Categories: ASHEcon, Careers in Health Economics, Membership, Newsletter, Newsletter Issue 2018:2

Careers in Health Economics: City Government

Careers in Health Economics: City Government

Learning to say it another way: jumping off the tenure track into local government

By Sarah Martin


When I was on the market in 2012 and deciding where to accept a tenure-track job offer, I received some very prescient advice from my boss, Robert Reich, former Secretary of Labor. He said to me: “Choose your job for the city and not the position, I don’t think you’re going to last very long in Academia. You love politics too much”

I was offended. In my opinion, a tenure-track position meant you had arrived. It meant that all of that hard work—being a first-gen college student, the methods courses, the field exams, working multiple jobs and raising three young children—was worth it. Policy was, admittedly, my first love. I was an undergrad Political Science major. I had dreams of being a lawyer turned Senator; I worked in communications for local political campaigns in California and was a political reporter for a local talk radio show. The writing was on the wall from the moment I set up all my stuffed animals at 5 years old and practiced my campaign night victory speech.

Professor Reich was right—within three years of tenure-track academia, I would make a leap and follow my heart. I would leave my position for a job in local government.

In 2014, shortly after starting my academic position, I was fortunate enough to be appointed by Mayor to the Kansas City Health Commission. Through that appointment, I got to know leadership of our local Health Department and eventually was offered the job of building a new division focusing on cross-sector policy analysis and development. In October 2017 I was promoted to Deputy Director and currently oversee policy, social epidemiology, communications and marketing.

The transition to local government has not been easy. Along the way, I’ve informally counseled friends and former colleagues as they have sought to inform the world of local government. Here are my hard-earned, top-three lessons learned.

  1. Data is only as good as the people who will act on it. Stay sane by staying realistic.

In an academic career, you are often presenting to people who either want to be there (colleagues, adoring fans) or who are forced to be there (your students). You put up a regression discontinuity graph, and everyone understands it. But now, you present to policymakers who may already have a view of the world that runs counter to the “facts” you’ve provided. You can throw every randomized control trial at them and it won’t matter if you haven’t done the harder work of forming relationships. It often takes a lot of political courage for policymakers to act; it’s much safer to maintain the status quo. Have compassion for their position. Do your best to get them the information they need. Just don’t be surprised if nobody cares about your pie charts.

  1. Use real person words (but make time to get back to your roots once and a while).

Do you know how many times a week I want to say “Endogeneity Bias”? It’s a lot. On the list of other things I want to say but don’t: confounding variables; “control for”; p-value. I have had to find creative ways to say all the things my economist advisors taught me in ways that everyone can understand. Nobody is impressed by your jargon; they feel left out, they feel disconnected. This does not mean you have to give up your words forever! I make sure to attend at least one research-focused conference per year where I can slip into my old way of speaking, stay up to date on the latest trends in the field, and practice talking about my work in front of people who actually care about whether my standard errors are robust.

  1. Keep your values close. What do you believe in?

Finally, we are rewarded in our research lives for being agnostic, for being objective and dispassionate. In local government, I’ve found freedom in getting to have an opinion that is solidly anchored to core values of my organization. We believe that where you are born should not predict how long you will live. The key to becoming a local government influencer is to state your values, consider them fixed, and keep your research as robust as you would if you were still on the tenure track. Having strong values and choosing what to study and what to pursue does not mean you have to sacrifice a strong methodology.

If there’s anything the transition from academia to local government showed me, it’s that there isn’t one perfect version of life post-PhD. Taking a risk is scary, but the payoff—influencing policy change that can make differences in the lives of people and generations that will follow—is more than worth it.

Sarah Martin is the Deputy Director of the Kansas City Missouri Health Department. She has an M.P.P., M.P.H., and Ph.D., all from the University of California at Berkeley.