you and how you got into just researching the public health workforce. And I know you play a significant role at Columbia University Mailman School of Public Health as the Assistant Dean and Director of Career Services as well. But not only that, you’ve been a coach, a career core- coach in this field as well for a number of years. So maybe take us back to what really got you interested in public health and the workforce and just exploring that field.

Heather 3:56
Sure. So you can kind of trace this interest in public service more broadly, all the way back to when I was in high school, and I was an environmental activist in my high school. So it goes way back. I’ve always been committed to the public good and public service. And I went after my undergraduate degree to get a master’s degree in nonprofit management. And I worked in a nonprofit organization for a year and then I kind of pivoted into higher education, career services, and I did that for many years. And until about 2008, that degree, my master’s degree in nonprofit management really wasn’t that related to the work I was doing in career development with undergraduates and graduate students. But I found a position at a policy school of Graduate School of Public Policy at the University of Washington. And it was very relevant to that work because my graduate students were studying things related to nonprofit management and public administration and policy. So I realized then that it was very meaningful to provide career guidance and employer relationship building for graduate students focusing on improving the public good. And then in around 2014, I was lucky to find this position at Columbia University in the School of Public Health. And I feel very honored to be in that role, because I get to work with these fabulous public health students and alumni and employers. And it’s just very engaging and satisfying for me to be able to guide students and alumni who are trying to basically, you know, improve public health and save the world in many ways. How I got into the research piece is that I began to part of my role in Columbia University is to gather data on the employment outcomes of the graduates. And this is something which is required for accreditation, through the program that the entity that accredits Schools and Programs of public health, that you have to gather these kinds of data. And I started to just anecdotally observe that there were some trends going on in the outcomes over the years that I was involved with gathering the data. So for example, I found that it looked like there were more of our graduates going into for profit companies, as opposed to the more traditional public health, in nonprofits, academia, healthcare, and hospitals, and especially government. And so you know, being surrounded by brilliant quantitatively oriented people, I found a graduate student to help me look at the actual data, and to do some statistical analysis. And some of my wonderful mentors and colleagues, such as some epidemiology professors, and other faculty encouraged me to try to publish this research. So that was my very first publication, which had to do with employment outcomes of public health students at Columbia. And we did discover a trend towards corporations and not so much away from government, government stayed very much flat, didn’t increase or decrease as a proportion of where graduates got jobs. But I did notice that trend and- and published that article, and then I’ve been going on to do additional research from there, partly focused on employment outcomes of the graduates, and then partly looking at what employers are looking for based on job postings and surveys of employers. So that’s been my focus.

Sujani 7:42
Oh, wonderful. And I guess, you know, even if you haven’t repeated that study, just recently, are you noticing, at least anecdotally, that that trend has kind of remained since you joined Columbia? Or are you seeing any shifts?

Heather 7:56
You know, it’s an excellent question. I had looked at that data. I think that I haven’t really analyzed it quantitatively in the last couple of years. But I feel like it’s probably just maintained the same proportions just over the last few years. So, but when I did start out at Columbia, like, when I was looking at the data from 2014, maybe 90% of the graduates were going into the more traditional sectors of nonprofit government and healthcare, academia, and only 10%. were going into for profit companies, but it went up to around 30% during the time period that I’ve been at Columbia, I think it’s kind of maintained at that level. I haven’t seen it go beyond that percent. But- but that’s a big change.

Sujani 8:39
Yeah.

Heather 8:39
And what you see when you look more in detail at what do those jobs entail in the for profit sector, you could argue that those are still actually public health jobs, or at minimum, they’re at least health care related jobs, very, very few of the graduates are going into things that are actually not related at all, to healthcare in some way, shape, or form, less than 1%, actually, all the jobs are still relevant. It’s just very, not traditional. So they’re going into data science, they’re going into tech startups, they’re going into consulting companies, marketing firms, it’s just very different from, you know, health insurance, which is the thing here. Yes, you know, so it’s definitely pivoted to some extent.

Sujani 9:26
That’s very interesting. I, I was under the impression that that 90-10 split is probably what still remains. And I’m curious to know if that split now, which you’re describing the 70-30. And it remaining over the years is similar across the world, and especially like in Canada. I’m wondering if that’s a similar split here as well.

Heather 9:49
So I’ll say two things. The first is that the trend that I described going on at Columbia, I cannot claim that that’s some sort of national or international trend.

Sujani 9:58
Yeah.

