Public vs Private: What are the Differences When Working in Public Health?

In my last blog post, I shared six ways in which I obtained public health experience before joining the workforce. Check it out here. Despite gaining experience in the field before I joined the public health workforce, there were many ways in which I was still naïve when I entered the field. One topic was knowing the differences in working for public vs private institutions in the field of public health.

To start, let’s talk about what it means to be a public institution. In this context, I am referring to work that is publicly funded – AKA by the government. When you work in public health at a public institution, you are working for the government or some extension thereof. It you work directly for the government then a City, County, or State agency is signing your paychecks directly. Alternatively, you may work as a contractor under an agency or an organization that is fulfilling a government contract. In this instance, the contracting company is signing your checks, and in some cases providing benefits, even though you are reporting to the public institution in completing your work. In these cases, you are working for a public institution.

Working for a private public health institution, in contrast, means that you do not work for a government agency either directly or as a government contractor. Broadly speaking, the funding for your work does not come from the government. There are, however, many exceptions to this which I will get into momentarily! Working for a private institution is a bit different because there is more flexibility in deciding how money is going to be spent. Compared to working for the government where every dollar granted for a taxpayer initiative is earmarked for a specific project or initiative, the private sector has more flexibility to decide where their money is going.

For example, I work as a government contractor for a state health department. I was hired to work on COVID-19. The funds that pay my salary came from a federal grant with the stipulation that they must be spent solely on COVID-19 work. That means that my work must focus on COVID-19 with very little wiggle room to focus on other topics or projects.

Now to complicate things a bit more, this distinction is not always so clear cut. Below are different types of institutions that hire public health practitioners. I won’t go into great depth here on each of these but to learn more, please check out the Public Health Hired Masterclass where these will be discussed in greater depth.

These institutions are:

1. Nonprofits
2. Government Agencies or Government Contractors
3. Hospitals/Health Plans
4. Private Consulting
5. Foundations/Philanthropy
6. Universities/Research Centers
7. Associations/Member-based Groups

Here are a few examples to illustrate the differences between working for a public or private institution and the impact your funding source has on your work.

Let’s say that you work for a nonprofit organization that focuses on tobacco cessation in a specific population. You have private funding from donors and fundraisers, so you have the flexibility to use your funding in the way that you best see fit to meet the goals of your initiatives. Now let’s say your nonprofit receives a grant from the state government to work on the same topic of tobacco cessation but the state really wants the nonprofit to devote their resources to working in a specific geographic area and to work with high school students. With the funding from the state, you can now hire staff to focus in this area. However, you can’t say how long their contract might last or if the state will renew your grant when the funds run out.

Or, maybe you work at a university as a researcher. A university with private funding might have the flexibility to fund whatever research topics they like. If the university provides you funding to study Zika virus vaccine development, fantastic! Research away! However, if the university receives a grant from the government that funds your work, the government might have more stipulations on how the funding can be spent. And this can be impacted by political will or who is currently in office. As you can see, the source of your funding can muddy the waters as it relates to public and private institutions.

The point here is not to convince you that either public or private in the field of public health is better or worse than the other! Simply put, this blog is to highlight some of the differences, how they overlap, and the role that funding plays in their work so you can make more informed decisions when choosing where to take your career in public health.

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Contributor: Elizabeth Weaver, MPH graduated from George Washington University School of Public Health in 2021 with her Master's Degree in Public Health and currently works for the Virginia Department of Health in Communicable Disease Investigation. In her spare time, she enjoys running, traveling, and studying Spanish." Connect with her on LinkedIn.