How to Build an Innovative Public Health Career

So you want to build an innovative public health career? Welcome and congratulations!

Although the career ladder within innovative corners of public health is far from well-defined, the advantage is that there are countless opportunities to acquire skills through direct experience. There are also lower barriers to entry because innovation generally doesn’t require greater education or credentials.

But first, a couple of prerequisites...

Step 0. Recognize that modern public health has extended well beyond the boundaries of academia and government. These newer perspectives are not typically taught in school.

Of the core courses that comprised your public health educational foundation, I would venture that innovation, technology and entrepreneurship were not part of that curriculum. Innovation is a word that somehow means everything and nothing. In the context of public health, innovation is a bit of a dirty word, a concept that is culturally at odds with evidence-based practices and approaches as taught in formal education.

Like any other discipline, there's a gap between theory and practice that requires you to build bridges, translate insights, and adapt to fit both ambiguous and dynamically changing contexts. You need to be willing to cross sectors to build a well-rounded, holistic view of how public health is and can be operationalized.

Every path in public health innovation is different. I’ll walk through my own story and identify lessons for how you can approach building your own innovative public health career. But before diving into that story, I have a bit of pre-work.

Era 1: Traditional Foundations

If you’re like most practitioners who have received a public health education, you start your career at a government agency or an organization funded by government grants such as a contractor or an academic institution. I began my career at the Academy for Educational Development focused on programs for childhood obesity prevention, worksite wellness, and diversity in HIV vaccine clinical trial recruitment.

This gave me a foundation for understanding the inner workings of federal grants. I also had rather outsized responsibilities given my level of seniority as a new college grad.

I led technical assistance for a network of community-based sites delivering childhood obesity prevention programming, connecting them to funding opportunities, facilitating knowledge transfer and relationships between sites, and other operational support. Under my tenure, the program grew from 100 sites to over 300 in just over a year.

Lesson 1: working in and supporting distributed teams

Lesson 2: scaling operational support through systems and process development

Inflection point 1: I realized I wasn’t learning anymore and needed a new challenge that better fit my interests in global health.

After some research as well as a “fuck it, I’m young and have relatively little to lose” attitude, I decided to move to Mozambique.

Why Mozambique? I studied Portuguese in college and wanted to strengthen my language skills. I was confident in my ability to support organizations with relatively little guidance because I had already done so in my job.

Through a hefty amount of networking through alumni networks plus good old-fashioned cold emails, I moved to Mozambique and worked on two different capacity building programs that supported youth living with HIV/AIDS. Because of changes in both visa and labor regulations, I left Mozambique and worked at an HIV/AIDS clinic in Argentina. In between the two countries, I worked on my first of two mobile health initiatives, conducting market research for a nonprofit working to build physician referral networks in Liberia and Ghana.

Lesson 3: periodically examine your career trajectory to see if it’s in line with growth and your interests

Lesson 4: be willing to take uncomfortable steps to stretch your beliefs about your abilities

I moved back to the United States in September 2008 as the economy took a swan dive into the Great Recession. By this point, I knew that most people working in global health had an MPH.

Before leaving the United States, I did what any good middle class black college grad is supposed to do: I took the GRE and GMAT as an insurance policy to be ready for grad school.

I say this snarkily but in all fairness, information about when and why to go to grad school was not particularly realistic at that time. Rather than making measured choices guided by opportunity cost, return on investment, or alignment with my career goals, I looked at grad school because I have parents who said of course grad school because education is an insurance policy for baby boomer people of color. This is not a global criticism of that position but if I had know then what I know now, I would have known that grad school was not a fit for me, at least at that time.

I served as an AmeriCorps Vista in Houston, acting as the head of programs for a small nonprofit that supported educational programs for kids in families of restyles refugees. Again, I found myself in a role with relatively outsized responsibilities relative to my seniority as I conducted a thorough needs assessment and proposed a plan to re-engineer programs from top to bottom to reduce costs, increase impact, and build a system to gather data that would support future grants.

Era 2: Grad school

At the same time, I applied to grad school for my MPH. I was curious about the dual degree MPH/MBA and made my list of schools with those that had both. Ultimately I chose Columbia because of its 6 month global health practicum. I planned on applying to business school during my first semester but decided not to after doing more research.

