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First-Destination Outcomes for 2015–2018 Public Health Graduates: Focus on Employment

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Objectives. To improve understanding of the future public health workforce by analyzing first-destination employment outcomes of public health graduates. Methods. We assessed graduate outcomes for those graduating in 2015–2018 using descriptive statistics and the Pearson χ2 test. Results. In our analysis of data on 53 463 graduates, we found that 73% were employed; 15% enrolled in further education; 5% entered a fellowship, internship, residency, volunteer, or service program; and 6% were not employed. Employed graduates went to work in health care (27%), corporations (24%), academia (19%), government (17%), nonprofit (12%), and other sectors (1%). In 2018, 9% of bachelor’s, 4% of master’s, and 2% of doctoral graduates were not employed but seeking employment. Conclusions. Today’s public health graduates are successful in finding employment in various sectors. This new workforce may expand public health’s reach and lead to healthier communities overall. Public Health Implications. With predicted shortages in the governmental public health workforce and expanding hiring because of COVID-19, policymakers need to work to ensure the supply of public health graduates meets the demands of the workforce. (Am J Public Health.
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First-Destination Outcomes for
20152018 Public Health Graduates:
Focus on Employment
Christine M. Plepys, MS, Heather Krasna, MS, Jonathon P. Leider, PhD, Emily M. Burke, MPH, Craig H. Blakely, PhD, MPH, and
Laura Magaña, PhD
Objectives. To improve understanding of the future public health workforce by analyzing rst-destination
employment outcomes of public health graduates.
Methods. We assessed graduate outcomes for those graduating in 20152018 using descriptive statistics
and the Pearson χ
2
test.
Results. In our analysis of data on 53 463 graduates, we found that 73% were employed; 15% enrolled in
further education; 5% entered a fellowship, internship, residency, volunteer, or service program; and 6%
were not employed. Employed graduates went to work in health care (27%), corporations (24%), academia
(19%), government (17%), nonprot (12%), and other sectors (1%). In 2018, 9% of bachelors, 4% of
masters, and 2% of doctoral graduates were not employed but seeking employment.
Conclusions. Todays public health graduates are successful in nding employment in various sectors. This
new workforce may expand public healths reach and lead to healthier communities overall.
Public Health Implications. With predicted shortages in the governmental public health workforce and
expanding hiring because of COVID-19, policymakers need to work to ensure the supply of public health
graduates meets the demands of the workforce. (Am J Public Health. Published online ahead of print January
21, 2021: e1e10. https://doi.org/10.2105/AJPH.2020.306038)
Public health academics has grown
rapidly in the past 2 decades at both
the undergraduate and graduate
levels.
1,2
However, we lack information
on postgraduate rst-destination em-
ployment and educational outcomes of
public health graduates. A scoping re-
view found 33 studies or reports since
1993 that included employment or ed-
ucational outcome data for public health
students after graduation.
3
Ten were
studies of schools outside the United
States, 18 were studies conducted by
schools of their own alumni, 14 were
studies of subdisciplines of public
health (e.g., health communication,
global health), 8 focused on either
undergraduates or doctoral students,
and 16 combined multiple cohorts of
graduates (often more than a decades
worth of graduates) into 1 analysis,
making the assessment of short- and
long-term impacts of degrees on
graduatescareers impossible. We
have identied only 4 broad, recent,
US-based studies, 2 of which are in the
gray literature, including the results
from the pilot project for this study.
47
An assessment of rst-destination
outcomes of public health graduates is
needed to ensure that there are enough
trained public health professionals to ll
rapidly changing workforce demands.
On the workforce side, researchers have
posited that vacancies from retiring
governmental public health workers
might be lled by the ample supply of
recent public health graduates.
8
On the
education side, an analysis of rst-
destination outcomes will help match
curricula with workforce needs and
identify emerging employment sectors.
Trends in public health enrollment have
changed, particularly with the increase
in graduates at all degree levels. It is
important for both academia and
practice to know that graduates have a
wide choice of employment options,
stretching beyond government and into
academia and the health care, nonprot,
and for-prot sectors.
6
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RESEARCH AND PRACTICE
In 2016, the Council on Education for
Public Health, recognized by the US
Department of Education to accredit
schools and programs of public health,
made changes to their criteria that
opened the door to curricula that
center learning around application and
translation, giving students the oppor-
tunity to apply their . . . knowledge to
real-life scenarios and job demands.
9(p3)
Further, schools and programs of public
health should educate the educators,
practitioners, and researchers as well as
. . . prepare public health leaders and
managers.
10(p108)
The public health
professional degrees, such as the master
of public health degree, are expressly
intended to prepare students for public
health careers. Determining whether
graduates enter the public health work-
force and which sectors they join are key
parts of evaluating these programs.
In 2014, the Association of Schools
and Programs of Public Health (ASPPH)
developed data-reporting standards,
aligned with the Council on Education
for Public Health, to capture the rst-
destination outcomes of public health
graduates within a year after graduation.
11
The data set also includes information on
graduatescontinued education, fellow-
ships, and other outcomes. We analyzed
this new rst-destination outcome data
set, focusing on employment, to improve
our understanding of the future public
health workforce.
METHODS
We assessed rst-destination employ-
ment and educational outcome data
reported by members of ASPPH, a
membership organization for domestic
and international Council on Education
for Public Healthaccredited schools
and programs of public health.
