Career Watch: State/Local Government
Each of the 50 states is different in its setup, and within each state there’s a range of types of public health agencies. If you’re starting a career in governmental public health or contemplating a mid-career change, you can expect anything from very specialized, program-focused work to generalist positions in areas like public health planning. In rural communities, most staff members need to be generalists, because staffs are small, and there’s such a wide variety of work to be done. While areas of specialty in local and state governmental public health map relatively well onto American Schools of Public Health requirements, there is a growing trend away from risk-factor and disease-specific specializations and toward a more flexible use of skills in a multitude of areas.
Depending on your skills and education, governmental public health jobs at the local and state level can entail anything from giving an individual baby an immu-nization to inspecting a septic tank or restaurant. You could find yourself working with a community coalition to address an issue like neighborhood walkability, or you could work with an advocacy group to spur change at the system level. In 2011, governmental public health began implementing a voluntary public health accreditation across the country, and there is increasing focus on quality improvement.
Current Job Opportunities
There are approximately 160,000 employees working in local public health agencies and 107,000 staff working in state public health agencies in the United States. At the local level, a vast majority of jobs are administrative or clerical, or in public health nursing. Other key positions include public health managers, environmental health workers, emergency preparedness staff, health educators, nutritionists, public health physicians, and epidemiologists. There are also opportunities for health behavior professionals and both public health information and informatics specialists.
Future Job Opportunities
These are dynamic times for governmental public health. Nationwide, the number of public health employees eligible for retirement from state public health agencies is expected to rise from 18 percent in 2010 to 27 percent in 2014. Both state and local public health agencies will need people from more traditional backgrounds, such as nursing and biological sciences, as well as individuals with expertise in less conventional areas, like communications, community organizing, and policy development.
Besides public health expertise, the most important skill you need in governmental public health is a clear understanding of your chosen community and its culture. You need to understand the role of governmental public health within your community, and how to maximize the efforts of both government and community partners. Politics is critical. You need to understand not only how your state or local government works, but how decisions are made, and you need to be open to compromise.
“The number of public health employees eligible for retirement from state public health agencies is expected to rise from 18 percent in 2010 to 27 percent in 2014.”
—Lisa VanRaemdonck, M.P.H./M.S.W. ’07, Executive Director, Colorado Association of Local Public Health Officials