Heather 9:59
I think that there’s not enough data yet to analyze that. However, one of the other projects that was recently published in the American Journal of Public Health, AJPH, is about first destination outcomes of public health graduates from all the member schools of this Association of Schools and Programs of public health, which I believe does include a few schools in Canada, and other countries around the world, mostly its US space. So again, you know, full disclosure, it can’t be sure that this applies to every country in the world. But, you know, we did gather data from member schools and programs from 2015, every single year through 2018. And, you know, basically, by 2018, we had 111 different schools, providing schools and programs of public health that are providing degrees, bachelor’s, graduate degrees, master’s, doctoral, about the employment outcomes. And so far, we haven’t yet really discerned if there’s some trend nationally, with all that data collection, there’s a- there’s, there are a few trends that you could actually say are significant in terms of certain things. But it’s- it’s a little preliminary, but if you wanted to see, you know, what, what proportion of graduates go into corporate versus not, it actually varies by degree level, at least according to this data that I’m talking about from, from the US mostly. So for instance, at of course, the PhD or DrPH doctoral level, you know, a good chunk of the graduates go on into academia, which is not surprising, you know, something percent, whereas master’s level, you know, it- well, if you look at who goes into corporate, for both masters and doctoral, at least nationally, it’s around 20%. If you sort of smushed together all the years of data together, it’s about 20%, that are going into for profit companies right now. So it might be higher at Columbia for various reasons. And then, you know, but for the undergraduates, the bachelor’s degree in public health, it’s actually 36% that go into for profit companies. So there’s so many unanswered questions to research, like, why is that? And exactly what kind of jobs is that representing? And is it I’m hopeful that those are still health related. But it could be a sign of, is that underemployment, that maybe at the bachelors level, it’s harder to find a job in what we consider the more traditional public health fields? It’s tough to say. But yeah, it’s nationally looks like for ba- for master’s and doctoral, it’s, it’s still maybe 20%, for profit. But in terms of government, it’s still 19% at the master’s level. And so that’s significant to think about, because if you define public health, at least, you know, in a lot of the research as the core government, you know, health departments, and only nine- 19% of your MPH grads, basically are getting jobs in government, then you have to ask, you know, is that going to give enough people to fill workforce gaps that are going on? You know, so this gets into some policy related issues of well, why aren’t they going into government, is government not paying as much as pharmaceutical companies pay? Well, these are things that we can research and then use to enhance the recruiting programs to get the trained people that we need to go into the kind of sectors that really need these kinds of candidates. So it gets into some policy issues.

Sujani 13:37
And I think the question that comes up in my head is whether that- that ratio kind of goes down as these graduates spend more time post graduation in their roles. You know, I think this study, you said, is looking at the first destination jobs. And I wonder how that kind of evolves once they spend 5 or 10 years in, say, government? Are they still staying in government? Are they moving on to different industries? So that- that’s also quite, I think, interesting to inform policies as well.

Heather 14:10
And you know, it’s ni- It’s nice that you mentioned that because of really, some colleagues of mine, actually, based at the University of Minnesota, are beginning to do more of a longitudinal study of their alumni. And they’re looking at when they graduated, what job did they have, and then what job do they have now, and what sector is it in, has it changed? Again, it’s very preliminary, So nobody’s published anything on it yet, but I think that’ll be very interesting and illuminating. And my hope is, eventually there could be again, some sort of national longitudinal study. In fact, I’m in the process of writing my dissertation, focusing on public health workforce and in the process of doing that I had to do a review of one of these. It’s called a scoping review. So it was a review of the literature on public health, employment, you know, graduate employment outcomes. And the what I discovered through that, and through working with a lot of different colleagues and collaborators is that the last time anyone did a longitudinal study of the employment of public health graduates was 1985. It was published in 1992. So really, there’s it’s probably time to do a big national study.

Sujani 15:22
Yeah.

Heather 15:23
There was a study that was published in 1992, longitudinal study of graduates of schools of public health, and they looked at 1956 through 1985 graduates, well, I think things have probably changed. It’s hard to do that again.

Sujani 15:36
Yeah. See, that was- That was another question I had for you. Because I’m recently seeing a lot more publications on the public health workforce. And I was just going to ask you, if that’s kind of a new area of research that you’re discovering, or am I just new to this area and reading about it more recently?

Heather 15:55
It’s an excellent question. I think more I mean, you know, the more you learn about things, the more you find out that you don’t know, right? So- so I want to say, oh, yes, 100%. There’s more research going on. But I don’t know for sure if that’s really the case, I do know that there were some really excellent studies of again, we’re talking about mostly the US. So I can’t say you know, internationally as much. But there was an enumeration of just how many human beings work in public health in the United States that was done- so there’s been there was a big study into the year 2000, by a researcher named Christine Gabby, who’s now in Australia, actually. But that was a major publication. And then the next time they did that was my, my colleague and collaborator, Angela Beck at the University of Michigan and her colleagues, they did another enumeration in 2014. So that was another landmark. And then from 2014, and 2017, there was a study done called PH WINS, which is the Public Health Workforce Interests and Needs Survey, which was a survey of people and local and state government health departments in the United States about their career. You know, it was partly their demographics and their level of education and things like that, and their role within the health department. But it was also about whether they were planning to retire or whether they were thinking about leaving the field. So those are some of the kind of landmark studies and I think that probably, in the last few years, there’s definitely been a big increase in interest in the public health workforce, partly from those kinds of studies, like PH WINS. But also this piece about it, the graduates of the schools of public health, again, there was very, very little out there. And one of the the scoping review that I did found that, you know, there were very few articles really focusing on what do you know, what these graduates actually do for work after they graduate. And the studies that did exist really were, most of the time, it was somebody who did a survey of all the alumni, whoever graduated at any point in history from their particular school, and they would sort of smush all the data into one big data set without any regard to when the person graduated, or how long they’ve been working in public health See, can’t really make much sense of that I- That’s my opinion, you can’t make sense of that. But also, the focus of the purpose of the study was usually to find out if people were satisfied with their degree. And not, that wasn’t even the research question like what- what are you doing with your life now that you finished your degree in public health? So definitely, there’s been new interest in the field. And now that we finally have some outcomes data, through this national collection, from the Association of Schools and Programs of public health, there’s so many new things that we can now find out and more research that could be done. So definitely, there’s been more research in both the public health workforce like the people who actually work in public health, however, you might define that. And it’s, again, mostly defined as government even though we know it’s way more broad than that. And then, just the beginnings of more really good research on the actual people who studied public health, and what are they now doing with their lives, and, you know, is there any mismatch between these two pieces of the puzzle, the public health workforce, and the actual people who studied the degree prob got a degree in public health? So you’re right, that there’s a lot more going on recently, in the last few years, for sure.

