Employee Compensation. Part 6
Health educators work in diverse institutions, such as community organizations, schools, government agencies, hospitals, wellness centers, corporations, and so on. They must communicate with a variety of populations that might have corresponding health problems. In addition to general methods, skills, and program strategies which are suitable to all of the public, community health educators should recognize the specific characteristics of target individuals and groups: their behaviors, ethics, and psychology. Therefore, recognizing their targets served is the first step for health educators to pursue their purpose. It is also one of the important more important part of job announcements. Community health education job announcements should also include the community health education specialty areas, college degree and health education major, professional responsibilities and competencies required, computer and other special skills needed, travel requirements, and a broad listing of employee compensation that included a salary range.
Employee Compensation
Salaries: The median salary was almost $14 per hour in part-time jobs, and $36,000. per year in full-time jobs. When compared to the national averages, the salaries of community health educators are significantly lower. Such an apparent disparity in salaries in the health education profession when compared to national averages warrants further investigation.
Summary
The purpose of this study was to explore the characteristics of community health education jobs in the USA from May-December 1998. Even though this study was based on 1998 data, the study provides valuable information to employers, health educators, and students about the status of community health education jobs. There is a need for a series of comprehensive national studies to be conducted to compare various health-related professions that includes health education. Such information may be useful to professional preparation programs and health educators to evaluate what needs to be done to further the profession’s standing among other professions. The significant differences highlighted in this study regarding the median salaries between community health education jobs and USA national median incomes based on educational attainment should be a cause for alarm among health education professional leaders. Such disparities in salaries are unacceptable, and negatively impacts on professional preparation program recruitment.
Health education professional associations and the National Commission for Health Education Credentialing, Inc., may need to incorporate into their strategic plans with the highest priorities: 1) to educate employers about what is a health educator, what is an appropriate job title, what are acceptable job qualifications and job descriptions, and what compensation is appropriate; and 2) to enact measures that will elevate the standing of the profession among other health professions.
Employee Compensation. Part 5
It is unclear from this study what are the differences in definitions between “diverse population” and “multicultural population”. These two terms may be synonymous? These terms should have been defined on the employer questionnaire. Diverse populations may have referred to the community health educator having to work with a wide range of individuals from different groups such as seniors, adolescents, gays, disabled, and so on. Multicultural populations may have referred to various racial and ethnic groups, most likely African American and Hispanic. The significance of multiculturalism in training public health professionals and in implementing public health programs have received increasing attention in recent years (Bayer, 1994; Green, 1982; Orlandi, 1992). Cultural competency, or the ability to interact with multicultural people, is essential to the success of health educators. When culturally competent, health educators are sensitive to the values, norms and practices of target population, and adjust their patterns of interpersonal interaction accordingly: To demonstrate respect, not to give offense, and hence, to communicate more effectively. Cultural competence needs to be part of the basic qualifications of public health professionals in the modern world, and if it is not already, it should be a standard part of the curriculum of all schools of public health including health education (Buchanan, 1997-98).
Bilingual Language Job Qualification: As mentioned previously, many health educators worked in multicultural environments. In order to communicate with people with different cultural and language backgrounds, community health educators should have multicultural skills, understand different cultures, and communicate effectively with their target population in suitable languages. In the original 250 job announcements, 14.4% of the job required or preferred the respondents to be bilingual, primarily Spanish. This may be a trend, especially with the increasing Spanish population in the USA.
Work Behaviors Job Qualification: Work behavior appeared to be an important job qualification worth noting on job announcements. 86% of employers thought it was necessary to indicate they were looking for community health educators who could work independently and were self-motivated. Other work behaviors were identified. All of the behaviors listed may indicate that employers were defining professional behaviors: work independently, self-motivated, creative, sensitive, flexible, working well in groups or team players, compassionate, patient, capacity to work well with children. Are health education students taught in college what is professional behavior? Are health education students expected to conduct themselves professionally in preparation to becoming a community health educator?
Typical Job Descriptions of Community Health Educators
Job descriptions provide information about job situations and job environments. The content of job descriptions for community health education positions should include at least the following information: target population served by the community health educator, target health issues and programs, the methods to conduct the health education program and solve the health issues in order to acquire the purpose of health education, the role of community health educator in the program, and some special work environments.
