Top 5 Public Health Jobs (that have nothing to do with public health)

September 20, 2010

For a long time, I’ve had an idea for a post that I never fully developed. Finally, I’m going to post it. Perhaps some of the potential insights are only partially percolated in the post; regardless, we proceed.

To me, the question “How can I save the world?” always seemed to imply “How can I help the sick? How can I make people live longer, happier lives?” I’m not sure if this is a common association, but an enormous amount of impact can be made through broadly improving public health.

Almost all of the world’s greatest tragedies are issues of public health. While the discipline often focuses on disease epidemiology or health policy, other major events clearly affect the health of populations: war, climate change, mental stress, natural disasters. Objectively, public health is not just vaccinating children but bringing conflict resolution, preparing for hurricanes, improving family dynamics, paving roads, building bridges (physical and metaphorical), and improving the quality of life for large numbers of people.

Unfortunately, such a broad scope can’t really be covered in a Masters program. Instead, we learn biostatistics and memorize long lists of risk factors for cancer, infectious disease, and other behaviors that lead to sickness. (It turns out, being really poor makes being healthy really difficult).

All of these many health-related disciplines, however, need leaders. And since getting an MPH can slow people down for two years, I’ve compiled a personal list of the top five occupations that I believe achieve the most public health (i.e. save-the-world) impact.

1) Teachers
One of the most impressive correlations that exists (in my opinion) is the correlation between health and education. From a 2007 NY Times article:

The one social factor that researchers agree is consistently linked to longer lives in every country where it has been studied is education. It is more important than race; it obliterates any effects of income.

Education improves the economy, decreases risky behavior, and even cuts down smoking; not to mention the vocational training in finding stable employment and improving the economy.

2) Engineers
According to charity:water, unsafe water and lack of basic sanitation cause 80% of diseases and kill more people every year than all forms of violence, including war. The social consequences are equally destructive:

In Africa alone, people spend 40 billion hours every year just walking for water. Women and children usually bear the burden of water collection, walking miles to the nearest source, which is unprotected and likely to make them sick.

Time spent walking and resulting diseases keep them from school, work and taking care of their families. Along their long walk, they’re subjected to a greater risk of harassment and sexual assault.

In many places, water is hard to come by. There needs to be water infrastructure and to create this infrastructure we need innovative engineers. Plain and simple.

Engineers have done a lot to help the world. From the CBS Business Network:

Engineers have built more than 36,000 large dams around the globe to control floods and provide hydroelectric power, irrigation, industrial supplies, and drinking water to an expanding population and economy.

3) Politicians (kinda)
Poor governance in low-income countries ultimately causes A LOT of global health problems. Poverty becomes exacerbated. Public interventions fail due to corruption. Private markets cannot be efficiently regulated and open the door to exploitation.

Maybe Wycleaf Jean had the right idea on how to help the poor: become a politician.

Admittedly, although many problems are caused by governance, I don’t know that being a non-corrupt, intelligent, or even musically talented politican is the best way to overcome the problem. Bureaucracy, international relations, and other social, political, and economic dimensions discussed in a long list of Yale seminars aren’t easily solved by one Senator’s voice.

But hopefully there will always be people like Nelson Mandella, John Adams, Ellen Johnson Sirleaf and others to prove me wrong.

4) City Planners
There are more people in the world that face obesity than malnutrition. When I first heard that I was amazed. Now, admittedly, it makes sense.

Coined the “obesity epidemic,” a epidemiological transition has led to heart disease, cancer, diabetes, and other BMI-related chronic diseases to (appropriately) take the foreground in Western health policy. (In just about every public health class I have ever taken, obesity is one of the first issues that is discussed).

What can be done to prevent obesity? There are lots of alternative ideas being thrown around: sugar taxes, gym subsidies, improved health education, high quality healthy foods in low-income neighborhoods. All have potential, but one area that needs more emphasis is city planning.

To improve food security, encourage walking, and get people out of the BK breakfast->cubicle->episodes of Lost->bed routine, we need city designers.

In New Haven, I ride my bike or walk everywhere. I have access to nearby healthy foods and a gym. I have groceries delivered to me from a nearby grocery store. (Incidentally, grocery story delivery man could deserve an honorable mention for this list: finally, a way to maybe get produce and fruit to low-income neighborhoods).

