The academic discipline of public health has massively grown in popularity in recent years. It’s estimated that there are around 140,000 public health students in the USA today, and thousands of graduates with degrees in the field, including Associate’s, Bachelor’s, Masters, and doctoral (DrPH and PhD) and in disciplines including epidemiology, environmental health, health behavior, health education, maternal/child health, health policy, biostatistics and more.
While there are several well-organized student associations for other health professions students, there has been no organization that uniquely or exclusively represents the interest of public health students and graduates…until now. And the consequences of this lack of organized power have been severe.
Medical students have the American Medical Students Association (AMSA), which runs 4 advocacy events per year. The American Student Dental Association is engaged in advocacy; similar associations exist for social work, nursing, and other health professions students. These organizations advocate for their professions, for student loan repayment programs, and more. Public heath students and graduates need to do the same.
Why we formed the National Alliance of Public Health Students & Alums
The Need:
It’s a life-and-death situation. The billions of dollars spent on healthcare in the US did not prevent more than one million people from dying of COVID-19. According to research, public health is the most effective means to keep us healthy. Yet, our public health system is woefully underfunded and marginalized, both in terms of practice and research. The governmental public health workforce experiencing chronic underfunding and extreme stress from Covid-19, an estimated 80,000 new hires are needed to replenish this workforce4—and that’s just to provide basic public health services, not even counting staff needed to respond to emergencies, pandemics, or local issues like an opioid overdose or lead poisoning crisis.
In practice, public health has continually struggled to receive minimal funding. There is a gap of approximately $10 billion per year to hire the 80,000 missing staff to provide essential public health services. Of every $1 spent on health in the US, more than 97 cents goes to healthcare and less than 3 cents goes to public health, despite overwhelming research that social determinants of health, what public health impacts, accounts for the vast majority of our health. Why? Public health is competing with the largest lobbying industry in the US, the health industry. Pharmaceuticals, health insurers, hospitals and the American Medical Association are all in the top 10 largest lobbying industries in the US.
In academia, schools of public health struggle to cover costs. Fewer scholarships are available for public health degrees, leaving students to take on debt. Although more and more public health students are graduating, funding for public health jobs has not kept up, leaving grads taking on jobs in for-profit corporations, healthcare, and other fields outside the core public health workforce. Only around 11% of public health graduates—the only individuals with degrees specifically tailored to public health—find jobs in local, state, or Tribal government each year, and their median earnings are lower than their student debt. Meanwhile, federal scientific research agencies do not prioritize public health funding. Instead, most goes to basic biomedical research, overlooking social issues involving implementation and behavioral change.
Competing interests perpetuate the funding situation. There are well-established, student-led, independent nonprofit organizations representing the interests of medical12, dental13, nursing14 and social work,15 students, with up to 85,000 members each. Most have membership dues of $35/year or less, and several include lobbying and advocacy as a core mission and organize up to four Lobby Days per year.
The Opportunity
Public health degree students and alumni possess latent power. An estimated 35,000 people graduate with a degree in public health every year, and approximately 140,000 students are currently enrolled in public health degree programs.1,2 This number is growing, with enrollment increasing 40% in the last year3. Several specific occupations which require or prefer public health degrees are listed in the American Rescue Plan, including epidemiologists, public health program managers etc.5
But, besides the new DrPH Coalition16, which represents a small proportion of public health students and graduates, no organization representing public health students currently exists. The APHA-Student Assembly17 is a wonderful organization and provides many opportunities to be involved with public health issues, but it is open to students of all majors. ASPPH is an incredible ally of NAPHSA and crucial supporter of our student loan repayment program advocacy, but primarily represents Deans, faculty and staff of public health schools and programs as opposed to students or alums of public health programs.18 Neither APHA nor ASPPH are 501C4 organizations, which can focus more exclusively on advocacy and lobbying.
NAPHSA is the solution.
The National Alliance of Public Health Students Alums (NAPHSA) represents the interests of future and current public health professionals, specifically students and alumni in associate’s, bachelors, masters, or doctoratal degrees in public health or one of the public health disciplines (epidemiology, environmental health, community health, health behavior, biostatistics, health policy and management, maternal/child health, global health). We empower public health students and graduates with advocacy skills to speak up for the public health profession, to advocate on behalf of the public health workforce, and to effectively transform their voices in policy, legislation, and funding. We also work to establish a unified identity for individuals with degrees in public health.
The organization has an independent charter and is incorporated as a 501C4 advocacy group, allowing us to focus entirely on advocacy. Activities will include conferences and meetings, advocacy trainings including a Massive Open Online Course, the Public Health Student Advocacy Academy, and Public Health Students and Alums Lobby Days. Policy platform will include:
- Full, permanent, non-discretionary funding for a specific loan repayment program for graduates in public health disciplines who work in local, state or Tribal government health departments, commensurate with actual hiring needs for trained public health professionals
- Increased, permanent spending on public health departments and related services to create permanent, fairly-paid jobs providing essential public health services
- Equitable federal research funding allocation to public health
- Support for the safety and well-being of public health professionals, especially in local, state, Tribal and territorial health departments and especially in health departments where staff have been harassed for protecting the public’s health
- Advocacy to fight unscientific and unethical rollbacks of public health legislation on the local, state, and federal levels, and to preserve the lifesaving policy power of the public health field
- Require health commissioners in state and local health departments to have training in public health, preferably a public health degree; and to remove requirements that they must have MDs
The organization will work in coalition with other organizations such as DrPH Coalition, NACCHO, ASTHO, Public Health Awakened, ASPPH, APHA, Trust for America’s Health and others.
