Yoko Kono, Li Chang, Research & Advisory Services, WES

Public health—an interdisciplinary field incorporating biostatistics, epidemiology, health services administration, health education/behavioral science, and environmental science—is one of the fastest growing and dynamic education sectors today, driven by a shortage of well-trained public health workers. The Association of Schools of Public Health (ASPH) projects that the U.S. will face a shortfall of 250,000 health workers by 2020. This manpower crisis is even more acute in developing countries. Consequently, and in response to market demands, enrollments in public health programs have grown tremendously over the past decade, both domestically and from overseas.

International students in U.S. public health programs are mostly pursuing graduate-level studies. Although not comprehensive, available data from the ASPPH placed international graduate enrollment at over 4,500 in 2012, up from 2,700 in 2000 in schools of public health (SPH).¹

Despite an overall rise in international students majoring in public health¸ the expansion of international students has been slower than the growth in domestic enrollment, and enrollments have been uneven across institutions. This article suggests that there are opportunities for schools and programs of public health to recruit and grow their international student bodies. However, research specifically on international public health students is lacking, and existing data fail to allow a deeper analysis of enrollment trends.

Against this backdrop, we aim to provide schools and programs of public health with knowledge to develop thoughtful enrollment-management strategies rooted in a deeper understanding of student mobility trends and international student segments. This article highlights current mobility patterns of international students pursuing public health degrees and offers a near-term enrollment forecast, based on a recent WES survey of public health admissions professionals. More importantly, we take a closer look at the profile of international master’s students majoring in public health, their motivation for pursuing their studies in the U.S., and their information-seeking journey when researching U.S. schools.

International Public Health Enrollment Trends in the U.S.

Currently, there are 51 SPH and over 100 programs of public health accredited by the Council on Education for Public Health (CEPH). Due to limited data, we examine trends among master’s and doctoral students at member schools of ASPPH.

In 2012, 4,500 international graduate students enrolled in U.S. schools of public health. Mirroring the proportion of international students as a percentage of overall graduate enrollments (15.1%), 15.7 percent of graduate students at schools of public health are from outside the U.S. According to the central application service for public health schools, SOPHAS², the top 10 countries of origin for international applicants are: India, China, Nigeria, Canada, Taiwan, Korea, Ghana, Pakistan, Saudi Arabia, and Nepal.

Despite a 67 percent increase in graduate-level international public health students between 2000 and 2012, two significant points of consideration have become evident:

• The share of international students in SPH has declined: ASPPH data show that international enrollment was as high as 18 percent in 2001 and decreased to 16 percent in 2012, suggesting opportunities for SPH to absorb more international students beyond current levels.

• International enrollment is concentrated in the top schools: In 2012, 10 schools enrolled over half (52%) of all international public health students, indicating challenges for other SPH in recruiting overseas.

Modest Outlook for International Enrollment Growth

In light of these concerns, WES conducted a snapshot survey of 31 schools and programs of public health this January to gauge the outlook on international enrollment for the Fall 2014 semester.³ Though not representative, we find that the following two insights suggest a modest outlook for enrollment growth:

• Tame increases in international enrollment for Fall 2014: While 60 percent of institutional respondents estimate a ‘slight decline’ or ‘no change’ in their international enrollment, only one-third expect ‘slight increases,’ and just two institutions expect ‘significant increases.’

• Internationalization priorities are constrained by financial resources: The number one priority among institutional respondents in meeting their international enrollment goals is ‘to increase overall international enrollment’ (62% of respondents), followed by a perceived need ‘to improve institutional capacity to support international students and scholars’ (59%). However, many schools find these goals difficult to achieve due to a lack of ‘budgetary resources to support marketing and recruitment activities’ (59%) and ‘personnel resources’ (45%).

The survey responses suggest that the in-bound mobility of international students to U.S. schools and programs of public health will grow modestly this fall. Stagnation in international enrollments could translate to increased competition among schools for qualified students. Therefore, schools and programs of public health that want to increase the size of their international student body should consider taking a more proactive and targeted approach.