12
We
collected rst-destination outcome data
for 64 592 public health graduates
across bachelors, masters, and doctoral
degree programs for the graduating
years 20152018 (Table 1 and Table A
[available as a supplement to the online
version of this article at http://www.ajph.
org]). This included 9513 graduates from
55 institutions in 2015, 13 588 graduates
from 75 institutions in 2016, 20 394
graduates from 112 institutions in 2017,
and 21 097 graduates from 111 institu-
tions in 2018. Across the pooled data,
31% of graduates were from bachelors,
63% from masters, and 7% from doc-
toral degree programs.
ASPPH collects data on rst-destination
outcome statusesemployed; employed
in a fellowship, internship, or residency;
pursuing continued education; not
employed but seeking employment; not
employed and not seeking employment;
and unknown. The statuses were mutually
exclusive; respondents were asked to
select the response that best described
their situation. ASPPH members also re-
port detailed employment information,
continuing education information, and
public health degree debt.
Individual ASPPH member schools
and programs collected data from their
graduates and reported to ASPPH.
ASPPH oered a core survey instrument
to members that was developed in
tandem with the data-reporting stan-
dards. ASPPH members could also use
their own data collection instruments,
which may have been in-house surveys
or surveys based on other nationally
accepted rst-destination reporting
systems, such as the National Associa-
tion of Colleges and Employers survey.
13
Members also may have collected in-
formation from faculty, social media
(e.g., LinkedIn), or elsewhere on the In-
ternet, with the precaution to verify the
data collected with these alternative
approaches. Consequently, the data can
generally be categorized as self-
reported graduate outcomes.
Because members have up to 1 year
to obtain a rst-destination outcome on
their graduates, data reported to ASPPH
were reported on graduates from the
academic years 20142015, 20152016,
20162017, and 20172018 (the class of
20142015, for example, was dened as
graduates from July 1, 2014June 30,
2015, with the time frame for obtaining
an outcome ending in June 2016). We
cleaned the data set and standardized it
to arm data-reporting denitions and
ensure that survey display logic and skip
patterns were adhered to, as well as to
identify any incompatibilities in ques-
tions individual members asked that
may have deviated from the core survey
instrument or ASPPH data-reporting
standards and denitions.
The data variables included graduate
outcome (we refer to this as rst-
destination outcomethroughout this
article, and this includes employed,
pursuing continued education, not
employed but seeking employment,
etc.), employment type (i.e., full time,
part time), employment sector (govern-
ment, nonprot, hospital, corporation,
etc.), employment sector detail (federal
government, local government, etc.),
salary, and degree debt. Detailed de-
scriptions of variables and value labels
are available in Table D (available as a
supplement to the online version of this
article at http://www.ajph.org). We cal-
culated descriptive statistics on rst-
destination outcomes, employment by
sector, and employment by sector de-
tail. We also assessed continued edu-
cation outcomes. We made bivariate
comparisons using the Pearson χ
2
test.
In further analysis, we focused on the
percentage of graduates not employed
but seeking employment by area of
study, although a number of areas had
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relatively few rst-destination outcomes.
We cleaned the data and analyzed them
in Stata 16.1.
14
RESULTS
Across all years and 64 592 alumni,
general public health was the most
common area of study (23% of gradu-
ates), followed by health policy and
management (14%), health education or
behavioral sciences (14%), and epide-
miology (13%).
Among a cohort of 55 institutions
reporting for each graduating year from
2015 to 2018, reporting of bachelors
degree program graduates increased
62% (from 2184 to 3541), masters
degree program graduates increased
21% (from 6475 to 7820), and doctoral
degree program graduates increased
6% (from 854 to 903). This was largely
driven by an increase in reporting of
graduates from the general public
health area of study. For bachelors
degree programs, 31% were general
public health in 2015, compared with
47% in 2018 (P.001). For masters
degree programs, 10% were general
public health in 2015 and 16% in 2018
(P.001). For doctoral degree pro-
grams, 3.0% were general public health
in 2015, and 4.6% in 2017 (P= .07).
Of the reported 64 592 public health
graduates, 53 463 (83%) had known
rst-destination outcomes. This was
71% for bachelors, 88% for masters,
and 92% for doctoral degree programs.
We observed dierential success in
determining rst-destination outcomes
by institution. For students graduating in
2018, the interquartile range (IQR) for
capturing postgraduate outcomes was
80% to 97% for bachelors (n = 43 insti-
tutions), 85% to 97% for masters
(n = 110 institutions), and 94% to 100%
for doctoral (n = 70 institutions) degree
programs. First-destination outcomes
are shown in Table 2.
