Australasian public health alumni employment outcomes

Introduction

In the era where chronic disease, pandemics, environmental disasters and conflict are taking a huge toll on human health, the public health workforce is essential.¹ The Australian public health workforce shortages are longstanding, with job demand increasing by 46% between 2003 and 2018.² These shortages were acutely obvious in the height of the COVID-19 pandemic, where government departments were required to hire new, inexperienced staff and stretch deployment of staff across the health sector to meet increased workload demands.³ The diverse and multisectoral nature of public health professionals, and the lack of an accrediting body, with the exception of public health physician training, makes it difficult to clearly define the public health workforce.^2,4,5 Graduate tracking, the process of tracking the employment outcomes of those who have had formal university-level training in public health, could aid in defining the workforce.

A scoping review of public health graduate tracking studies conducted in 2021 indicated that data on graduate career paths is limited, varied in quality, and has unclear and inconsistent reporting on employment outcomes.⁶ Despite these limitations, findings consistently identified that graduates worked across various fields, including health care, education, government, and non-profit and private sectors. The proportion of graduates working across these sectors largely depended on the country, when graduates completed their degree and how soon after graduation the data were collected.⁶ Only three of the studies reported on employment outcomes of Australasian public health graduates.^7–9 To our knowledge, all of the public health graduate tracking studies to date have relied on self-reported survey data with varying response rates, time points and generalisability.

The rise of professional networking sites, such as LinkedIn (www.linkedin.com), represents an opportunity to access and collect data on alumni career pathways.¹⁰ In 2017, LinkedIn incorporated an alumni tab on universities LinkedIn pages that provides high-level insights on what alumni have accomplished since graduation.¹¹ The aim of this study is to provide a broad snapshot of Australasian public health alumni employment outcomes using the data collected via the LinkedIn alumni tab. This includes describing where alumni have most frequently lived and worked, what type of work they have been employed in and what skills they have self-reported as having.

Methods

Results

LinkedIn pages were found for 36 of the 37 CAPHIA member institutions. The University of Papua New Guinea has a company LinkedIn page, but not a university-affiliated page; therefore, data on alumni were not available for this institution. The universities had a total of 4,226,954 alumni on their pages, 14,424 of which matched the criteria for this study (Table 1). The majority of participants went to universities in the eastern states of Australia (63%), which consist of New South Wales (NSW) (28%), Victoria (24%) and Queensland (18%). There were 682 (5%) alumni from non-Australian universities.

Where they work

There were 3876 data points, across 250 organisations, detailing ‘where they work’. The most common employer for 24 of the member institutions was the institution where the alumni studied. Exceptions to this were the Australian National University, Macquarie University, Torrens University, University of Wollongong, Central Queensland University, James Cook University, Federation University and the University of Western Australia, which were the second most common employer, the University of Tasmania and Victoria University which were third, and the University of Canberra and Charles Darwin University, which were fourth most common employers of alumni at that university.

Coding of the ‘where they work’ data, in accordance with ANZSIC,¹⁴ was obvious in some instances and difficult to discern in others. For example, universities were easily coded as ‘higher education’. In contrast, the World Health Organization (WHO) did not readily fit within any existing categories, but was deemed to best fit ‘foreign government representation’, which included the primary activity international government organisation (United Nations, World Trade Organization, etc.) administration.

Higher education (43%), public administration and safety (27%) were the most common industries alumni have worked in, followed by health care and social assistance (22%), as well as professional, scientific and technical services (4%) (Fig. 1). All other industries accounted for the remaining 4%.

Fig. 1.

What industry alumni have worked in. Industry classifications based on Australian and New Zealand Standard Industrial Classification (ANZSIC) (ABS, 2013).¹⁴ ‘Other’ comprises other services, retail trade, rental, hiring and real estate services, financial and insurance services, arts and recreation services, manufacturing, mining, information media and telecommunications, electricity, gas, water and waste services, wholesale trade, and administrative and support services.

