Climate change is acknowledged to be a major threat to public health [1
]. Just as public health practice must constantly adapt to emerging viral outbreaks, non-communicable diseases, or other health threats, it must also be prepared for the diverse threats to human health posed by climate change. Several reports and large-scale commissions [3
] point to the need for training for the health workforce, including the public health workforce, in skills and content to help lead efforts to mitigate and manage the impacts of climate change on health.
A 2008 report by the Association of Schools and Programs of Public Health (ASPPH) mentioned climate change as a key, new area of public health education [11
]. The 2016 Council on Education in Public Health (CEPH) competencies for public health education include areas of focus, which allow public health professionals to protect human health from climate change impacts, such as analyzing data, discussing structural bias, assessing “population needs, assets and capacities that affect communities’ health” and “applying systems thinking” [12
Many competencies required for environmental health science students, such as “approaches for assessing, preventing and controlling environmental hazards that pose risks to human health and safety” [13
] are applicable to climate change. However, knowledge of climate change specifically is not yet a core competency of public health degrees in the United States. New initiatives exist, such as the Global Consortium on Climate and Health Education, which now has 193 members [14
] and recently proposed a set of Core Climate and Health Competencies for Health Professionals [15
]. Additionally, the Association of Schools of Public Health in the European Region (ASPHER)’s 2018 Competencies does list climate change as a competency within “Population Health and Its Material-Physical, Radiological, Chemical and Biological-Environmental Determinants” [16
] and the Council of Academic Public Health Institutions Australia (CAPHIA)’s Foundation Competencies for Public Health Graduates in Australia include “identify and describe the impacts of climate change and implications for ecologically sustainable development” and “climate change theory” [17
To further identify existing research on the skills, competencies, and job market for individuals with training in both public health and climate change, we conducted a brief narrative review of the literature, primarily focusing on a keyword search of Google Scholar of “climate change” AND “public health” AND “workforce”, which yielded 28,100 results, and “climate change” AND “public health” AND “jobs”, which yielded 86,000 results; we also conducted a search of Pubmed.com for “public health education” AND (“climate change” OR “global warming”). Inclusion criteria included a focus on expected hiring needs for professionals with training in both climate change and public health. Articles that did not include information related to issues with workforce or training needs were excluded.
To identify competencies needed in a future workforce, and to ensure training aligns with labor market demand, it is accepted practice to rely on input from public health employers and organizations. Many ASPPH competencies are based on “blue ribbon panels” of employers [18
], as are the Core Competencies for Public Health Professionals developed by the Council on Linkages Between Academia and Public Health Practice [19
]. Similar employer input is needed to understand which skills current employers expect of public health graduates with respect to climate change. While employer surveys have been conducted in several public health workforce research articles [20
], analysis of job postings-a potential key indicator of current employer requirements-has only rarely been used in the public health field [26
]; this, combined with a survey of employers, can provide a fuller labor market analysis than has been conducted in the past.
Through our analyses, we can attempt to estimate current and future hiring trends for public health professionals with training in climate change-related competencies, as well as continue to identify the training needed to help address the threat of climate change. For those institutions creating new training programs focusing on both climate change and public health, it will be important to assess whether their graduates will be in demand in the labor market, and if so, which sectors are most interested in hiring candidates with these skills. We attempt to address the questions: Which employers currently seek graduates with training in both climate change and public health; and is the demand for such graduates likely to grow?
The current state of the job market for public health graduates with training in climate change can be described as “emerging”. From the Indeed.com job description data analysis, we can see there are relatively few roles—even in search results from a broad-based job board with keywords focusing on public health and climate change—currently available for a graduate with a master’s level public health degree and a focus in climate change. Notwithstanding, it is likely that graduates would benefit from training in climate change-related competencies, even if the overt focus of their job is not directly related to climate change. Additionally, resonating with Wals, Corocoran, and others who frame educational institutions as change leaders, graduates with training in both climate change and public health can influence their institutions from within, to create systemic change in grappling with global warming.
The analysis of publichealthjobs.org data seemed to show that while jobs within public health that mention climate change or global warming were a very small proportion of the total, the fraction of such job postings had shown a statistically significant (p < 0.0001) increase over the last 16 years. This trend should be monitored by those involved in public health education and career placement of public health graduates, bearing in mind that while prior trends are often used to predict the future, they are not always the best indicator of future trends in a quickly changing world.