By creating cities that can be navigated on foot (with efficient transportation) instead of relying on cars and highways, urban planning can create metropolitan hubs that have improved access to healthy foods while increasing exercise and even decreasing a reliance on (economically- and environmentally-) costly vehicles.

5) Journalists
I like to think I’m an idealist and an optimist. Yet, I get overwhelmed with global problems and discouraged trying to make an actual difference. It is during these times I consider dropping out of school, becoming a Park Ranger, and leading a content life in the wilderness. Or, investment banking.

Despite basically focusing on many of the world’s greatest tragedies, journalists like Nicholas Kristof inspire me and get me back on track. In order to truly address the plethora of public health issues (whether germs, genocide or gender inequality), we need to hear about them. Journalists bring these issues into the spotlight. They inspire. They mobilize. They tell people about the enormous disparity and they recruit the future leaders that will devote their lives to ending them.

Oprah can mobilize a social movement. Ben Franklin used journalism to influence the American Revolution. Glenn Beck can (unfortunately) get millions of people to hang on to his every word. This is a powerful tool to create enormous shifts in our world. Unfortunately, the economic future of journalism remains uncertain so it probably won’t pay that well.

At least there are always blogs.


MBAs and Social Enterprise

November 1, 2009

The Financial Times posted a new story today about MBAs turning to social enterprise.  It’s always reassuring to see news stories  about this stuff — it makes me hope that the idea of social businesses is more than just a trend and really the future of philanthropy.

The article cites an Acumen Fund investee healthcare chain, LifeSpring Hospitals, and it’s ability deliver services to some of the world’s poorest communities.  Finally, these are the organizations that will be featured in the Harvard Business School case studies!

Such stories reflect the extent to which the boundaries between the private sector and civil society are eroding. “Business and the citizen sector are two operating sectors and they really need to come together,” says Bill Drayton, founder of Ashoka, the social entrepreneurship organisation. “Business schools should be at the centre of this merging of the sectors.”

Exactly.  Current MBA curriculum, without question, can offer enormous insight for those trying to address global issues of today.  But the standard business school framework–teaching future entreprenuers and managers how to maximize financial returns–won’t cut it when the business model changes from monetary profits to social profits.

Schools are using various parts of the curriculum to expose their students to the principles of social entrepreneurship. Electives remain one of the most common means of doing so, with case studies that highlight pioneering leaders.

Electives are great, but even better is changing the culture of business school to acknowledge the desire of young professionals to use business skills to provide clean water, deliver medications, or increasing access to education.  In my experience, Yale’s School of Management (currently ranked 10th in the 2010 US News Graduate Business School Rankings and 1st in the specialty ranking in Nonprofit) has done so much more than just offer extra courses.

In addition to elective options, Yale offers enormous extracurricular resources: a Program on Social Enterprise and Nonprofit Organizations,  active student organizations like NetImpact, and almost weekly lunches or talks from speakers involved in private foundations, corporate social responsibility, and microfinance.  Furthermore, Yale seems to draw students that have a passion for social enterprise; class conversations have an affinity for social responsibility and corporations that have double or triple bottom lines.

Yale’s great rival, Harvard University, has gained some good press for its initiative to get MBA students to sign an oath on responsible value creation. The line that sums it up for me:  ” I will strive to create sustainable economic, social, and environmental prosperity worldwide.”

The oath is a great start to shift the focus of MBA students, but it’s still just an oath.  (In every public health course I have ever taken, a student always cites the Hippocratic Oath and is always shut down by the professor’s response of “eh.. that doesn’t really have any real power to do anything.”)

The double bottom-line is this:

  • The power of an MBA education offers a lot of potential to solve global issues of poverty, hunger, education, and health.  Creating a culture in graduate school that acknowledges social benefits of business skills can go a long way to contributing to major world problems.  The oath is a good start, but only a start.
  • Not only should MBA students be aware of social problems, but individuals that  dedicate their careers to social problems should be cognizant of the practical skills that business school can offer.  Ultimately, social business could be the future of foreign aid and poverty alleviation — let’s just hope people keep jumping on the bandwagon.