Short Term Strategy
We have gathered more than 2,450 signatures on a sign-on letter for public health loan repayment, which was presented to the Senate HELP Committee to support the PREVENT Pandemics Act to support public health student loan repayment.
In August, 2022, we organized the first-ever National Public Health Students & Graduates Hill Week. More than 100 public health students and graduates became involved, and organized advocacy meetings with their elected officials to push for public health student loan repayment (including HR 3297 and the PREVENT Pandemics Act). We leveraged the time and effort of the individuals who signed the letter to organize this event on a state-by-state level. Working with seasoned public health advocates, we organized a “boot camp” style lobbying training day before the Hill Week, training students on how to speak to elected officials.
Medium Term Strategy
We are inviting individuals to apply for leadership roles in a new Public Health Students & Graduates Association, including President, Vice President, Treasurer, Secretary, Policy Director, and Communications Strategist/Content Writer. We will create a mission, vision, and strategy.
Students and graduates of public health programs will be invited to join the association for a nominal donation, with proceeds going towards funding for advocacy efforts, website hosting, social media strategy, newsletter writing, and events.
Long Term Strategy
Eventually, campus chapters will be created at public health schools around the United States, with a national representation. Additional chapters representing Associates, Bachelor’s, Masters, and Doctoral students may be established. The organization will become self-sustaining financially and organizationally. A membership and sponsorship program could be established, similar to the Institutional Partnerships and membership levels for the American Medical Students Association, which has a $3.2 million budget (https://www.amsa.org/get-involved/work-with-us/partner/). The mission of the organization will be to advocate to reduce the burden of student loan debt for public health graduates who work in the public health workforce; for permanent, sufficient funding for the public health workforce; to advocate for public health infrastructure and institutional power; to advocate for leadership roles in health departments to include and prioritize individuals with degrees in public health (and to advocate to change legislation that mandates that health commissioners must have medical degrees only), and to raise the profile and power of individuals with degrees in public health.
References
1. Leider JP, Plepys CM, Castrucci BC, Burke EM, Blakely CH. Trends in the Conferral of Graduate Public Health Degrees: A Triangulated Approach. Public Health Rep. 2018;133(6):729-737. doi:10.1177/0033354918791542
2. Resnick B, Leider JP, Riegelman R. The Landscape of US Undergraduate Public Health Education. Public Health Rep. 2018;133(5):619-628. doi:10.1177/0033354918784911
3. KarlPK. Driven by the pandemic and “the Fauci effect,” applicants flood public health schools. STAT. Published March 17, 2021. Accessed May 5, 2022. https://www.statnews.com/2021/03/17/driven-by-pandemic-applicants-flood-public-health-schools/
4. Staffing Up | PHNCI. Accessed February 26, 2021. https://phnci.org/national-frameworks/staffing-up
5. Krasna H, Fried LP. Generation Public Health: Fixing the Broken Bridge Between Public Health Education and the Governmental Workforce. American Journal Of Public Health. Published online July 2021.
6. Plepys C, Krasna H, Leider J, Burke E, Blakely C, Magana L. First-destination outcomes for 2015-2018 public health graduates: focus on employment. American Journal Of Public Health. 2020;111.
7. Beck AJ, Leider JP, Krasna H, Resnick BA. Monetary and Nonmonetary Costs and Benefits of a Public Health Master’s Degree in the 21st Century. Am J Public Health. 2020;110(7):978-985. doi:10.2105/AJPH.2020.305648
8. Park C, Coles E. The Impact of Student Debt on Career Choices among Doctor of Public Health Graduates in the United States: A Descriptive Analysis. International Journal of Environmental Research and Public Health. 2022;19(8):4836. doi:10.3390/ijerph19084836
9. S. Rept. 109-319 – PANDEMIC AND ALL-HAZARDS PREPAREDNESS ACT. Accessed May 5, 2022. https://www.congress.gov/congressional-report/109th-congress/senate-report/319
10. Read the Affordable Care Act, Health Care Law. HealthCare.gov. Accessed May 5, 2022. https://www.healthcare.gov/where-can-i-read-the-affordable-care-act/
11. Crow J. H.R.6578 – 116th Congress (2019-2020): Public Health Workforce Loan Repayment Act of 2020. Published April 21, 2020. Accessed September 2, 2020. https://www.congress.gov/bill/116th-congress/house-bill/6578
12. Advocate. AMSA. Accessed May 5, 2022. https://www.amsa.org/advocate/
13. Advocate | ASDA | ASDA. Accessed May 5, 2022. https://www.asdanet.org/index/get-involved/advocate
14. Leadership U — National Student Nurses’ Association Leadership University Honor Society. Leadership U — National Student Nurses’ Association Leadership University Honor Society. Accessed May 5, 2022. https://www.nsnaleadershipu.org/
15. Home – Congressional Research Institute for Social Work and Policy (C.R.I.S.P.). Accessed May 5, 2022. https://crispinc.org/
16. DrPH Coalition. DrPH Coalition. Accessed May 5, 2022. https://drphcoalition.org
17. Student Assembly. Accessed May 5, 2022. https://www.apha.org/apha-communities/student-assembly
18. ASPPH | About. Accessed May 5, 2022. https://www.aspph.org/about/
National Alliance of Public Health Students & Alums (NAPHSA) 