Sujani 19:35
Yeah. And I guess it goes without saying that now with the pandemic, that interest and probably research is it’s not going away, and we’re going to see more of it. I’m just thinking about, you know, even the split of graduates going into the public sector versus the private sector. I’m, at least I’m predicting that we might see more individuals going into the private sector as a result of the pandemic. I don’t know what your predictions are kind of in that lens.

Heather 20:08
So it’s fun that you asked because I had yet another publication that recently came out.

Sujani 20:13
We’re gonna have to link up all of these publications in the show notes for sure.

Heather 20:17
Very recently, we had an article that came out in an international journal, and it was about labor market competition for public health graduates and the way we discerned this labor market competition had to do with analyzing job postings. So this was labor market competition. And it’s a comparison of workforce taxonomies, with job postings before and during the COVID 19 pandemic. And this is in the International Journal of Health Planning and Management. So what we did for this project is two things. First, we had to ask ourselves, well, what actual job functions exist within the realm of public health? And it’s such a, it sounds like a simple basic question. We know there’s needed for, you know, epidemiologist, educators, health- health, public health program managers, biostatisticians, we know there’s certain types of jobs that exist. But then you have a lot of question marks about, do you count the person who- who’s taking out the garbage at the health department office? Does that person count as a public health worker, particularly is the maintenance crew? Or a, you know, the the accounting staff, right? They’re human resources, do those exactly count? They’re supporting the efforts of the health department, but that’s not really a public health career. So specifically, it’s related, but not. And then there’s the flip side of that about, you know, what are some of the occupations you could get with your degree in public health that might not exist, again, in our local and state or governmental health departments? And so it sounds kind of simple on the surface, but it’s not. So what we did is started out by reviewing the literature, again, to see what are some of the taxonomies of occupations that we think exist in- in public health, and there were really not that many that were actually published. So there were a few, there’s, there’s sort of a couple one in the UK, one in the US that again, my colleague Angela Beck, and her colleagues at University of Michigan put together. And then there was a very recent article where somebody went through all the literature, and kind of put together their own taxonomy by synthesizing like all kinds of surveys that had been done in the public health workforce and in countries all over the world. And so we try to match these all up. And then to make sense of them, you have to think about how do you categorize an occupation, that’s where you get into sort of workforce research and industrial psychology and other types of disciplines where the focus is categorizing different kinds of jobs. And so that’s where I basically went in and matched the taxonomies that existed in the literature with some categorizing methods that are used. So there is something called ISCO eight, which is the International- there’s an international standard, put out by ILO, the International Labor Organization, that has to do with categorizing different occupations. And then the US Department of Labor also has its own categories. And then there’s sort of a cross reference between these two. So anyway, long story short, we categorized all of these taxonomies and then match them with actual codes that had been put together by the people who are experts in categorizing different occupations. That was step one, step two, though, is that we looked at a data set of about 38,000 job postings where the employer said they wanted to hire a public health graduate. And we then, those we got from a data set by a company called Burning Glass technologies, which combs the internet for all job postings ever. That’s what they claim. So they scrape the internet for millions and millions of job postings every day. And then they have some sort of algorithm with fancy natural language processing that they use to categorize by what the job posting said about the qualifications needed. And so we matched those. But we also did a study of job postings from March 2019 through October 2019 and compare that with March 2020 through October 2020. To look at whether there’s differences from the pre COVID time to the during COVID time remembering this is in the United States.

Sujani 24:42
Yeah.

Heather 24:43
And so here’s what we found is that there is an increase from the before COVID to the during COVID time period, in certain industries, especially insurance companies and pharmaceutical companies. Now, I’m going to guess that because we have a new federal administration that’s putting in a ton of money into the public health workforce shift yet again, if I were to pull that’s in the future, I’m gonna guess more jobs in government will show up because there’s all this money going to hiring people into government to address the pandemic. But there was a shift partly because I think nonprofits and universities had some budget cuts during that time. There is also an increase in need for people with quantitative skills. So the jobs relating to quant epidemiology biostats, were expanding greatly. So anyway, that was what we found in a nutshell.

Sujani 25:37
Oh, fascinating. Yeah, because I guess the thought that I had was that private industries, or the private industry will see an approach or this is my optimistic thought is that they will see the appreciation for public health, and then want to integrate professionals in public health into their workforce. So that was kind of the thought that I was going down. But yeah, the funding definitely also shifts the labor force to either side. Just going back on your, your statement of just categorizing what we mean by a public health job is super difficult. Even though on the surface, it seems like a simple task, we often run into that issue. And we’re thinking about, who are we serving as PH SPOT, you know, it first started off with those traditional roles that you mentioned. And now I’m seeing that a lot of our community members, they may not be in those traditional roles. And they may be the program’s support for a school of public health or communication specialists within a public health organization. And it’s really, it’s really tough. So I’m going to have to take a look at kind of the process that you’ve taken in your paper to really help us in that angle. I think that brings me to your book, the 101 Plus careers in public health, and I think you’re coming out with the third edition soon, or maybe it’s out already.