SA (53%) and Queensland universities (48%) had the highest proportion of alumni who have been employed by higher education organisations. The higher education institutions most alumni have worked at were the University of NSW (n = 186), University of Sydney (n = 146), University of Queensland (n = 135), University of Melbourne (n = 126) and Monash University (n = 117).

State governments represented the majority (80%) of public administration and safety employers. ACT universities had the highest proportion (61%) of alumni employers in this industry. The government departments most alumni have worked in were NSW Health (n = 267), Queensland Health (n = 220), Victorian Department of Health (n = 128), Australian Government Department of Health and Aged Care (n = 68), WA Health (n = 59), SA Health (n = 57) and WHO (n = 37). Victorian universities had the highest proportion of alumni employed in health care and social assistance (40%). The majority of employers in this industry were hospitals (79%), of which the most frequently worked at were Victoria-based: Austin Health (n = 92), Monash Health (n = 63), Alfred Health (n = 8), Western Health (n = 53) and the Royal Melbourne Hospital (n = 45).

The most predominant professional, scientific and technical services was scientific research services, which accounted for 145 of the 147 entries. Of these, Telethon Kids Institute (The Kids Research Institute Australia), Burnet Institute, George Institute for Global Health, Murdoch Children’s Research Institute, Menzies School of Health Research and the Kirby Institute all had over 10 instances where alumni had worked there. The majority (50%) of the other employers were categorised as ‘civic, professional and other interest group services’. The most frequently cited employers were the Royal Australian College of General Practitioners, an international accommodation provider, Cancer Council NSW, Chemist Warehouse, Woolworths, BUPA, Public Health Association of Australia, Black Dog Institute, and the Australian College of Rural and Remote Medicine.

Discussion

This descriptive observational study of secondary data describes the employment outcomes of 14,424 public health alumni from 36 Australasian universities. Alumni have lived in all parts of the world, but were most likely to live in the Australian state/territory in which they studied or the eastern states of Australia. The most common employers were universities, government, or health care and social services organisations, with alumni working in health care, community and social services, research or education roles. The most frequently self-reported skills were broad, encompassing knowledge, technical and soft skills. Less cited skills often related to public health specialisation, such as Health Promotion and Health Policy.

A key finding of this study is that the number one employer of Australasian public health alumni were universities; nearly half (43%) of all data on ‘where they work’ was a university, with their alma mater being their most likely employer. Education and research only accounted for 23% of what alumni do, indicating that employment of alumni at universities may be in professional roles, such as operations, health care and/or social services, which account for over half (56%) of university employment.^15,16 Further strengthening this interpretation, prior research indicates only 2% of the Australian Master of Public Health graduates are employed as university lecturers.⁹ Alumni employment at universities is likely to be driven by students’ awareness of opportunities for employment in this sector as a result of the careers advice that academics are able to more confidently provide them,^17,18 communication regarding available roles (e.g. emails, university job boards) and continuation of research pathways, which often include teaching assistant/associate work. It is also possible that alumni are including voluntary or educational experience, such as an unpaid research placement or a PhD program within their work experience, inflating this finding.

As the public health workforce is poorly defined, it is difficult to ascertain whether alumni have been working for employers and doing work that relates to public health.^9,19 Working for government health departments and working in community social services are most likely to be in public health. Some organisations (e.g. Public Health Association of Australia) are also much easier to discern as public health than others. Education and research, and even program or project management work, could be public health,⁹ but without detail on the type of research or education, this cannot be confirmed.

Difficulties mapping the public health workforce are partly due to the lack of presence of public health within Australian and New Zealand industry and occupation classifications. There is no mention of public health within industry classification, and there are only two occupations that explicitly mention public health: (1) ‘specialist physicians nec.’, which can be used for specialisation as a public health physician, and (2) ‘registered nurse (community health)’, which is synonymous with ‘registered nurse (public health)’. Although there is no mention of public health within industry, public health is included in three UK occupational classifications: (1) ‘health service and public health managers and directors’, (2) ‘public health analysts’ and (3) ‘public health doctor’. In North America, the public health industry is captured by the ‘Administration of Public Health Programs’ industrial classification, and public health is explicitly mentioned within the descriptions of ‘medical and health service managers’, ‘environmental scientists’ and ‘specialists (including health)’, ‘healthcare social workers’, ‘health education specialists’, ‘health specialities teachers (postsecondary)’, and ‘dietitians and nutritionists’ USA occupational classifications. This indicates the need for Australian and New Zealand classifications to be updated, something that was missed in the 2021 and 2024 occupation classification revisions.

