Date of Defense:
April 28, 2017
My first job in public health was as the Children’s Health Administrator in the Department of Maternal and Child Health (MCH) for a state department of health. I was unsure what my title meant but believed ultimately that to be an administrator was equivalent to being a manager, which I had been before. I looked forward to assessing needs, planning programs, and developing evaluations of programs. But what I saw and learned very soon after my arrival on the job was that while staff in epidemiology completed any required needs assessments, the planning of programs and their evaluation were left to the sub-recipients of our federal grants. Discourse among staff about program planning occurred almost never, and my involvement in projects amounted to monitoring budgets, which I did when I was not attending meetings almost all day, every day.
After my first month of work, I felt disappointed and confused. I had misunderstood what my job would entail. What did it mean to be an administrator? My core public health course on the topic of management used a text (Quinn, Faerman, Thompson, McGrath, & St. Clair, 2011) devoted exclusively to management; we did not address administration. Perhaps being an administrator was different from being a manager. I experienced déjà vu as I thought back to my experience as an intern in Workforce Development at the Maternal and Child Health Bureau at HRSA. The work of project officers (i.e., public health analysts) seemed to me to be routinized and boring with few opportunities for creative thinking. They monitored budgets and deliverables. Was that what it meant to be an administrator?
In this summary, I define the terms administration and management, reflect on what I learned from my blackbox experience, and conclude that knowing what administration and management mean has clarified for me the kind of work I want to pursue in a future public health position.
My first public health job was as a full-time Children’s Health Administrator in Maternal and Child Health. The primary responsibility included administering several child health projects: the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program; Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health, a SAMHSA collaborative project; and the Early Childhood Comprehensive Systems (ECCS) grant. The major part of my work entailed monitoring progress on federal grant performance measures and budgets, which included managing sub-recipient funds to ensure compliance with federal funding requirements.
My employer was a department of health in a politically conservative Midwestern U.S. state. The department of health is almost the smallest unit in the state’s organizational structure and is a standalone department. Of the state’s 28,000+ employees, only 762 or less than 3% of state employees work for the health department.
For my research, I chose to examine the terms administration and management assuming that an administrator is part of an administration and a manager, part of a management team. In this section, I describe what I learned about the meanings of administration and management.
Administration and management while used interchangeably have subtle differences in meaning. The role of public administration (of which public health administration can be considered one type) is to apply social and other sciences to solve public problems (Holzer & Gabrielian, 1998). The public interest model of public administration reflects a belief that government organizations are best led by individuals with scientific knowledge reflected by their academic credentials (Uveges & Keller,1998). Administrators formulate plans and policies based upon science. An administration determines what is to be done and when it is to be done. Sometimes, however, public administrations adopt plans and policies based upon public opinion, social and religious factors, culture, and ideology. Administrators require vision and conceptual skills in additional to expertise in a given area and are typically found in government, military, and educational organizations.
Management is primarily a doing or executing function (Quinn, Faerman, Thompson, McGrath, & St. Clair, 2011). Thus, it is about plans and actions. Management puts into practice the policies and plans decided upon by an organization’s administration. A manager decides who should do the work and how the work will be done and motivates staff to get the work done. Management decisions are shaped by the values, opinions, and beliefs of the managers. Managers require technical knowledge and skills. Management as a term is used most typically by business enterprises. Finally, management can be considered a subset of administration.
Understanding the terms administration and management helped me to understand that my position was indeed one of being an administrator. My job was to determine what the deliverables would be and when they would be delivered. I was not the doer of the work. Neither was I involved in how the work would be completed. I was hired as an expert in content areas related to the work to be done: child development, home visiting, early childhood mental health, and systems thinking.
The objective findings about my role as an administrator were confirmed through informal interviews with other public health employees working on the same projects. States rarely hire employees to execute the deliverables on grants primarily because the scope of the projects is so very large. Instead, states contract with nonprofits to do the work because they have the capacity and hopefully the expertise required to complete the work. My job as an administrator was to see that that the work assigned got done on time and within the budget allocated.
I learned that the terms administration and management, while often used interchangeably, are different. We assure a more competent workforce and less disappointment when employees understand their roles and responsibilities. When we understand who determines the plans and policies of organizations, we can better advocate on behalf of individuals and communities.
It would behoove the field of public health to educate students and staff about the roles and responsibilities of administrative and managerial staff across organization types. Students who are not in the health management track are likely to find the information useful.
As a doer, I now know that my place in public health is on the front line working with stakeholders in building programs, changing systems, and developing logic models. I better understand how I can use my knowledge and skills to support the core public health functions and essential public health services.