Employee Compensation. Part 4
The role of the health educators are well recognized to be more than simply delivering health information (McKenzie & Lurs, 1993). In order for those health educators who are responsible for planning, implementing, and evaluating health promotion and disease prevention programs to be successful in their work, they must have the requisite skills and knowledge. The Certified Health Education Specialist (CHES) (NCHEC, 2000) credential was designed to meet the goal of standardizing the minimum level of professional competence. However, the certification is not required in nearly all US states, although there are many benefits derived from the credentialing of school health educators (Girvan & Kearns, 1993). This study also found that only small percentage of employers (8.4%) required or preferred the community health educator applicant to possess the CHES certification. This implies that the benefits of CHES are not recognized by most employers. As discussed previously, more aggressive advocacy for the profession is needed by professional associations and the National Commission for Health Education Credentialing, Inc., to educate employers about what is a health educator, how are they professionally prepared, what are the benefits of hiring a health educator, and what is CHES.
College Major Job Qualification: The results of this study showed that most employers viewed majors other than health education to be acceptable professional preparation to perform the duties of a community health educator. Although almost 89% of employers required applicants to have a college major in health education or public/community health, they also listed other majors that would be acceptable, indicating that they did not understand the significance of hiring someone with the appropriate professional preparation. Apparently, health education is not view as a profession with a unique set of knowledge and skills if individuals with other college majors (e.g., biology, nutrition, psychology) are hired.
These findings are consistent with previous studies. Alperin & Miner (1993), for example, found that institutions often filled health education job positions with individuals who had diverse preparation rather than only applicants with a health education major. Perception by employers about the uniqueness of health education professional preparation may be one reason why other majors are considered acceptable for community health education jobs.
Work Experience Job Qualification: Work experience is one of the more frequently cited job qualifications employers seek in applicants (National Association of Colleges and Employers, 1999). In this study, work experience was divided into the four practice areas of administration, education, research, other. A common work experience across all practice areas was health education program planning and evaluation. Assessment, planning, implementation, and evaluation is at the heart of health education responsibilities and competencies. The community health educator is expected to manage health education programs, design curricula, and conduct research to determine whether the program has met its mission, goals, and objectives. All other responsibilities outlined above are related to one or more stages of the health education process. For example, community health educators were required to have had work experience with diverse and multicultural populations. Having such experiences gives the community health educator understanding of the culture for which the health education program is intended. Such understanding is essential to plan a program tailored specifically for that population.
Employee Compensation. Part 3
Geographic Distribution of Community Health Education Jobs
The geographic distribution of the community health education job announcements varied according to region of the country. The differences are likely to be related to demographic and economic statuses of each region. There were more job announcements in the northeast and west, possibly due to dense populations and strong economic growth.
Job Titles
There were 143 job titles for Community Health Educator. The results of this study identified four categories of community health education job titles according to target health issue, job qualification, professional hierarchy, administrative hierarchy, or area of professional responsibility. It may be helpful for health education professional associations such as Society for Public Health Education (SOPHE, 2000), American Association for Health Education (AAHE, 2000), and International Union for Health Promotion and Education (IUHPE, 2000) to educate employers about what job titles are acceptable and what are the responsibilities of a community health educator. Education of employers is not a new idea. The New York State Coalition for Health Education (NYSCHE, 2000) has been a leading advocate for educating employers about the health education profession for many years, and their employers brochure have served as models for other professional associations to use (NYSCHE, 2000).
There are more pragmatic reasons for standardizing health education job titles. For example, job titles may affect the way in which health educators and students find jobs using the Internet. Using the keywords “health educator” may produce only those job titles containing those words. Other job titles such as Wellness Coordinator may be missed during the search.
Work Environment Characteristics
The study has shown that the majority of community health education jobs being offered were in non-profit and governmental institutions. Over half were from non-profit institutions alone (excluding governmental institutions). For profit organizations only provided insignificant amount of job openings in the same period.
Nine community health education work settings were classified in this study. Most of the jobs being offered were in governmental health departments and nonprofit health-related organizations. There were very few job openings in the clinical setting, educational institutions, for teaching and counseling students, and for-profit companies.