Nearly half (49%) of the data for ‘where they work’ were in public service or health care. The high frequency of healthcare-related data observed for ‘where they work’ (22%), ‘what they do’ (26%) and ‘what they are skilled at’ (7%) reinforces this. When comparing the data from the two most populous states, working in public administration and safety was more likely in NSW (NSW Health was the number one employer), whereas health care was more likely for Victorians (the top five health services were Victorian). The NSW Government Health Department operates more than 220 public hospitals in addition to providing community and public health services through its local health districts. This means that NSW Health workers, who could be working in hospital settings, were coded as public servants. In contrast, the Victorian Department of Health supports rather than operates health services. These contextual differences, which have ramifications for coding/categorisation, exacerbate difficulties in defining the public health workforce.

Previous research supports within²⁰ and between country⁶ variability of public health alumni working in government. As this study only included CAPHIA member institutions that had LinkedIn pages, only one out of the five New Zealand, one out of the two Fiji, and one of the Papua New Guinea universities that offer qualifications in public health were included. CAPHIA has only recently expanded to include members from countries other than Australia.¹² For this data, to confirm or refute findings of inter-country variability, a wider range of universities across this region need to be included. An understanding of the employment ecosystem (e.g. health system) within and between countries is also needed to accurately categorise data.

The top two self-reported skills, public health and research skills, are central to public health graduate competency. However, when the various Microsoft Office skills were combined, this became the number one skill – a skill not mentioned in the CAPHIA¹² foundation competencies for public health graduates. This aligns with previous research, indicating there were a number of skills included on information technology alumni LinkedIn profiles that were not covered/weakly developed in the curriculum, most of which were program/software-related (e.g. Python, Android).²¹ This suggests that there may be implied skill development through task completion and feedback, rather than implicit teaching. For example, students are required to use Microsoft tools to create assessment documents and presentations, but may not be instructed in how to best use these tools and develop their skills. This is perhaps even more important for Microsoft Excel, where the functions are greater in frequency and complexity than in other tools. Similarly, although leadership, communication and teamwork are evident in the CAPHIA competency framework, other soft skills identified by alumni were not. These included public speaking, customer service, time management and interpersonal skills. In contrast, the WHO and Association of Schools of Public Health in the European Region (ASPHER) Competency Framework for the Public Health Workforce in the European Region has a greater focus on soft skills.²²

To support students in enhancing their readiness for different public health career paths and roles, it may be important to integrate, more implicitly, the development of technical and soft skills into competency frameworks and subsequent curricula. Although soft skills are transferable and stable, the required technical skills are constantly evolving with technical advances. This is evident currently with the emerging use of AI technologies.²³ Rather than naming certain software, the goal should be to support students in developing the skills to learn, adapt and even critically assess the value of new technologies.

Conclusion and future directions

This study demonstrates an efficient and scalable approach for describing graduate employment outcomes using LinkedIn to track alumni. While the data provides a useful snapshot of employment patterns across institutions, it has clear limitations and should be interpreted cautiously. Future research should explore how this approach can be extended across a broader range of disciplines and international contexts, particularly in settings where comprehensive graduate outcome data are not routinely collected. To better understand the long-term trajectories of public health graduates, longitudinal tracking and mixed-method approaches – including surveys and/or tracking individual alumni and interviews – would offer richer insights. While not a substitute for professional consultation, these data can complement more traditional forms of stakeholder engagement in curriculum review processes by shedding light on career paths and emerging roles in the public health workforce. Access to such data will also aid students’ understanding of career opportunities that studies in public health afford.

Supplementary material

Supplementary material is available online.