Across all years, 73% of all graduates
with reported rst-destination out-
comes were employed; 15% were en-
rolled in further education; 5% had
a fellowship, internship, residency,
TABLE 1Number and Percentage of Public Health Graduate Respondents by Characteristic and Year
Graduated: Association of Schools and Programs of Public Health Members, Graduating Years 20152018
Characteristic
2015 (n= 9513),
No. (%)
2016 (n= 13 588),
No. (%)
2017 (n= 20 394),
No. (%)
2018 (n= 21 097),
No. (%)
Pooled (n= 64 592),
No. (%)
Degree
Bachelors 2 184 (23) 3 981 (29) 6 394 (31) 7 150 (34) 19 709 (31)
Masters 6 475 (68) 8 720 (64) 12 673 (62) 12 645 (60) 40 513 (63)
Doctoral 854 (9) 887 (7) 1 327 (7) 1 302 (6) 4 370 (7)
Area of study
Allied health 431 (5) 891 (7) 1 192 (6) 1 505 (7) 4 019 (6)
Biomedical sciences 120 (1) 150 (1) 292 (1) 465 (2) 1 027 (2)
Biostatistics 443 (5) 576 (4) 862 (4) 923 (4) 2 804 (4)
Environmental sciences 585 (6) 674 (5) 1 091 (5) 929 (4) 3 279 (5)
Epidemiology 1 334 (14) 1 805 (13) 2 516 (12) 2 526 (12) 8 181 (13)
General public health 1 361 (14) 2 984 (22) 5 185 (25) 5 441 (26) 14 971 (23)
Global health 388 (4) 600 (4) 818 (4) 653 (3) 2 459 (4)
Health disparities 12 (0) 24 (0) 67 (0) 31 (0) 134 (0)
Health education/behavioral sciences 1 446 (15) 2 147 (16) 2 719 (13) 2 860 (14) 9 172 (14)
Health informatics 0 (0) 3 (0) 58 (0) 38 (0) 99 (0)
Health policy and management 1668 (18) 1 820 (13) 2 850 (14) 2 852 (14) 9 190 (14)
Maternal and child health 296 (3) 361 (3) 519 (3) 426 (2) 1 602 (2)
Nutrition 335 (4) 349 (3) 396 (2) 415 (2) 1 495 (2)
Public health practice 295 (3) 358 (3) 562 (3) 502 (2) 1 717 (3)
Other 799 (8) 846 (6) 1 267 (6) 1 531 (7) 4 443 (7)
Reporting institutions
Unique count of reporting institutions 55 75 112 111 118
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TABLE 2Number and Percentage of Public Health Graduates by Degree Level and Known First-Destination Graduate Outcome: Association
of Schools and Programs of Public Health Members, Graduating Years 20152018
Degree
Employed,
No. (%)
Fellowship, Internship,
Residency, No. (%)
Volunteer or Service
Program, No. (%)
Enrolled in Further
Study, No. (%)
Not Employed and Not
Seeking, No. (%)
Not Employed and
Seeking, No. (%)
Total Reported
Outcomes, No.
Outcome
Unknown,
No.
Bachelors
2015 880 (65) 27 (2) 8 (1) 350 (26) 8 (1) 79 (6) 1 352 832
2016 1 991 (66) 34 (1) 24 (1) 726 (24) 29 (1) 198 (7) 3 002 979
2017 2 710 (63) 63 (1) 59 (1) 1 163 (27) 30 (1) 305 (7) 4 330 2 064
2018 2 961 (57) 78 (1) 80 (2) 1 623 (31) 26 (0) 452 (9) 5 220 1 930
Masters
2015 4 294 (77) 324 (6) 14 (0) 690 (12) 26 (0) 231 (4) 5579 896
2016 6 237 (79) 484 (6) 20 (0) 818 (10) 55 (1) 313 (4) 7927 793
2017 8 531 (79) 435 (4) 29 (0) 1 314 (12) 80 (1) 474 (4) 10 863 1 810
2018 8 513 (76) 628 (6) 34 (0) 1 393 (12) 126 (1) 457 (4) 11 151 1 494
Doctoral
2015 617 (78) 118 (15) 1 (0) 35 (4) 6 (1) 9 (1) 786 69
2016 645 (77) 153 (18) 2 (0) 16 (2) 6 (1) 15 (2) 837 51
2017 975 (80) 198 (16) 3 (0) 21 (2) 6 (0) 21 (2) 1 224 104
2018 919 (77) 226 (19) 0 (0) 15 (1) 8 (1) 24 (2) 1 192 107
Total 39 273 (73) 2768 (5) 274 (1) 8 164 (15) 406 (1) 2 578 (5) 53463 11129
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volunteer, or service program appoint-
ment; 5% were not employed but were
seeking employment, and 1% were not
employed and were not seeking em-
ployment (by choice). Comparing the
2015 and 2018, respectively, graduating
years, the percentages of employed
graduates by degree level were 65% and
57% for bachelors(P.001), 77% and
76% for masters(P= .37), and 79% and
77% for doctoral (P= .38). Twenty-six
percent of bachelors degree program
graduates were reported as enrolled in
further education for graduating year
2015, compared with 31% in 2018
(P.001), 12% of masters in 2015 and
2018 (P= .82), and 4% versus 1% of
doctoral graduates in, respectively, 2015
and 2018 (P.001). Not employed but
seeking employment was highest for
bachelors degree program graduates at
6% in 2015 and 9% in 2018 (P.001),
followed by 4% for masters degree
program graduates in 2015 and 2018
(P= .90), and 1% versus 2% for doctoral
degree program graduates in, respec-
tively, 2015 and 2018 (P= .14).
Among those with reported full-time
employment, we captured employment
sector for 26 422 graduates. Employ-
ment sector was not reported for fel-
lowships or internships. Overall, 27%
of graduates were employed in health
care organizations, 24% for-prot
organizations, 19% academic institu-
tions, 17% government agencies, 12%
nonprot organizations, and 1% other
sectors or self-employed. The distribu-
tion of employment sectors varied by
degree level (Table 3). Doctoral degree
graduatestop employment sectors
were academic institutions (42%), for-
prot organizations (21%), and govern-
ment agencies (16%). Masters degree
graduates found employment in health
care organizations (29%), for-prot or-
ganizations (21%), government agencies
(19%), and academic institutions (18%).