Heather 27:05
Thanks for asking about that. Yes, that’s coming out in August 2021. I wish it was, I wish it was already out. But you know, that book, it’s the third edition. That book has been around for, I think, 15 years, but this is the third edition. So my friend and co author Dr. Beth Seltzer, who is a preventive medicine, public health physician in the New York City Department of Health. She was the original author of this book, and we took that project on. Officially we signed on to update the book back in September of 2019. Little did we know, at that moment, how much this book would need to be revised because of COVID. And so the- what I- what we did is this book has 25 chapters, it has an intro to what a public health is very short history of public health, then it gets into how do you determine what public health career is right for you. And then it goes into what degree programs or education might you need to go into different public health careers. And we spell out what are some public health types of careers that you could get without a college degree. What about a bachelor’s degree? What about a Master’s or PhD or an MD? Right? So we focused on various career paths that you could go into, then the middle of the book, which is the substance of it is kind of public health careers, by different topics. And so we have infectious disease, chronic disease, maternal child reproductive health, we have aging, environmental health, it goes on and on global health health policy, we had to write an entire new chapter that didn’t exist before, which was data science, technology and IT type of public health jobs that didn’t exist in the previous book. Every single chapter had to be rewritten because of COVID. And we also have interviews, I think it’s 54 different public health professionals that are profiled in the book and we’ve replaced almost every single person from what we had before. So much has changed, that the whole thing had to be reframed. Going back to the how do you define a public health career though, that’s an excellent question about what did we include in this book, and actually, we wound up with more than 101 I think it’s 120 different careers in public health. And it couldn’t be more than that. And so the way that I visualize it is that we’re looking mostly at public health careers, where the person in that field is contributing to the 10 essential services of public health as defined by the Centers for Disease Control and Prevention. 10 essential services and you can look this up. It’s, it’s, again, a broad definition, but because we had that definition, that meant we’re not really focused thing only on jobs you could get with your MPH, there are jobs that you could certainly get with that MPH that don’t really necessarily contribute to the 10 essential services that are certainly health care related or even related, just more broadly to other things. But we decided to frame everything. And every time we would put a new job in the book or interview a person for the book, we would have to say what does this do that does prevention of disease or promotion of health or protection of the population, or that supports people that are doing those things? And that was kind of the framing. And the thing, when when you look at it like that, you you have hundreds of different kinds of careers that could do that, where there’s a combination of the occupation, the job function, the what you’re actually doing all day in your field, like, what’s your job title, combined with the topic area of public health, and I mentioned those some of those are, you know, environmental health or occupational health or injury prevention or, and so on. And so that’s how we framed it. And I’m sure we left out plenty of jobs that you could get with an MPH. But I thought it was kind of nice and refreshing to have that clear. Is this really a public health job? And actually kind of this is one of the times where we gently bumped heads like my co author, because I was like, well, don’t you want to include health insurance? Don’t you want to include? And she was like, well, you know, she had very particular opinions, which are, which is well- well founded, to keep this really focused on public health as we define it, from the CDC. And then of course, at the end of the book, we have a whole section on how do you actually get these jobs. What kind of resume do you need. What interview prep do you want to do? How do you do networking in the field, we have hundreds of resources, websites, professional societies to join, we’ve researched the salaries and employment prospects of every occupation. I really enjoyed writing that book, I have to say that I was astonished that anybody was willing to be interviewed for the book, because every person we interviewed was, you couldn’t imagine the stress that they were dealing with in trying to deal with COVID. It was- it was definitely a lot of just kind of heart wrenching stories that these public health professionals could share in what they were trying to face. But yet at the same time, a really inspiring time to get into the field. So my hope is that the outcome is people will read this, people who are studying public health will have a clearer idea of the different directions they could go into, and be equipped to pursue those opportunities. And also, people that never thought about public health have no idea what it is even today, that they will pick up this book and be inspired to go into the field. So- So that’s- if it succeeds that way, I’ll be really excited that we got more people excited about the field and actually having a clue of what it- what it entails.

Sujani 33:03
Now it does sound like the perfect reference book for anyone looking to study public health, or at least you know, explore the field. So I’m really happy that you mentioned some, some things in there. But maybe I’ll start off by saying that even though we are recording this podcast episode, at the end of March, I just checked our publication schedule, and the timing might line up perfectly for the launch of that book. So I think it’s July that we had you slotted so it might, yeah, it might work out perfectly. And, you know, you- you answered a really good question when you were talking about the contents of the book, and it was around what jobs you could get with an undergraduate degree or maybe not even a degree? And that’s a question that I get quite a bit with the PH SPOT community. And, you know, I don’t have the background to answer that sometimes. So I’m often looking for resources to see how I could address that. But I’m curious, and I might be testing your memory here, if you remember any of the careers that you could just kind of get people started in their research, if they have that question. You know, I have a bachelor’s degree, I don’t have a master’s and maybe I’m not pursuing a master’s in the near future. What sort of roles can I anticipate in public health?