Lesson 5: have the courage to trust your interests.

In hindsight, I made the wrong choice of grad school. Columbia’s MBA program was very finance heavy which was not what I wanted from an MBA. Had I prioritized my interests in the MBA as well, I would have chosen a school that was a fit for both degrees rather than just one.

By this time, I settled into many of my intro classes only to discover how much of a mismatch my personality was for school. I had become used to independence and more agile action in my work. Grad school meant sitting in three hour lectures passively receiving information that was regurgitated in reading responses and biostatistics problem sets. Again, there is nothing intrinsically wrong with this but it was not a fit for where I was in my career.

Inflection point 2: make it work

Tim Gunn gives good life advice. Now that I was in grad school that I didn’t want to do and not earning the MBA I wanted to have, I found ways to make the time work for me.

I worked on my second mobile health project: building a mini MBA for managers of community health workers as well as operational protocols for the mobile health enabled public health surveillance system in 14 countries in Africa.

I did my practicum in Brazil at a university in Rio. My work was an evaluation of child and adolescent mental services. Our central question: How do we increase access to care? How do we extend and expand continuity of care? My final work prepared a set of recommendations for the Ministry of Health to use to inform policy.

Lesson 6: credentials are not everything. Skills acquisition is.

I may not have been in an MBA program but I geared my classes and experiences as much around MBA competencies as I could manage with a strong focus on operations.

When I returned for my last semester, I decided to take this same approach to my first job after grad school by targeting consulting jobs. I knew I would learn and reinforce analytical skills and client management skills which would be invaluable regardless of the characteristics of any future job I would have.

I worked as an analyst for a small biotech consulting firm, conducting market research and competitive analysis and building models that informed commercialization. In layman’s terms, I lived in the land of Excel and PowerPoint. Just to be clear, this was not a job I was passionate about. I did the work because it filled gaps in skills that I wanted to have for a job that I didn’t know existed yet. Sometimes looking at your career as a toolbox that you need to equip rather than a destination is helpful when you don’t have the insight or clarity to articulate what you want.

Inflection Point + Era 3: Break with tradition

I revisited my hustler days during my nights and weekends. I went to digital health events and eventually took on a small contractor role supporting digital health startups with crowdfunding. After several months, along came the opportunity that I didn’t know I was waiting for.

Lesson 7: social capital is king

I moved to San Francisco for a role at Rock Health. I led XX in Health, a diversity iniatiave supporting women in digital health leadership as both founders and operators. Working in this space as a public health professional was like drinking from the firehose. Founders didn’t understand my degree and I didn’t understand why gamification was supposed to solve all of our healthcare woes.

Confusion aside, I regularly connected with emerging and established leaders in a rapidly growing space. I never realized how much you could learn simply by expanding who you know. More importantly, how much you could accomplish with those same relationships. With that vantage point of the industry and the major players in it, I leapfrogged years of serendipitous meetings at conferences and cold emails and rapidly learned the ins and outs of this space.

Lesson 8: bend, don’t break.

Coming to digital health as an outsider is disorienting. I think everyone goes through their own trough of disillusionment where you first bend to Silicon Valley culture and then learn to push back against some of the egregious excess. Supporting female founders by introducing them to diverse talent and connecting them to investment opportunities was one major way that I could push back.

Eventually I realized I needed to push back on other things, namely the hustle mentality that demands 15 hour workdays and still says that you’re not working hard enough. While my work was undoubtedly impactful, it didn’t have the significant impact on vulnerable populations that I had when I worked in global health.

At ZeroDivide, I led pilot programs and research efforts that focused on leveraging tech to improve the health of vulnerable populations. I could see the direct line from my work to the positive human scale impact.

Lesson 9: Show and tell.

I also took this opportunity to revisit the gaps in my toolkit and decided to work on communication. I reached out to Women 2.0 to write articles focused on diversity and inclusion in tech. I also sought out conference speaking opportunities to share the good results of our pilots and Marshall support for follow on funding and lead advocacy for policies that supported adoption of digital technologies for vulnerable, largely Medicaid eligible populations.

Words can’t express how communication can accelerate your career by creating opportunities for people to see you in action and connect you to opportunities. It is not enough to keep your head down and hope that people will see you. Talking about your work is not bragging. It’s about serving other people by helping them see how they could benefit.

