At long (long, long) last: the APHA @ih_section's #GlobalHealth Jobs Analysis has been published!

Wednesday, February 28, 2018

Ah, sweet victory. The Global Health Jobs Analysis project that I spearheaded has finally been published in BMC Public Health. The project, which came to me as a completely insane idea at the end of the 2015 APHA Annual Meeting in Chicago, was done over the course of about eighteen months by a group of dedicated volunteers who collected, entered, and analyzed data completely outside of their day jobs. All publications, as well as a link to an up-to-date data repository, are listed on the project page linked above. Here is the abstract:
Background
The number of university global health training programs has grown in recent years. However, there is little research on the needs of the global health profession. We therefore set out to characterize the global health employment market by analyzing global health job vacancies.

Methods
We collected data from advertised, paid positions posted to web-based job boards, email listservs, and global health organization websites from November 2015 to May 2016. Data on requirements for education, language proficiency, technical expertise, physical location, and experience level were analyzed for all vacancies. Descriptive statistics were calculated for the aforementioned job characteristics. Associations between technical specialty area and requirements for non-English language proficiency and overseas experience were calculated using Chi-square statistics. A qualitative thematic analysis was performed on a subset of vacancies.

Results
We analyzed the data from 1007 global health job vacancies from 127 employers. Among private and non-profit sector vacancies, 40% (n = 354) were for technical or subject matter experts, 20% (n = 177) for program directors, and 16% (n = 139) for managers, compared to 9.8% (n = 87) for entry-level and 13.6% (n = 120) for mid-level positions. The most common technical focus area was program or project management, followed by HIV/AIDS and quantitative analysis. Thematic analysis demonstrated a common emphasis on program operations, relations, design and planning, communication, and management.

Conclusions
Our analysis shows a demand for candidates with several years of experience with global health programs, particularly program managers/directors and technical experts, with very few entry-level positions accessible to recent graduates of global health training programs. It is unlikely that global health training programs equip graduates to be competitive for the majority of positions that are currently available in this field.
BMC series journals are all open access, so the full paper is available on the web and as a PDF download.

This was quite the learning experience for me - almost a baptism by fire into the peer review process. I suppose it is a taste of what is to come when I begin my PhD in epidemiology at U Maryland's School of Public Health this fall(!). I also hear that it is considered bad juju in academia to go into the gory details of the peer review exchange (unless your reviewers are blatantly sexist), so I'll refrain for the moment.

More important than certain people's conclusions that descriptive analyses aren't worthy of publication is the fact that now there is an evidence base for what has long been anecdotally known by anyone who has ever tried to get a job in the global health field (or international development more broadly). The TL;DR version of the paper is there aren't enough jobs for MPH grads, and - based on the continued growth of global public health programs - nobody seems to be communicating that to prospective students who are looking down the barrel of a 50+K-student-loan-debt gun. Based on my reading of the literature, it looks like schools of public health have been leveraging the popularity of global health in the media to bring in more students:
Driven by global pandemics such as HIV, increased foreign aid budgets from the U.S. and other high-income nations, the emergence of new multilateral institutions and NGOs such as the Gates Foundation, and increasing prioritization of country ownership of health programs, both the politics and the funding structure of global health work have shifted. Global health has also experienced increased levels of attention and funding. Interest among students in high-income countries has increased as well, as evidenced by the impressive growth in the number of global health graduate programs.
This looks a whole lot like the law school crisis that hit headlines about five years ago:
Ninety-two percent of 2007 law school graduates found jobs after graduation, with 77 percent employed in a position requiring them to pass the bar. For the class of 2011 (the latest class for which there are data), the employment figure is 86 percent—with only 65 percent employed in a position that required bar passage. Preliminary employment figures for the class of 2012 are even worse. The median starting salary has declined from $72,000 in 2009 to $60,000 in 2012. A while back, the Bureau of Labor Statistics estimated that 218,800 new legal jobs would be created between 2010 and 2020. As law professor Paul Campos points out, because law schools graduate more than 40,000 students per year, those jobs should be snapped up by 2015—leaving only normal attrition and retirement spots left for the classes of 2016 to 2020. Meanwhile, tuition has increased dramatically over the last several decades.
For the record, we got lucky and managed to land a very thoughtful and thorough editor at BMC, who recommended that we share the results through CUGH and other avenues. I fully plan to do so to the extent I can (while still keeping my day job).

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