Heather 34:22
That’s a great question. And I would say it depends a little bit on whether you have some, I guess, practical experience in the field or maybe can do some internships while you’re a student. And it also very much depends what you studied in your undergraduate program. So and it probably also depends on the really on the location and the particular rules or regulations, where you live and who qualifies for what kind of jobs but definitely, at least here in the US there’s an incredible shortage of public health nurses and you can become a nurse- registered nurse with a bachelor’s degree in nursing and so for sure, if you’re inspired about public health, and you’re interested in nursing, there’s opportunities, lots and lots of opportunities. There are lab technicians, which are more sort of the hard scientists, there’s public health labs where you could be testing different types of samples, whether those are from a restaurant inspection to see if there’s a salmonella going on and things like that. There’s also health promotion, and health education, you can certainly do that it’s probably easier to do those kinds of jobs with a match- master’s degree. But there are some more entry level kinds of jobs, sometimes program coordinator jobs program assistant jobs where you can use your bachelor’s degree, you know, sometimes nutritionist positions, at least in the US, if you get the right kind of nutrition, bachelor’s degree, and you become a registered dietician, and so forth, then, actually, yeah, it depends where you are, whether it’s required to be registered. But usually you can do that and become a public health nutritionist. And sometimes other kinds of communications can be another option. So social media is now a big force in public health, health outreach, communication, things like that. And then finally, to the Environmental Health Sciences kinds of jobs where you’re a what we call, I guess, still people are referred to as a registered sanitarian, for example, there’s tons of those kinds of jobs, where you’re going out and inspecting different kinds of facilities to make sure that, again, they’re following the rules and regulations. There’s just a lot of these kinds of positions that you could work in, maybe with only a bachelor’s degree, industrial hygiene could be one, wellness program coordinating, I’m just looking at my my, my book chapter actually, looking at some of these regulatory affairs, it varies by again, what you’re qualified for. Sometimes social work depends if you need a master’s degree or if you need to be licensed. Sometimes there are more entry level kind of behavioral health types of jobs that might be related to public health. So and then also some of the tech jobs so data analyst, if you have enough quant quantitative skills, you know, certain kinds of technology positions could be could be relevant. One last thing, advocacy, advocacy, community outreach, community engagement, you know, community health worker is another one where you might not actually even need a bachelor’s degree, you need to be able to engage in your community and to build relationships with people. So again, you may not even need the bachelors. But I’m sure if you had that bachelor’s degree in public health that would make you feel really well qualified for some of the, you know, more community outreach kinds of jobs.

Sujani 37:49
Well, that’s reassuring that there’s a whole section in the- in the book, just speaking to that one question. So I’m, I’m looking forward to it. And I think the other piece of that book that’s at least quite valuable just hearing about it is the tactical kind of practical steps that you said it offers towards the end. And I mean, we don’t need to get too much into it, because I’m sure we’re gonna we’re gonna promote this book, because it sounds like it’s got more than these two questions that I’m asking you about it. But, you know, just in terms of career advice, and job application advice, what are some things that you could say, to our listeners, or even new grads, about just succeeding in the in the application process?

Heather 38:36
Another awesome question. So again, it depends a little bit what you’re applying for, but some broad, broad, sweeping advice, having been a career coach for 22 years, I can say pretty definitively, there’s the first thing is to be able to clearly describe your achievements and make them relevant, or think of how they are relevant to your future employer. And so when you’re writing your resume or your CV, thinking about using the words and phrases that you see frequently in the job descriptions for positions you’re applying to, that’s important because sometimes, there are screening mechanisms when you apply for positions where if you don’t have the right buzzwords, or keywords that you may not even be reviewed, you might your resume may not be seen by the human beings in charge of hiring. So you just have to reflect within reason. Like you can’t- you can’t put in things that obviously that you actually didn’t do or something but But you make sure that you’re using the words from the posting. And if you keep looking at job postings and you discover that you’re missing a particular skill that gives you information that you know what, maybe you need to go out and get training or pursue an educational program that would give you that particular skill. But anyway, so framing it from the point of view of what the employer is looking for. And then the harder part is showing what you’ve achieved which is tricky because especially in public health, sometimes those real long term outcomes don’t get, they’re not really measurable for a while. So how do you know that your smoking cessation program actually helped a few people quit smoking as compared to people who didn’t use the program? And how do you know that it was? You know, because of your program that they quit, right? It’s tough to measure. But within reason, you could measure what how many people actually took part of your probe- in your program, how many did you do outreach to increase participation? And if so, did you expand participation by 20%, for instance, you know, for example, so thinking of your achievements, second piece of advice beyond framing achievements, and using the right kind of wording that matches the career you’re interested in, is the dreaded networking. I know many people that are just allergic to networking, and they have palpitations, and they get the breakout in hives, when I describe the idea that you have to build relationships in the field. But what I can tell people is, rather than feeling like this is some sort of a fake, people think it is artificial, or they feel anxious that they’re bothering other people, or that they, you know, don’t want to be bother anyone. So I reframe it as, don’t you love talking to people about your passionate area of interest in public health? Isn’t that enjoyable to you to share your- your, you know, what your heart is set on in terms of solving a public health issue? Well, most people feel that way. Right? So if you can find others in your chosen field, and public health attracts people, generally speaking, who are pretty passionate about making the world better, this is not a field you go into, because you want to become a millionaire. Really, it’s a field that you go into, because you want to help the world somehow. And so if you find those in your field that share an excitement or passion with you, then you can connect with them about that. And this is important, because if you build those relationships, you know, this is not directly, obviously, related to finding a job because you don’t want to start out by asking random strangers if they would get you a job, because that’s a way to maybe alienate some people. But if you build relationships in advance with people that are in your chosen field, because you’re sharing an interest in the field, then when it’s time for you to find a job, those are your- that’s your team. That’s your support team. So that, you know, when you do apply, you can say, you know, I enjoyed meeting you at the ABC, Canadian Health Association Conference, or whatever you went to where you met somebody, I’m making this up. But, you know, I enjoyed meeting you. And thank you for speaking with me last month, and I noticed that your organization is hiring is it okay, if I mentioned in my application that I’ve spoken to you just name- naming a person that works in the organization can help you get more interviews, and more interviews can give you more job offers. The other thing I’m going to say quickly is that this is a process and it’s a learned skill, you can learn this whole skill of job seeking, networking, and of course, interviewing for jobs. And it’s very daunting, if you haven’t done it before, or you haven’t done it in a long time. And it’s also pretty anxiety provoking for everyone. Because there’s lots of rejection, even though you might be the most spectacular person in the world, you still will be rejected at some point. So just know that, you know, take advantage of every support that you have. If your university has a career services office, make sure you’re taking full advantage of that if you have, again, your own network, take advantage of that if your school, if you’re attending school, if there’s an alumni group, or association or LinkedIn page, make sure you’re using all of those resources, join a professional association and all of that so that you don’t feel stranded trying to do this all on your own because it can be kind of daunting. But again, I’d like to be optimistic that, you know, I’ve been saying this to everyone that I think it’s going to be the best job market for public health graduates in a century probably, for all the- for all the worst reasons, that stock market very worst reasons. That’s what I keep saying it’s because of COVID. It’s, it’s there’s a sudden recognition of just how much we need people with these kinds of skills and training and passion and help out. So I’d like to think that it wouldn’t be a waste of time to think about studying public health right around now.