Bachelors degree graduates were dif-
ferent from both doctoral and masters
degree graduates, with for-prot
TABLE 3Number and Percentage of Full-Time Employed Public Health Graduates by Degree Level and
Known Employment Sector: Association of Schools and Programs of Public Health Members, Graduating
Years 20152018
Employment Sector Bachelors Degree, No. (%) Masters Degree, No. (%) Doctoral Degree, No. (%) Total, No. (%)
Academic institution 507 (10) 3479 (18) 947 (42) 4933 (19)
Academic 493 (10) 3248 (17) 894 (40) 4635 (18)
Other 14 (0) 231 (1) 53 (2) 298 (1)
For-prot organization 1905 (38) 3978 (21) 467 (21) 6350 (24)
Consulting 240 (5) 1359 (7) 95 (4) 1694 (6)
Health information technology 70 (1) 287 (1) 31 (1) 388 (1)
Insurance 82 (2) 324 (2) 14 (1) 420 (2)
Other 1513 (30) 2008 (10) 327 (15) 3848 (15)
Government agency 518 (10) 3748 (19) 357 (16) 4623 (17)
Federal 141 (3) 834 (4) 175 (8) 1150 (4)
Local 175 (4) 985 (5) 37 (2) 1197 (5)
Other 75 (2) 800 (4) 76 (3) 951 (4)
State 124 (2) 1106 (6) 67 (3) 1297 (5)
Tribal 3 (0) 23 (0) 2 (0) 28 (0)
Health care organization 1351 (27) 5488 (29) 266 (12) 7105 (27)
Hospital 452 (9) 3039 (16) 126 (6) 3617 (14)
Other 899 (18) 2449 (13) 140 (6) 3488 (13)
Nonprot organization 596 (12) 2401 (12) 182 (8) 3179 (12)
Other 569 (11) 2271 (12) 173 (8) 3013 (11)
Trade association 27 (1) 130 (1) 9 (0) 166 (1)
Other employment sector 64 (1) 61 (0) 10 (0) 135 (1)
Self-employed 23 (0) 68 (0) 6 (0) 97 (0)
Total known sector 4964 19 223 2235 26 422
Unknown sector 369 874 65 1308
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organizations (38% overall, with 30% of
all undergraduates nding employment
in for-prot corporations outside con-
sulting, health information technology,
and insurance) being the top employ-
ment sector, followed by health care
organizations (27%), nonprot organi-
zations (12%), and government agencies
and academic institutions, each at 10%.
Table 4 shows the proportion of
alumni with known rst-destination
outcomes, excluding those enrolled in
further education, who were not
employed but were seeking employ-
ment by degree level and area of study.
A higher than average proportion of
graduates sought employment in cer-
tain areas of study. At the bachelors
degree level, maternal and child health
(19%) and allied health, nutrition, and
public health practice (each at 11%) had
higher than the average of 10% not
employed but seeking employment. At
the masters level, health disparities
(13%), nutrition (11%), global health (8%),
environmental sciences (6%), and
biomedical sciences (6%) were higher
than the average (5%). At the doctoral
level, the areas of study above the av-
erage (2%) were nutrition (4%) at the
highest, followed by general public
health, health education and behavioral
sciences, biomedical sciences, global
health, and maternal and child health (all
at 3%).
Salary data were reported for 9857
full-time employed graduates. The data
were reported as absolute values and
are presented in ranges in Table B
(available as a supplement to the online
version of this article at http://www.ajph.
org). The median salary among bache-
lors degree graduates who were
employed full time was $36 000
(IQR = $30 000$46 000). For full-time
employed masters degree graduates,
the median salary was $58 000
(IQR = $45 000$73 000), and for
doctoral degree graduates, it was
$80 000 (IQR = $55 000$101 000).
Public health degree debt was cap-
tured consistently among those who
reported debt, although it was not
captured consistently regarding
whether a graduate had debt. Conse-
quently, we were able to examine debt
levels only for the 6451 responses with
reported debt loads (Table C, available
as a supplement to the online version
of this article at http://www.ajph.org).
Among 1574 bachelors degree pro-
gram graduates with any debt, 55%
had $25 000 or more debt, as did 80%
of 4521 masters degree program
graduates and 73% of 356 doctoral
degree program graduates. Overall,
44% of graduates with reported
debt had more than $50 000 in debt
and 10% had more than $100 000
(comprising 3% of bachelors, 12%
of masters, and 24% of doctoral
graduates).
TABLE 4Number and Percentage of Public Health Graduates Not Employed but Seeking Employment by
Degree Level and Area of Study: Association of Schools and Programs of Public Health Members, Pooled
for Graduating Years 20152018
Area of Study Bachelors Degree, No (%) Masters Degree, No (%) Doctoral Degree, No (%)
Allied health 145 (11) 25 (5) 3 (2)
Biomedical sciences 0 (0) 25 (6) 4 (3)
Biostatistics 0 (0) 45 (3) 2 (0)
Environmental sciences 12 (5) 109 (6) 8 (2)
Epidemiology 1 (9) 259 (5) 12 (1)
General public health 373 (9) 151 (3) 5 (3)
Global health 5 (6) 134 (8) 6 (3)
Health disparities . . . 12 (13) . . .