Job Qualifications
The discussion of Job Qualifications will parallel the results presented in the previous chapter. These job qualification areas include: college degree, licensure/certification, college major, type of work experience, and years of work experience.
College Degree and Licensure/Certification Job Qualification: As Pickett and Pickett (1995) found in their study that public health educators needed at least a bachelor’s degree with a major in health science or community/public health education. There are many undergraduate programs in community health education that qualify the students for entry-level jobs. A master’s degree in public health is a plus and often is required for posts above the entry level. If they wish to progress into program planning, design, and implementation, they need graduate training in an accredited program (Pickett & Pickett, 1995).
The findings in this study support the conclusions by Pickett & Pickett (1995). The majority of the jobs required at least bachelor’s degree. There were very few community health education jobs that required only an AAS degree or no degree was required at all.
Employee Compensation. Part 2
At least 73% employers provided their employees with paid vacation. The length of paid vacation time varied. Most employers provided 2 weeks of paid vacation (40.9%). However, 9.6% of employers provided no paid vacation time. Among the institutions in which paid vacation was provided, 97.6% provided from 2 to 4 weeks.
In addition to paid vacations, two thirds of community health education jobs had pension plan benefits (67.8%), while only little more than half had paid training (53%), and tuition reimbursement/ remission (52.2%) benefits. Other benefits such as merit pay (30.4%) and annual bonuses (12.2%) occurred less frequently.
Discussion
This was an exploratory, descriptive study of community health education jobs in the USA from May-December 1998. Discussion of the results of this study is organized along the nine research questions under investigation.
Where Community Health Education Jobs Are Found on the Internet
While traditional job listing sources, such as newspaper classified advertisements and professional journals, are still popular for job-seeking, Internet sources are becoming more popular. Job announcements and a more expeditious job searching source in recent years. Not only does it provide most of the job opening list without geographic restriction, it is also acting as an effective means to review job descriptions, transmit your cover letter and resume, complete company application forms, submit writing samples, provide written responses to interview questions and even receive and accept job offers via e-mail.
For community health educators, there are many ways to find jobs through the Internet. The most likely methods to find community health education jobs are through health education job web sites, organizational and governmental job web sites, job search engines, and online newspaper classified listings (Tomita & Taub 1999). The most effective method to find community health education jobs is to use specialized health education job web sites, such as Health Education Professional Resources (HEPR) Job Bank. Among the primary job sources, the results of this study have shown that almost half of the job listings in community health education were from CareerPath, an on-line newspaper classified listing. One-fifth of the job listings were from America’s Job Bank. Only a few were from the other web sites. Those who master the electronic world of the Internet, and are knowledgeable about health education job web sites, will greatly enhance their success of finding the ideal job.
Seasonal Distribution of Community Health Education Jobs
The results of this study indicated that the community health education job announcements varied according to month. Most job openings were advertised in the Fall, peaking in October. It is very likely that there is another peak in the Spring (indicated by relatively high percentage in May). However, the Spring peak is somewhat speculative due to the limitation on the scope of our data collection time span.
This seasonality perhaps can be explained by the seasonality of general business activity in the states; most people may take vacation in the Summer and/or holiday seasons. It might be difficult to organize interviews while some of the key persons in an organization are not available. This seasonality also coincides with the school calendar of most educational institutions. Special business activities related to fiscal year end could be another factor contributing to the number of December job announcements.
Employee Compensation
Research Question #9, “What compensation packages for community health education jobs in the USA from May-December 1998?,” was answered by describing the salaries and benefits of the community health education jobs.
Salaries
The salaries of community health education jobs were defined according to whether the job was part-time or full-time, the level of education, and the years of experience. Since the sample was small (N=115) and the salaries had a mildly skewed distribution, median scores were reported. The median salaries were $13.98 per hour for part-time and $36,000. per year for full-time jobs.
Community health educator salaries varied according to the level of college education required for the position (N=115) (see Table 5). Full-time community health educators with only a baccalaureate degree earned $31,000. for full-time work. There was approximately an $8,000. differential between those jobs requiring only an AAS degree versus those requiring a BA/BS degree. Likewise, approximately a $9,000. differential between BA/BS and MA/MS degrees. There was a large differential of $18,000. between those jobs requiring an MA/MS versus MA/MS, PhD Preferred. Those jobs requiring a PhD for the position earned less than those requiring an MA/MS, PhD Preferred.