Era 4: Entrepreneurship

By this point in my career, I had a pretty robust toolkit: communication and analytical skills, solid track record in driving growth for communities and community-based initiatives, and broad network. I struck out on my own as a consultant with my own practice, Riveted Partners.

For over three years, I worked with startups, nonprofits, and corporations to leverage technology to enable people to make better decisions for better health outcomes. It was the best of times and it was the worst of times. If you’re an entrepreneur or know any entrepreneurs, then you understand the roller coaster of building a business. There is both an illusion of freedom as well as a mirage of constraint. The only currency that really matters is persistence.

Becoming an entrepreneur will teach you more about your capabilities and potential than any other job ever would. But that does not mean it is for everyone. You need a baseline tolerance for ambiguity and discomfort as you will have to make decisions with incomplete information. You also need a certain level of self-compassion and kindness because you will screw up in both small and large ways. Sometimes you may fall apart as a result but you have to learn how to put yourself back together if you want to be successful. Also know that you can fail even if it’s not your fault. There is a certain amount of luck and timing that can be a complete gamechanger.

One principle that has enabled my innovative or unusual career: always be learning. I read everything I can get my hands on. I ask people question about their interests. I try out new approaches to learn if there are new ways of doing work. This has allowed me to be creative and nimble throughout my career in ways that are impossible to do as a specialist.

I’ll admit that I’ve felt insecurity as a generalist in a world of specialists. It’s taken time as well as seeing the inner workings of several businesses to understand the value of drawing insights from a wide variety of sources, a growth mindset that prioritizes learning and continuous adaption, and the ability to synthesize complex solutions and break down operational tactics for a large range of audiences to understand and act upon.

Always be learning led to the launch of P2Health Ventures when I saw the disconnect between available funding, diverse entrepreneurs, and the scale up of digital health solutions that addressed the social determinants of health. I’ve always taken a broad view to problem solving, so using capital as a tool for impact was not a bizarre tangent from work that I had done before. Investing lends itself to generalists. With countless needs and several moving parts, the ability to prioritize and envision the impact of all the combinations of actions is invaluable.

I came to venture capital as an outsider. I had no formal business education nor did I have a finance background. While I had stated my own business, it was not venture-backed so I didn’t feel like I could claim proper founder cred. It was my ability to learn and adapt as well as the social capital I built that allowed me to shift my career in a way that most public health professionals would not have thought possible. A major part of career innovation is daring to imagine something beyond what you know. The rest is about continuing to experiment through the failures and mismatches until you find the right fit.

Era 5: Futures and Beyond

Lesson 10: Find your people

As I said at the beginning, every public health innovation career path is different. It's often winding and unclear beyond two steps ahead. Because of this it can feel lonely.

I've gotten good at building a community when I can't find one in the wild. Turns out my parents are wrong that you can't make friends on the internet; joining Twitter in 2008 has resulted in invaluable professional connections. Hosting P2Health events connected me to a network of amazing entrepreneurs and innovations working to leverage tech for better public health.

Luckily, if you're a public health innovator, there's already a community built for you. Andre Blackman has created Onboard Health, a diverse community of innovators and a platform to connect, equip and launch (into amazing opportunities) a diverse, dynamic workforce dedicated to sustainable innovation in health.

True to my dedication to experimentation, I realized that venture was not a good fit for the impact I wanted to have at this point in my career. I wanted to be in a space where I could learn from colleagues, add more tools to my toolkit, and have a larger more global scale for impact.

Luckily, I found all of those assets and more when I started working in strategic foresight. It combines my client management expertise from consulting, the broad perspective and generalist growth mindset, and creative communication skills that I acquired through writing and speaking. It also came with a larger platform as my research helps to inform and influence organizations ranging from multinationals to local associations understand future possibilities so they can make better decisions today. I truly love my work.

I could not have imagined this role as a public health professional, much less worked toward it as a specific goal. It took:

1. Deciding to not make the safe choice of employer
2. Learning to talk to people and learn what they do
3. Doing good, interesting work
4. Making a change when I stopped being able to be impactful

I know this was a long explanation and not something as simple as a LinkedIn tip. The truth of the matter is that there are no career paths, only career pivots. Be clear about purpose and flexible with your methods and you will get to where you need to be.