Health education/behavioral sciences 138 (8) 251 (5) 15 (3)
Health informatics . . . 2 (2) . . .
Health policy and management 28 (9) 265 (4) 6 (1)
Maternal and child health 46 (19) 43 (5) 2 (3)
Nutrition 18 (11) 66 (11) 3 (4)
Public health practice 13 (11) 40 (4) 0 (0)
Other 255 (17) 48 (3) 3 (2)
Total 1034 (10) 1475 (5) 69 (2)
Note. The table excludes respondents who reported they were enrolled in further study.
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DISCUSSION
First-destination outcomes for public
health graduates, particularly employ-
ment outcomes, are a key metric in
assessing the supply and demand
equation of the public health workforce.
Graduatesrst-destination outcomes
provide academia insight into changes in
the job market, which may then inform
decisions on the degrees and areas
of study an institution oers. If rst-
destination outcome data show changes
in employment trends in an area of
study, schools and programs of public
health may alter their courses and cur-
ricula to align with these trends. A
schools or programs ability to prepare
graduates with the competencies
demanded by the workforce may help
ensure student success, not only in
nding employment that uses their ed-
ucation but also in nding career satis-
faction. Further, as public health
responds to the COVID-19 pandemic,
new competencies may be needed to
address such crises.
The variability in employment out-
come by area of study is consistent with
previous research. It is not surprising
that biostatistics graduates have the
lowest rates of unemployment, consid-
ering that statistics is the eighth fastest-
growing occupation in the United
States.
15
Global health graduates, on the
other hand, have higher than average
rates of job seeking, consistent with
another study.
16
Higher job seeking in
global health graduates may be attrib-
utable to current job openings in the
eld requiring more extensive experi-
ence than most recent graduates
have.
17
Employment by degree level shows
that graduates with advanced public
health degrees had better employment
outcomes, similar to ndings of a na-
tional data collection by the National
Association of Colleges and Employers.
5
This study shows that rst-destination
employment outcomes of public health
doctoral graduates are more favorable
than had been reported in another
study, in which data were collected be-
fore or upon graduation.
18
However,
questions remain regarding whether
bachelors degree graduates are com-
peting for the same jobs as masters
degree graduates. This study does show
that there are dierences in employ-
ment sectors by degree level, however;
an analysis of employer requirements
may elucidate the answer further. In
addition, there may be demand for dif-
ferent education formats to replace or
bolster formal degrees (certications,
micromasters, etc.) that increase the
number of public health workers with
needed competencies.
Governmental public health remains a
key necessity for communities, nations,
and the world, as shown in the COVID-19
response. Filling new or vacated gov-
ernment public health positions is cru-
cial.
8
However, although there has been
an increase in bachelors degree grad-
uates, they do not seem to be lling
governmental vacancies at high rates.
Historically, masters and doctoral de-
gree graduates have entered govern-
mental public health at higher rates. A
study analyzing 2404 public health
graduates from 1978 and 1979 showed
that 52% of graduates found employ-
ment in government,
19
and in a 1992
longitudinal study of 2429 graduates,
42% of graduates in the classes of 1956
1965 found their rst-destination em-
ployment in health departments,
whereas 17% of the classes of 1976
1985 began their careers in health
departments.
20
If government agencies wish to recruit
public health graduates, recent litera-
ture suggests they may need to reassess
hiring practices to recruit enough
trained candidates.
21,22
Even if only a
small minority of current governmental
public health employees have degrees
in public health
23
although it could be
argued that this is also an indicator of
underfundingif there is a workforce
shortage, it is uncertain whether there
will be enough public health graduates
who will enter government agencies to
ll the gap. This potential workforce
mismatch should be explored further.
24
Although it is too soon to know how
the COVID-19 pandemic will aect the
class of 2020, the hardest hit employ-
ment sectors (e.g., restaurant, travel,
entertainment, and retail) are less likely
to employ public health graduates,
25
although furloughs and layos in the
public sector have begun.
26
Additionally,
health care systems across the country
have been laying osta, although
health care, science, technology, engi-
neering, and mathematics occupations
may have smaller numbers of jobs at risk
for layos.
27
Overall, sharp declines in
job postings, including for statisticians
and other highly skilled professionals,
in geographic areas most aected by
COVID-19 are concerning.
28
There may be new opportunities re-
lated to pandemic response, such as
epidemiology and contact-tracing
eorts.
29,30
Occupations that were
growing quickly before the pandemic,
such as data analytics, may continue to
grow.
31
However, informal surveys of
college recruiters (not specic to public
health; n = 246) show that 7.8% to 9.0%
have rescinded job oers and 31.0%
delayed start dates for full-time hires.
32
Anecdotally, informal discussions with
career service professionals from sev-
eral public health schools indicate that
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2020 graduates appear to be employed
at rates similar to those of previous
years. For both traditional public health
roles and new COVID-19related posi-
tions, graduates appear to be more
exible about the roles they will accept.
Regardless of what we now know about
the workforce, recalibration may be
necessary after the current pandemic.
Return on investment in higher edu-
cation is a much-discussed topic that
may play a larger part in explaining the
vocational decisions of graduates. A
recent study found
anetbenetincareeroutcomesas-
sociated with a public health masters
degree, although . . . some other
masters degrees likely oer greater
lifetime earning potentials or lower
lifetime debt associated with degree
attainment.