Salary Differenced According to Years of Work Experience
Working experience also affected the health educator’s salaries. In the full time job positions of the survey (see Table 6), the tendency was for health educators with greater working experience was to earn higher salaries. Taking the standard deviation into consideration, there were no significant differences in average salaries between working experience in “0-1 year” and “none needed”. And there were also no obvious differences between “0-1 year working experience” and “1-2 year working experience”.
Benefits
The benefits were divided into many kinds: insurance, leaves, vacation, and other benefits like pension, bonus, paid training, tuition reimbursement, merit pay, etc.
Medical, dental, life, vision, and disability insurance was available to employees. 87.8% and 79.1% employers provided both employees and their families with medical and dental insurance, respectively (see Table 7). Among them, 9.6% provided only their employees with medical insurance benefits; and 8.7% provided only their employees with dental insurance. Almost half of the employers provided both their employees and their families with life insurance (58.3%), vision insurance (50.4%), and disability insurance (43.5%).
Eighty seven percent of employers provided sick leaves and 74.8% provided paid sick leaves. Only 13.0% employees were unavailable for their sick leaves. 76.5% and 67.8% employers provided maternal and paternal leaves, respectively. Nearly half of the leaves, however, were unpaid.
Target Population of the Community Health Education Job
Below is a list of target populations identified among the community health education jobs (see Table 3). Many of the job announcements contained multiple listings of target populations (e.g., infant/maternal and families). A large number of job descriptions identified an age-specific target population (e.g., infant/maternal, children, youth, teens/adolescents, adults, seniors), while others identified target populations according to their social roles (e.g., health professionals, families, women, minority/diverse background, students). The Other target populations combined hard-to-classify populations (e.g., patients in hospital or clinics, work site, farmers, and consumers).
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Community Health Education Specialty Areas
Many of the job announcements had multiple listing of specialty areas. The five most frequently occurring community health education specialty areas were: General (47%), HIV/AIDS/TB/STD (32.2%), Tobacco Prevention (27.8%), Diabetes (18.3%), and Chronic Diseases (17.4%). For other listings, see Table 4. Jobs specialty areas not listed in the table occurred in less than 1% of the cases. These specialty areas included vision, trauma prevention, worksite security, health policy, health information, health care marketing, and career consulting.
Computer and Other Special Skills
Research Question #8, “What are the special skills being requested for community health education jobs in the USA from May-December 1998?”, was answered through a descriptive examination of the computer and other special skills required for the community health education position. What were the skills which employers in health education expected from their employees? Of the 115 respondents, most required word processing skills (N=85, or 73.9%) and e-mail and Internet skills (N=69, or 60.0%). Other important computer skills included knowledge of presentation (N=51, 44.3%), database management (N=42, 36.5%), statistics (N=40, 34.8%), and spreadsheet (N=35, 30.4%). Just typing skills were insufficient for jobs in the contemporary health education field (8.7%). Besides these, some respondents also mentioned other skills (N=7, 6.5%) including web page design, web maintenance, and computer literacy.
Aside from computing skills, other special skills were important. Communication skills (N=91, 79.1%), program planning (N=85, 73.9%), program implementation (N=84, 73.0%), program evaluation (N=81, 70.4%), teaching and training (N=77, 67.0%) and program assessment (N=58, 50.4%) were the most sought after. Other skills including administration and organization (N=42, 36.5%), supervision and coordination (N=41, 35.7%), budgeting (N=30, 26.1%), consulting (N=26, 22.6%), grant writing (N=35, 30.4%), research (N=33, 28.7%), and Other (N=7, 6.0%).
Travel Requirements
Travel was required in 59.1% of the jobs offered (N=115). In 11.3% of the jobs, community health educators were not required to travel whereas 24.3% may need to travel. Therefore, most of the jobs in community health education (83.4%) require or may require the employee to travel. There were missing data on 5.2% of the cases.