Sujani 44:33
I remember at the start of the pandemic, I had that discussion with my husband, where he was kind of fascinated about the public health workforce and just see the passion that’s driving the pandemic response. And I remember telling him like, you gotta have people like that, if you’re going to kind of battle this pandemic. I think it’s the passion that’s driving everyone to do something in this environment right now. I’m glad you mentioned that networking. And the point that I always reiterate is, you know, often people can jump into starting networking with the motivation of trying to find a job. And I often don’t find that that successful because you know, no one wants to be approached by someone for the first time. And the question is, can you get me a job? So how do you- how do you- How do you suggest people find that motivation even before they need a job, so say, when they’re entering their first year of, you know, some sort of training in public health or, you know, during the periods of time when they’re not desperately looking for a job, because I know, it’s often the other way around when you’re nearing graduation, or you’re looking for that next job? That’s when you- that’s when most people at least start to network with peers or mentors in their field?

Heather 45:53
Yeah, I think that’s an excellent question. And I like to use the example or the concept of sort of planting your seeds before you want to harvest your flowers, you know, so if you try to cultivate, and they literally use that term, cultivate those relationships in advance, then it will definitely benefit later, I definitely run into this challenge where people have not done the networking, and they’re about to graduate. And they’re in that panic mode. And they suddenly read all the emails that we’ve been sending them, and I’m just thinking of my- you know, you sent you try to send this message, and it doesn’t always come across, because people don’t realize just how important it is to have those relationships in advance. And then they’re frantically trying to do networking before graduation. So you know, what I tell people is that when you reach out to professionals in your field, and you’re asking them for what we call an informational interview, where you’re going to sit down and talk to them for 30 minutes, or whatever, and ask them about their career and to get career advice, and to learn more about the culture of their organization, and to get an input on your CV and tips on the hiring process and things like that, and maybe introductions to others in the field. You don’t want to start by saying I’m looking for a job. But it’s fairly obvious to most people that probably at some point, you’re going to be looking for a job. And that’s probably why you reached out you just, it’s just for whatever reason, consider just a little too direct to actually say that, but most people will guess that you’re eventually looking and they’ll be kind enough to talk to you anyhow. And as long as you don’t directly ask in the beginning and put them on the spot, then it’s usually just fine. And essentially, what you’re doing is- is you can approach someone, I usually suggest an approach where you would reach out and start with how is it that you found this individual. So I found you on LinkedIn when searching for alumni of my school to determine you know, who work in environmental health in Montreal, whatever, you know, that’s your intro. So it’s not like you’re basically starting with saying, I am not a stalker, I am not a spammer, I actually have a reason to be contacting you. Here’s how I got your name, right.

Sujani 48:09
Yeah.

Heather 48:09
And your second step would be who are you in a sentence? You know, I am a second year MPH student at Dalhousie University, studying environmental health, whatever, you know, and then what do you want them to do? I would love to meet with you via Skype, or zoom or whatever, in the next two weeks to briefly learn about your career and gain some career wisdom throat from you, I truly appreciate your consideration. You’re just asking for a call. And then in that call, you’re asking mostly for advice for guidance. And at some point, you can say, you know, just full disclosure, I will be looking for a job, you know, in May of 2021. And I’d love your advice, like how do you how did you navigate the job market? You know, how did you get your position at the Ministry of Health or whatever it is, you know, how did you find that opportunity? I had Grand Challenges Canada, I’m just making this up.

Sujani 49:02
They’re doing great with these examples.