7(p1)
A future analysis of this data set may
identify salary dierentials among em-
ployment sectors and the possible impact
of degree debt on vocational choice
perhaps showing graduates with higher
debt choosing elds with higher salaries.
Overall, a study of the longitudinal
career paths of public health graduates
would illuminate the longer-term earn-
ings of public health professionals. Such
career path studies would also show
whether public health graduates gain
government experience at some point in
their careers, whether they are moving
to higher-paying sectors earlier to pay
odebt, whether new and dierent
employers are seeking graduates with
public health skills, and the impact of the
COVID-19 pandemic on graduates
careers.
Limitations
This study has several limitations of
note. The data we analyzed were
collected by more than 100 institutions
during the rst 4 years of ASPPH
members reporting graduatesrst-
destination outcomes. The decentral-
ized approach to rst-destination out-
comes reporting allows institutions to
customize their collection methods,
creating possible hard-to-detect issues
with standardization. Therefore, we
used rigorous data cleaning and mem-
ber data checking to identify data issues,
although data-reporting issues may re-
main. For instance, we found that some
institutions reported unknown graduate
debt levels as 0, whereas other institu-
tions reported no debt levels at 0 and
unknown debt levels as missing. Addi-
tionally, some institutions relied on
graduate self-reporting of debt, and
even when asked about public health
degree debt,some graduates may have
reported all educational debt (including
from previous degrees). Relatedly, there
are several areas that have high levels of
unknown or missing data. About 80% of
records had associated graduate out-
comes for graduating in 2017, and 83%
in 2018.
Of note, 2017 was the rst year that all
members of ASPPH reported graduate
outcomes across all public health de-
grees. Certain members have higher
levels of unknown or missing data; this is
problematic as an internal validity con-
sideration. This is particularly the case
for bachelors degree graduatesdata,
which have greater levels of unknown
outcomes. We have analyzed multiple
years and examined outcomes by in-
stitution (some institutions may have
more resources than others for complex
data collection on alumni). Sensitivity
analyses, excluding institutions with
lower reported outcome rates, did not
appear to change national estimates.
Consequently, generalizability is not
implicated, although greater precision
would be achieved with higher levels of
reporting. Another caveat with these
data is that previous work experience of
the graduates is not known. Additionally,
we did not directly clarify the factors
inuencing the career decisions of
public health graduates, including salary,
debt, or previous internship experience.
Finally, employment sector data were
not collected for graduates entering into
fellowship, internship, or residency
programs, which might change the
percentages entering certain sectors,
along with the salary data, for sectors
that rely more heavily on fellowships for
recruitment.
Public Health Implications
Postgraduate rst-destination employ-
ment and educational outcomes of
public health graduates have important
implications for public health policy and
practice. Especially now, public health
has an unprecedented opportunity to
aect the health and well-being of
populations via dierent employment
sectors. Governmental public health has
long experienced a workforce shortage
owing to underfunding,
8
but research
has shown that public health graduates
experience barriers to employment in
the sector.
22
This new study, showing
that only 17% of graduates enter gov-
ernment work, underscores the need
for continued policy eorts to increase
funding to and encourage employment
in the government sector.
Employment data indicate that public
health graduates are entering employ-
ment sectors at dierent rates than
historical data show and potentially
expanding public healths impact
whether these graduates are contrib-
uting to the 10 essential services
of public health in an obvious way
33
or advancing the sustainable
e8 Research and Practice Peer Reviewed Plepys et al.
RESEARCH AND PRACTICE
AJPH Published online ahead of print January 21, 2021
developmental goals and innovating
with new technologies for the well-being
of diverse populations. With the COVID-
19 pandemic, new opportunities for
employment may be on the horizon as
government, businesses, and commu-
nities continue to respond and change
their practices.
In addition, with the growth and
changes in public health degree pro-
grams, it is important to know which
areas of study are achieving the best
employment outcomes, identify which
sectors are recruiting these graduates,
and help schools and programs of public
health communicate their impact to
prospective students, employers, and
those who support their educational
missions. With more focus on public
health and more students studying
public health, there will be a better-
educated citizenry who understand and
appreciate public health and value its
contributions to their lives.
34(p428)
With
more graduates embarking on careers
both in and outside the traditional public
health workforce and being engaged
citizens, public health graduates are
ready to [embrace] health as a value
worth pursuing and protecting,which
may then lead to healthier communities
overall.
35(p200)
ABOUT THE AUTHORS
Christine M. Plepys, Emily M. Burke, and Laura
Magaña are with the Association of Schools and
Programs of Public Health, Washington, DC.
Heather Krasna is with Columbia University Mailman
School of Public Health, New York, NY. Jonathon P.
Leider is with the University of Minnesota School of
Public Health, Minneapolis. Craig H. Blakely is with
the University of Louisville School of Public Health
and Information Sciences, Louisville, KY.
CORRESPONDENCE
Correspondence should be sent to Christine M.
Plepys, MS, Association of Schools and Programs of
Public Health, 1615 L St NW Suite 510, Washington,
DC 20036 (e-mail: cplepys@aspph.org). Reprints
can be ordered at http://www.ajph.org by clicking
the Reprintslink.
PUBLICATION INFORMATION
Full Citation: Plepys CM, Krasna H, Leider JP, Burke
EM, Blakely CH, Magaña L. First-destination out-
comes for 20152018 public health graduates:
focus on employment. Am J Public Health.Pub-
lished online ahead of print January 21, 2021:
e1e10.