While “approaches for assessing, preventing and controlling environmental hazards that pose risks to human health and safety” [13
] is not yet a core competency of public health degrees in the United States, the employer survey indicates that a large majority of respondents believe that there may be a growing need for graduates with training in climate change and health. The survey indicates that key skills include knowledge of climate mitigation, health equity and climate justice, an understanding of “downstream” effects of climate change, risk assessment, and technical skills in statistics, GIS mapping, and the carbon cycle. Comments from the responders indicate key themes focusing on these areas as well as communication (especially persuasive communication), finance/budgeting, cross-disciplinary collaboration and systems thinking, analytical skills, and an understanding of climate impacts on mental health, which resonate with Frankson et al.’s [53
]. One Health Competency Domains including management, communication and informatics, values and ethics, leadership, team and collaboration, roles and responsibilities, and systems thinking. These skills also appear to be in alignment with the competencies proposed by ASPHER, CAPHIA, and the Global Consortium on Climate and Health Education.
Importantly, the scope and framing of this study focused primarily on the role of educational institutions in preparing graduates to solve the problems of today, and to meet the demands of today’s employers. Universities, however, not only provide education, produce research, and perform service to their communities; in addition, “higher education can play a pivotal role in turning society toward sustainability” [54
]. This is an especially essential role in the face of massive and unpredictable global issues such as climate change. Universities create innovation, and can use their often privileged place in society to advocate for a sustainable future and to equip all of their graduates with understanding of their own environmental impact, both in the personal lives and in their careers. The challenges of climate change are profound enough to require an epistemological change; “sustainability is not just another issue to be added to an overcrowded curriculum, but a gateway to a different view of curriculum, of pedagogy, of organizational change, of policy and particularly of ethos” [54
]. Additionally, following Scharmer’s Theory U, we note that knowledge itself is not in short supply; instead, there is a “knowing-doing gap: a disconnect between our collective consciousness and our collective action” and our entire “mental and social operating system” must be upgraded from “ego-awareness to eco-awareness” [55
]. Therefore, while this article focused on historical trends and current and near-term workforce needs to attempt to predict, shape, and model the need for public health students with training in climate change, the disruptive reality created by climate change likely cannot be modeled through such methods. Education should therefore help graduates develop new capacities, allowing them to deal with disruptions and lead a transformational change. The issues of sustainability are so far-reaching that it can be argued that educational institutions must reframe their full mission, using sustainability as their foundation.
There are several limitations to the analysis. Indeed.com may not capture all jobs; some jobs are never posted; and the US-focused part of the site was the only section of the site analyzed. A re-examination of these findings over a longer period of time would be helpful. The publichealthjobs.org database has a self-selection bias towards employers specifically recruiting for public health, though this is part of the reason this database was selected for analysis; and the number of job postings mentioning climate change or global warming was sparse, but is useful in indicating trends over time. The employer survey was distributed to a convenience sample of employers, with certain industries/sectors overrepresented and with a likely bias towards those in the United States (especially those based near New York City). While the response rate of 14% appears to be low, it is comparable with other employer surveys in the public health field, where studies have included rates as low as 13.4% [20
] and 19.5% [23
]. It is important to note, as those in public health have observed from responses to crises such as Ebola and Zika outbreaks [56
], funding—and thus the need to use this funding to quickly hire highly trained public health professionals—can change quickly, if and when current events or policy priorities shift. Thus, prior trends (such as a 16 year retrospective analysis of job postings) cannot be assumed to be an accurate indicator of future job market growth. Finally, there is a need for further research in this area; competencies required for tackling climate change also require students and employers to identify and adapt to uncertainty and change, and universities have a special role to play in creating transformative change and disruption using their own critical analyses.
Climate change is a growing threat to human health. While the current job market for candidates with training in both climate change and public health is relatively small, it appears to be growing; and it is likely that training in climate change competencies will increasingly benefit a range of public health organizations as climate change impacts continue to grow. Schools of public health can incorporate the skills and competencies related to climate change into their curricula and consider making them an integral/foundational part of the curriculum, if such training is not yet currently required. Employers, too, may benefit by taking note of the special intersection of skills and competencies offered by public health graduates with training in climate change-related issues. Graduates with such training can bring their paradigm-shifting lens to the work they do within any public health-related organization. Future research, including analyzing job postings, graduate employment outcomes, labor market projections, and employer surveys, could benefit curriculum development for educational institutions in countries around the world, and educational institutions could also remain at the forefront of the paradigm-shifting change that impacts the future public health workforce. By listening to the voices of current employers and assessing labor market trends, while also taking a wider view regarding the role of educational institutions in creating a sustainable world, these institutions can develop the skills and mindset needed to protect the public’s health from emerging challenges such as climate change.