Heather 49:06
Doing my best here, right? So, you know, how did you find these opportunities? And do you have any suggestions for me? And you know, you can’t in that original initial meeting, say, you know, can you get me a job at whatever organization, but you can say, you know, I truly appreciate your advice and wisdom. And if I- you know, is it okay, if I follow up with you, if I, you know, have other questions, and you can ask for it. You can ask for introductions, actually something people forget to do is do you know anyone else that I should speak with who works in public health, you know, in Vancouver, or whatever. So that’s what you may want to do to expand your network. But the following up and saying thank you is really important. So I would always send a thank you email. And then after the fact a couple of weeks later, really, that’s when you might say you know, I noticed that there is a new position open at your organization, and it’s a perfect fit for my background. Would it be okay with you, if I mentioned in my cover letter that I spoke to you, and that’s, you know, again, it’s not a huge favor, you’re not asking this person to write a letter of recommendation for you, hopefully, they thought you were, you know, a lovely person when they met with you. And that can be enough to help you get a little bit of what they call a foot in the door. But also, if you’re lucky, and you kind of strike up a relationship or a conflict, good conversation with the person they may volunteer to help you that’s kind of the ideal situation isn’t they say, oh, I see that you’re also an you’re an alum of the same school. Let me, let me see what I can do to help you, I’m going to forward your resume for you, or, you know, we actually have a position available. And you should really apply for that. And I’ll make sure that I reach out to the hiring manager to see if they would take a look at your resume, they may just volunteer to help you also, there’s one other thing to mention is that sometimes people are just a little late in the game with the networking. And maybe they’ve already applied for a position at the organization. And after the fact they’re following up for networking. And that’s actually okay, as long as you’re sort of thoughtful, so that you’re not putting too much pressure on the other person. So what I recommend in that situation is more along the lines of a follow up where you could say, you know, I’m reaching out to you, because I’ve recently applied for the role of a, b, and c, you know, I know that we have multiple people in common. And I would love to just get your thoughts about what the position is like, do you know anything about the role, do you know who’s in charge of the hiring of that role, you can do that. And you can also say, I understand if you are not able to speak to me, because I’ve already applied because sometimes there’s a policy where you’re not supposed to kind of give any extra favors to someone just because maybe they went to the same school. But sometimes by doing that follow up, you’re also showing extra enthusiasm and interest. And that can be seen as a good thing, as long as you don’t go overboard, and you’re not sending emails every single day to try to follow up. And then the other thing to do is if you use LinkedIn, you can see who you may know, who knows someone at your target organization. So that would be what’s called a second degree connection. So maybe I wanted to work at a certain organization. And I see that I have a friend who’s connected to someone in that organization, I could say to my friend, you know, I see you’re connected to so and so at Public Health Agency of Canada, this probably doesn’t pertain to civil service so much, actually, but maybe a nonprofit or hospital or something. And you could say, would it be okay, if you sent my resume along to the person who you’re connected with at that organization. And you know that, that is a recommendation where it’s not, you know, you’re not doing networking, per se, you’re more like getting someone to just sort of send your resume forward. And even that can get more attention to a point where it can help with getting you more interviews, depends on what you’re doing depends on the type of hiring the organization does, I find that in government, sometimes, who, you know, doesn’t necessarily help as much, because there’s a very structured and streamlined process, but it also depends on your relationship with the other people and how the hiring process works. It’s generally not a problem negative, though, to try to leverage your network to get you more interviews, it’s usually seen as a plus, in my experience, generally, as long as you don’t go overboard and become a nuisance. It’s usually fine.

Sujani 53:34
You know, they’re just the way you outline the response to that question is an indication of I think, how valuable that chapter in your book is going to be just those practice. Thank you for those practical tips that our listeners can take away. I feel like they might need to also take some notes and just follow it step by step, just the way you outlined it. So thank you very much for that.

Heather 53:56
Sure. This is definitely not something people need to kind of invent on their own. This whole strategy around networking is, I would say, a well trod path. It’s like very, there’s so many articles on how to use LinkedIn to get introductions, how to use your second degree contacts on LinkedIn, how do you use an alumni network. What’s the appropriate way of reaching out to people to get their advice. You know, definitely no need to reinvent the wheel. Although the book does definitely outline, you know, even has some example emails that you could use when reaching out to someone and then how do you follow up with the person or what if they don’t respond to you. And you know, that kind of thing.

Sujani 54:37
Yeah. And then I think the- the one thing that I might add to this is that the person that you’re reaching out to might sometimes also find a benefit and you know, chatting up with you because they might come up with new ideas. And just the fun fact that the reason and the motivation for creating PH SPOT was because I was being contacted by many new grads, kind of when I had graduated just to learn about the path that I had taken. So, yeah, I mean, for me, it was about trying to create a, an online platform where my peers could learn from others in the field. And not just me, because I found this that one summer, I was just meeting with a bunch of new grads every day or every- every evening or weekend. And they felt that they were hearing a kind of a one sided biased opinion from me about my career. And I really wanted to create a platform where they could learn from others. And so I just want to say, you know, I found it beneficial to sit down and speak to new grads and students. And similarly, I think, just others in the field as Heather mentioned, they’re passionate, they’re often passionate, and they’re often willing to give back and wanting to make sure that the next generation of public health professionals are on the right track and are supported.