Acceptance Date: October 24, 2020.
DOI: https://doi.org/10.2105/AJPH.2020.306038
CONTRIBUTORS
C. M. Plepys and H. Krasna are co-rst authors. C. M.
Plepys, H. Krasna, E. M. Burke, and C. H. Blakely
conceptualized the project and collected the data.
J. P. Leider analyzed the data. All authors contrib-
uted to and provided critical review and nal
approval of the editorial.
ACKNOWLEDGMENTS
Portions of this study were presented at the 2020
American Public Health Association virtual confer-
ence, October 2428, 2020.
We wish to thank all of the Association of Schools
and Programs of Public Health member schools and
programs of public health that contributed data to
this study and the career services stawho support
the career development of graduates.
CONFLICTS OF INTEREST
The authors have no conicts of interest to declare.
HUMAN PARTICIPANT PROTECTION
We have reported all data in aggregate with no
identiers; therefore, the Association of Schools
and Programs of Public Health determined that
this study is not human participant research.
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... Occupational variance is not only the case in Australia. Plepys et al. (2021) found that employed graduates from the United States entered health care, corporations, academia, government, non-profit, ranging from 27% in health care, to 12% in non-profits [9]. , found that postgraduate public health students from Columbia University between 2012 and 2016 went into non-profit, government, and private sectors [10]. ...
... Occupational variance is not only the case in Australia. Plepys et al. (2021) found that employed graduates from the United States entered health care, corporations, academia, government, non-profit, ranging from 27% in health care, to 12% in non-profits [9]. , found that postgraduate public health students from Columbia University between 2012 and 2016 went into non-profit, government, and private sectors [10]. ...
... We can add to this statement, saying that there are a diverse range of positive employment prospects which graduates might find themselves well matched to, given a public health education. In the United States, Plepys et al. (2021), when analysing the destinations of 53,463 public health graduates, noted that public health graduates enter a variety of sectors, with government being a fairly moderate contributed of employment (17% of employed graduates enter government after graduation) [9]. This is in contrast to higher levels of government employment in Canadian [12] and South African [11] studies and indeed previous Australian findings [6]. ...
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... Analysis of the 2017 PH WINS survey by the Association of Maternal & Child Health Programs (AMCHP) found that many within the MCH workforce report planning to leave their agency (28%) or plan to retire (24%), respectively (AMCHP, 2019; de Beaumont Foundation, 2019). At the same time, the U.S. now graduates over 35,000 bachelors, masters, and doctoral students each year in public health broadly, though only a small fraction (17%) go into governmental public health following graduation (Plepys et al., 2021). These 'first-destination' outcomes for recent graduates have been characterized for public health graduates, though relatively little has been published about MCH graduates, including how many graduates there are each year. ...
... Graduation outcomes data were obtained from ASPPH for public health graduates across the 2017-2019 academic years, with outcomes data from up to one-year post-graduation ("first-destination outcomes"). Data collection methods are described in detail elsewhere (Plepys, 2021). Employment sector by degree level was reported. ...
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Context: Much has been written about the public health workforce, but very little research has been published—and none in a peer-reviewed journal or other report since 1992—regarding the employment outcomes and employment sectors of graduate students pursuing public health as an area of study. Objectives: Our objectives were to review the literature and analyze data regarding the employment outcomes of public health graduate students and to examine how public health schools and programs might respond to changes in the sectors hiring their graduates. Design: We reviewed the literature regarding the employment of public health graduates; analyzed 5 years of graduate outcomes from Columbia University's Mailman School of Public Health using logistic regression; and we examined data collected by the Association of Schools & Programs of Public Health. Participants: The study included data from surveys of 2904 graduates of Columbia University's Mailman School of Public Health, across 5 graduating cohort years, for whom there were employment sector data available for 1932. Results: Much of the research on the public health workforce has defined it as governmental public health. Across each of 5 graduating classes from Columbia University's Mailman School of Public Health, the odds of for-profit sector employment increased by 23% (2012-2016), while hiring by government agencies declined or remained flat. Publicly available employment data from the Web sites of schools of public health and from surveys by the Association of Schools & Programs of Public Health show that hiring of new graduates by for-profit corporations now either closely matches or exceeds governmental hiring at many schools of public health. Conclusions: Public health graduates are increasingly working outside of government, and additional analyses are required to determine whether core competencies of public health curricula reflect the needs of the employers that are hiring public health graduates today. Schools and programs of public health should invest in their career services offices and gather input from employers that are currently hiring their graduates, especially as the sectors hiring them may be changing.
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Objectives: To examine the job search, employment experiences, and job availability of recent global health-focused master's level graduates. Methods: An online survey was conducted from October to December 2016 based out of Washington, DC. The study sample includes students graduating with master's degrees in global health, public health with a global health concentration or global medicine from eight U.S. universities. Results: Out of 256 potential respondents, 152 (59%) completed the survey, with 102/152 (67%) employed. Of unemployed graduates, 38% were currently in another educational training program. Out of 91 employed respondents, 62 (68%) reported they had limitations or gaps in their academic training. The average salary of those employed was between $40,000 and $59,000 annually. The majority of respondents reported they currently work in North America (83.5%.); however, only 31% reported the desire to work in North America following graduation. Conclusions: Discrepancies exist between graduates' expectations of employment in global public health and the eventual job market. Communication between universities, students and employers may assist in curriculum development and job satisfaction for the global public health workforce.