Job Description
Years of Work Experience: Most job positions required at least one year of work experience in health education (84.3%). 72.2% of employers required between one and five years of experience in the field: 0-1 year (N=7, 6.1%), 1-2 years (N=27, 23.5%), 2-3 years (N=29, 25.2%), 3-5 years (N=27, 23.5%), >5 years (N=14, 12.2%)
Bilingual Language: 85.6% of the 250 job announcements did not specify whether bilingualism was being sought as a job qualification. However, 8.4% required bilingualism, and 6% bilingual preferred. Spanish was the predominant bilingual language required or preferred.
Work Behaviors: Work behaviors required of applicants were working independently (86.1%), self-motivation (86.1%), and other (17.4%) (N=115). Other behaviors identified were creativity, sensitivity, flexibility, working well in groups, being compassionate, patience, and a capacity for working well with children. Many of the job announcements stipulated more than one work behavior.
Job Description
Research Question #7, “What are the job descriptions of community health education jobs in the USA from May-December 1998?”, was answered qualitatively examined first for typical descriptions of community health education jobs. Then, the target population(s) and specialty areas of the community health jobs were quantitatively examined. Other job description information revealed in this study included full versus part time status and personality characteristics required. Of the 115 respondents, 97 employers provided full time job positions (84.3%). Only 15.7% of the jobs were part time.
Typical Job Descriptions
Job descriptions outlining the responsibilities of the community health educator were included in the original job announcements (N=250). The job descriptions were either merged in the job announcements or listed in a separate part titled “job description”, “job duties,” “general description of the position,” and “essential responsibilities.” The contents of the job descriptions included the target population of the community health educator, the health issues or health programs the job position involved, and any methods, skills and program strategies required of the position.
The following were the typical job descriptions found in the original job announcements (N=250):
1. Plans, implements, and coordinates assigned health programs (e.g., tobacco control, family planning, AIDS education, child health, etc.).
2. Conducts community needs assessments for the purpose of health program planning.
3. Designs and delivers health education programs for specific groups such as human service providers, health care providers, and the general public.
4. Conducts outreach programs to meet goals and objectives of specific plans.
5. Provides extensive coordination and collaboration with area social service agencies serving target populations.
6. Operates a computer to enter, modify and review data; retrieve health information.
7. Designs and distributes appropriate health education materials such as pamphlets, flyers, and posters.
8. Designs appropriate heath education curriculums, conduct health presentation, education training and teaching.
9. Prepares and publishes newsletters of other educational materials for purposes of community education and promotion of community programs.
10. Prepares news releases and special features on assigned health topics.
11. Provides consultation, advice, networking and support services to county and community organizations as appropriate.
12. Assesses and counsels clients in areas such as diet, health promotion, and behavior change.
13. Provides case management for selected high-risk individuals.
14. Maintains up-to-date referral systems for a variety of programs.
15. Reviews various documentation and processes, forwards, or takes other action as appropriate.
16. Gathers information and statistical data; performs research and conducts studies; and disseminates educational information.
17. Develops and implements evaluation tools to measure and program effectiveness.
18. Prepares grant applications, comprehensive reports, and various correspondence to program operations and activities; provides recommendations to produce a more effective program.
Other responsibilities identified were:
1. Maintains departmental files and records.
2. Maintains inventory of department supplies; initiates requests for new or replacement materials.
3. Answers the telephone and provides information.
4. Responds to requests for information or assistance.
Job Qualifications
Research Question #6, “What are the professional qualifications for community health education jobs in the USA from May-December 1998?”, was answered by examining individual qualifications: college degree, licensure/ certification, college major, type of work experience, and years of work experience. Each of these job qualifications will be discussed below separately.
College Degree: Forty eight percent of the jobs required the baccalaureate degree (N=48), 25.2% a master’s degree (N=29), 19.1% required a baccalaureate degree but preferred the master degree (N=22), 6.1% a master’s degree, but doctorate preferred, and 4% required a PhD degree (N=115). A majority (95.7%) of jobs required at least a baccalaureate degree. Only 4.3% of jobs either required no college degree or an AAS degree was required. Half of the jobs required or preferred a master’s degree.
Licensure/Certification: Certified Health Education Specialist (CHES) certification was either required or preferred in only 8.4% of jobs out of 115 cases. Seven jobs (2.8%) required RN licenses, although as will be discussed below, Nursing was among the list of alternative college majors acceptable for community health education jobs announced.