Heather 56:00
You know, I just want to chime in one more thing about the networking piece and how it benefits the other person. So you may be thinking as a new graduate, or someone switching into the public health field, you know, why would anyone want to talk to me and give me advice, you know, so besides the fact that, you know, public health folks do tend to be very passionate, and they also tend to be very nice, I can’t say every single person, but most of them are very kind hearted, you know, the issue focused, helpful human beings. That’s my general broad experience of public health people, which is why I love working with them. So besides that, though, that the person who’s providing you that informational interview, or that networking, or that guidance, or whatever, they benefit also and the way like you describe the benefit in multiple ways. So you’re, first of all, giving that other person an opportunity to be listened to. And so if you’re asking questions, like, tell me how you got your position, or tell me about your career history, I’d love to learn like how you went from, you know, your degree program, in epidemiology into XYZ position, that that type of question. People often like talking about themselves, and they don’t always have an eager audience of people listening to them. And so that’s kind of a key thing that you’re offering to them in a positive way. So that’s one thing. And then another thing is, you’re also providing them with opportunities to give back because, you know, someone else probably gave them career advice in the past. And now you’re, you’re giving them the chance to reciprocate that. And then last but not least, maybe they’re actually hiring, or someday you’re going to connect to them, and they’re going to need a job, and you might be the one hiring them, you just never know, if you keep in touch with people, the what goes around comes around. So- so that’s why we tell people, don’t hesitate to do the networking and feel like you’re somehow being selfish, because you’re actually helping the other person in some way or another. And also do try to be helpful. So instead of being I think a colleague of mine, came up with this idea, don’t be a go getter, be a go giver, go give people things, try to think of how you could help them. Maybe you’re studying public health, and you just read a really interesting article, and you want to share it with them, you know, anything you can do to be helpful is good.

Sujani 58:22
I just noticed the time we’ve been chatting for quite a while. And I’m gonna have to have you back on Heather for more questions that I have just percolating in my head. But maybe to wrap this episode up, you talked about it very briefly, I think it was probably during the time we’re talking about networking. Just your thoughts about the future for public health. And I know, I know, we’re optimistic that there are going to be a lot of opportunities, but just want to give you a chance to say a little bit more about. Yeah, that topic and what- what you are thinking new grads and maybe recent grads can expect for the workforce?

Heather 59:02
This is a great question. It’s, it’s, I get this question from time to time. And I wish I could, you know, on the one hand, I’m tempted to say, well, my predictions are these seven things. But I have to be very humble and say that it’s so hard to predict. And just like when we took on the book project in September 2019, I was like, oh, this won’t be that bad. We’re just revising here and there a few things. And then, you know, December, January came around my colleague and co author, who again, is public health preventative medicine physician, she was like, gosh, I wonder if this COVID thing might be, you know, that’s it, who knows if that’ll be an inch, you know, and then, you know, and then it just kind of overwhelmed. And of course, she got overwhelmed. Also, she was called up to be an emergency responder on every level. So it’s really difficult. But anyhow, I wish I could say I would have you know, predicted that outcome, but of course not so it’s hard to predict. I do think I could make a few guesses though, educated guesses that I think, the expansion of access to data is going to make a difference in public health. There’s so much data available health related data, that there are jobs that we couldn’t even imagine a few years ago and things like, like, I remember the first time one of my graduates, an EPI, an epidemiology grad actually had gotten a job at Fitbit. And then that person went on to get a job at 23andme, which is genetics, personal genetics, testing type company, right. So those jobs didn’t exist. In the past, we didn’t have fitness tracking apps with billions of data points on people’s exercise habits, right? So those now are jobs in the future, and the current, current and future. So Tech is a very big piece. And I think the data and tech and data science and all that it’s definitely growing, I do think, also climate change is going to unfortunately, create opportunities relevant to public health, the public health aspects of what climate change is going to do to health is going to be huge. And so people with an understanding of climate impacts on health and policy around climate change, and mitigation, if there is such a thing, you know, I think that’s going to be very important. I think there’s never going to be an end to the need for people like public health nurses and environmental health specialists who are kind of the backbone of local, local public health efforts, that’s never going to go away. And there’s a huge shortage of people in some of those roles. And so people willing to do that is important. And then we also, of course, have health equity, which has always been a huge issue. It’s always been an issue. And now, especially in the United States, I think people are finally like they recently revised the 10 essential services in public health at the CDC, to center on equity. And I think that’s going to be crucial that people are understanding of health equity, that they have cultural humility that they understand how to partner as equals with various communities, is been a tragic, tragic situation in the US about the health disparities that we’ve seen around COVID, and the inequity, so I feel like there’s a tremendous dire need for people who can boost health equity and really understand how to leverage those principles to ensure that everyone has a chance to be healthy. So that’s my guess, if I had to guess a couple things, I’m going to say climate change, data science and tech, and an equity are going to be in the future. But again, I can’t promise you know what the future will bring. Because certainly I couldn’t have predicted how COVID would have changed everything. But yeah, I think it’s a brilliant time to be part of public health. It’s always been a tremendously valuable field. And if you’ve been thinking about it, and haven’t been sure whether you want to pursue it, I would say pretty definitively now is a pretty great time to think about that. And if you’re already in the field, thank you for what you do. Thank you so much for what you do. I have tremendous regard for people in the field. I’m more of a career counselor. So I’m sort of removed a little from the day to day of public health even though I work in a public health graduate school, so I just have great regard for people doing this work. So thank you so much for asking me my predictions and letting me ramble about my research. It’s been really lots of fun speaking with you and I’m delighted to come back anytime.

Sujani 1:03:34
Wonderful. Thank you so much, Heather.

I hope you enjoyed that episode with Heather Krasta on the public health workforce. And as usual, we will make sure to link all resources mentioned in this episode on our show notes page, which can be found at pHspot.ca/podcast. And until next time, thank you so much for tuning in to PH SPOTlight and for the invaluable work that you do for this world.