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Trends in the conferral of public health degrees provide a lens into the public health workforce. As the needs of workforce development grow and change, it is imperative to accurately characterize trends in degree conferrals to estimate the future size and composition of the public health workforce. The challenging task of enumerating public health degree conferrals aligns with the equally challenging task of enumerating the public health workforce, for which the “methodology used needs further improvements in standardization, specificity, data storage, and data availability.”1 Although a 2015 study characterized the growth of the undergraduate public health major in the United States,2 our study focused on graduate-level public health education trends in the United States
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Introduction: The purpose of this study is to reconcile public health workforce supply and demand data to understand whether the expected influx of public health graduates can meet turnover events. Methods: Four large public health workforce data sources were analyzed to establish measures of workforce demand, voluntary separations, and workforce employees likely to retire at state and local health departments. Data were collected in 2014-2016 and analyzed in 2016 and 2017. Potential workforce supply (i.e., candidates with formal public health training) was assessed by analyzing data on public health graduates. Supply and demand data were reconciled to identify potential gaps in the public health workforce. Results: At the state and local level, ≅197,000 staff are employed in health departments. This is down more than 50,000 from 2008. In total, ≥65,000 staff will leave their organizations during fiscal years 2016-2020, with ≤100,000 staff leaving if all planned retirements occur by 2020. During 2000-2015, more than 223,000 people received a formal public health degree at some level. More than 25,000 students will receive a public health degree at some level in each year through 2020. Conclusions: Demands for public health staff could possibly be met by the influx of graduates from schools and programs of public health. However, substantial implications exist for transferal of institutional knowledge and ability to recruit and retain the best staff to sufficiently meet demand.
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Objectives A key goal of schools and programs of public health is to prepare graduates for careers in the public health workforce after graduation, but are they achieving this goal? We assessed how the employment outcomes of students earning public health degrees are collected and described in the literature. Methods Using the Kirkpatrick model of training evaluation as a framework, we conducted a 6-step scoping review: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating and summarizing the results, and (6) consulting stakeholders. We included articles published from January 1, 1993, through July 4, 2020, that provided data on employment status, employment sector/industry, job function, or salary of public health graduates. We excluded articles that were not written in English and were about dual-degree (ie, doctor of medicine–master of public health) students. We found and reviewed 630 articles. Results We found 33 relevant articles. Most articles focused on a single school and combined multiple graduating classes, focused on subspecializations of public health, or focused on graduates’ satisfaction with their curriculum but not employment outcomes. Data were inconsistently categorized, and studies were difficult to compare. Conclusions Research on public health graduates’ employment outcomes is scarce and does not follow consistent protocols. New standards should be adopted to systematize the collection of data on employment outcomes of public health graduates.
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Objectives: Previous surveys of public health graduates examine where they work; however, little is known about public health graduates' employment decisions or the factors that facilitate interest or deter interest in working in governmental public health settings. The purpose of the current pilot study was to build on the information previously collected in graduate surveys by expanding questions to undergraduates and asking about decisions and factors that influence choices of employment. Methods: A pilot survey of graduates of public health programs was conducted. Respondents provided information about their degree programs, year of graduation, and current employment. Questions asked where they applied for jobs, factors they considered, experiences with the application processes, and so forth. Descriptive statistics were calculated using frequencies and proportions. Open-ended responses were qualitatively reviewed and general themes were extracted. Results: Employment preferences were ranked the highest for not-for-profit organizations (ranked first among 21 of 62, 33.9%), followed by governmental public health agencies (ranked first among 18 of 62, 29.0%). Among master of public health graduates, 54.7% sought employment within this setting, although only 17.0% of those employed full time at the time of the survey were employed within a governmental public health agency. Job security (84.7%), competitive benefits (82.2%), identifying with the mission of the organization (82.2%), and opportunities for training/continuing education (80.6%) were the most influential, positive factors garnering interest in working in governmental public health. Factors that were the biggest deterrents included the ability to innovate (19.2%), competitive salary (17.8%), and autonomy/employee empowerment (15.3%). Conclusions: Approximately half of the respondents applied for a job within governmental public health in anticipation of or since graduating. However, only a quarter of employed respondents are currently working within governmental public health, suggesting a missed opportunity for recruiting the other quarter who applied and were interested in governmental positions.
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Objectives: To examine postgraduation employment trends among graduates of doctoral programs in public health from 2003 to 2015. Methods: We analyzed pooled cross-sectional data from a census of graduates receiving a research doctorate from US accredited institutions. The outcome of interest was employment status. Covariates included public health discipline, sociodemographic characteristics, and institutional attributes. Results: Of 11 771 graduates, nearly two thirds secured employment in either academic (34.8%) or nonacademic (31.4%) settings at the time of graduation. The proportion of those still seeking employment increased over time. Individuals who were White, younger, trained in either biostatistics or epidemiology, or from an institution with the highest level of research intensity were significantly more likely to secure employment. Academic employment was the most common setting for all 5 public health disciplines, but we observed differences in employment patterns (e.g., government, nonprofit, for-profit) across disciplines. Conclusions: Certain characteristics among public health doctoral recipients are correlated with postgraduation employment. More research is needed, but the observed increase in individuals still seeking employment may be attributable to increases in general public health graduates from for-profit institutions. (Am J Public Health. Published online ahead of print July 19, 2018: e1-e7. doi:10.2105/AJPH.2018.304553).