College Major: There were four college major requested among the job qualifications (N=115): health education (37.4%), public/community health (20%), either health education or public/community health (31.3%), and no major required (11.3%). The results indicate 88.7% of jobs required a health education and/or public/community health major.
In addition to the college majors above, employers were also asked if there were alternative majors acceptable for the job positions. Only 6.1% of respondents did not accept alternative majors to other than health education or public/community health. There were at least 19 types of majors acceptable as a community health education job qualification other than those mentioned above.
Work Experience: The Work Experience job qualification was divided into four responsibility areas of Administration, Education, Research, and Other among the 115 job announcements (see Table 2). The most frequent Administration work experience required in descending order were Program Management & Planning (66.1%), Community Organization & Group-Oriented Work (60.9%), Coordinating Health Education Services and Wellness Programs (59.1%). Other Administration work experiences were required in less than half of the cases: Social Work, Human Services, Public Affairs (36.5%), Fiscal, Grant or Health Market Management (32.2%), Health Administration, Supervision (25.2%). The most frequent Education work experience required was Community Program Planning and Evaluation (69.6%). Classroom teaching was required in only 27.8% of the cases. The most frequent Research work experience required was Program Planning & Evaluation Research Methods (53%). Behavioral and Epidemiological Research Methods were required in less than 20% of the cases respectively. Other work experience required included Working with Diverse Populations (66.1%), Working with Multicultural Populations (60%), clinical experience (27%), and Consulting (23.5%).
Geographic Distribution of Community Health Education Jobs
Research Question #3, “What is the geographic distribution of community health education jobs in the USA from May-December 1998?”, was answered through analysis of the job location by USA region. The geographic distribution of community health education jobs revealed Northeast (30.8%) and West (30.4%) had the highest percent of available positions, followed by Middle West (12.8%), Southeast (18%), and Southwest (8%).
Job Titles
Research Question #4, “What are the typical job titles for community health education jobs in the USA from May-December 1998?”, was answered by listing all job titles and determining the most frequently occurring. There was a total of 143 job titles for community health education jobs (N=250) (see Appendix B for complete list). The job title of Health Educator had the highest percent (25.5%), followed by Health Education Specialist (2.8%), and Health Educator II and Public Health Educator (tied at 2.4%). Interestingly, the job titles Community Health Education Coordinator, Community Health Educator, and Community Health Educator II each occurred in only 1-2% of the cases. The majority of job titles (45.6%) were repeated only once.
The structures of community health education jobs titles vary, and may be categories into four categories according to: target health issue (e.g., AIDS Educator, Diabetes Project Coordinator, and Lifestyle Educator), job qualification (e.g., Bilingual Family Educator, Certified Childbirth Educator, etc.), professional hierarchy (e.g., Health Education Associate, Health Educator I, Health Educator II, Health Educator III, Health Education Specialist, Senior Health Educator), administrative hierarchy (e.g., Assistant Wellness Director, Disease Control Program Administrator, and Health Care Program Manager, Dean of Health Careers and Wellness), area of professional responsibility (e.g., Community Education Coordinator, Public Health Advisor, Wellness Education Consultant, etc.).
Work Environment Characteristics
Research Question #5, “In what types of institutions are community health education jobs offered in the USA from May-December 1998?”, were answered by examining the number of institutions that were either (N=115): 1) for-profit, non-profit, or government, and 2) specific work setting.
More than half of the community health education jobs were offered in institutions that were non-profit (N=106, 56.5%) and a little over a third of in government (N=41, 35.7%). Only a small portion of jobs were offered in institutions that were for-profit (N=9, 7.8%).
The community health education jobs were then examined for their specific work setting. There were nine specific working settings identified. Most job positions (N=65, 56.5%)) were in a government agency (N=33, 28.7%) and non-profit health-related organizations (N=32, 27.8%). Jobs in the remaining work settings occurred in less than 10% of the cases: Community health centers (9%), health management organizations (9%), medical treatment facilities (e.g., hospitals, clinics, and nursing homes) (8%), and educational institutions (e.g., schools, colleges and universities) (8%), health research institution (5.2%), health consulting organizations (4.3%), other (3.5%), and insurance company (0.9%). The work settings with the lowest percent of cases in for-profit institutions.