7 Essential Points About U.S.-bound International Students Pursuing Master’s Degrees in Public Health

Schools and programs on limited budgets that wish to recruit more qualified international students must understand who their prospective students are and what defines and motivates their decision-making process when applying to programs in the U.S.

Applying the WES segmentation framework, which categorizes the informational needs and behavioral differences of international students into four segments, we found seven essential points to consider when recruiting international students interested in public health at the master’s level.⁴

International students seeking master’s degrees in public health, hereafter referred to simply as public health master’s students, are:

1. Heavily skewed towards the Striver segment (36%) compared to all master’s students, averaging 31 percent, but less so compared to doctoral students pursing public health (53%).

This segment is representative of the prototypical U.S.-bound international student who is academically gifted, driven, and counts on aid from higher education institutions. This group is followed by Highfliers and Strugglers who comprise 30 and 21 percent, respectively. Explorers are the minority, making up just 12 percent of public health master’s students.

2. Largely characterized by comparatively lower financial resources (57%) and are more dependent on financial aid and grants than other international master’s students.

Family and friends are the main financial supporters, but public health students are less dependent on this source than the average international master’s student (54% vs. 66%). Moreover, they are much more likely than their international master’s peers to rely on institutional financial aid (33% vs. 23%). Public health master’s students are almost twice as likely as overall international master’s students to utilize grants (25% vs. 13%), with a quarter citing it as one of two main sources of funding.

However, differences exist among public health students, by relative academic preparedness and financial resources, in terms of the type of information that they need most.

Those with higher academic preparedness are slightly more likely to seek program content and course offerings (50% vs. 44%) and school reputation (50% vs. 40%) than public health students with lower academic preparedness. And those with lower financial resources are much more likely to search for financial information, such as tuition and cost of living (41% vs. 27%), and aid and scholarship opportunities (36% vs. 11%).

3. High-caliber students.

Among public health respondents who self-reported their GPA, nearly 91 percent indicated a grade of B or above. Also, two in three (65%) public health master’s students reported no plan to take any intensive English program, showing a slight positive margin to the average among international master’s students (63%).

4. Motivated by career advancement.

Public health master’s students pursue study abroad in the U.S. because they want to expand their career and life opportunities (83%), and they generally believe that there are more top quality higher education options outside their country (80%). These patterns may be a reflection of the growing demand for public health degrees worldwide coupled with the limited number of high quality programs in developing countries.

5. Interested in program and research details, and less so in non-academic factors.

The three most frequent areas of information sought by public health master’s students are program content (48%), school reputation (47%), and application requirements (35%), generally mirroring overall international master’s student patterns. Public health master’s students are less interested in location (24%), student services (13%) and cultural/religious accommodations (4%).

6. Heavily dependent on web-based conduits.

Public health master’s students primarily use school websites (89%) and web searches (74%) during their decision-making process. They are less likely to rely on other sources, such as online discussion forums and social media, compared to international students overall with the exception of virtual fairs—which they are nearly twice as likely to use (10% vs. 6%).

7. Most influenced by family and friends, but more likely than others to be reinforced by alumni and faculty.

Public health master’s students are no different from their international master’s peers in that they ranked family, friends, and current students at a U.S. HEI as the top three influencers, in order of importance, during their study abroad decision-making process.⁵ However, alumni (4.14 vs. 3.89 on a scale of 7) and faculty (3.87 vs. 3.85) from a U.S. college/university are more influential for public health master’s students than for international master’s students overall. Prospective public health master’s students are more likely to trust recommendations from their peers precisely because public health is relatively new and a growing field.

Recommendations and Conclusion

Our analysis shows that the needs and preferences of international students in public health programs differ by their segments. Effective enrollment strategies will understand these differences instead of pursuing a one-size-fits all approach.

We recommend that schools and programs of public health consider the following arm-chair recruitment strategies:

• Re-assess tuition costs/discounts and need and merit-based financial aid opportunities to attract public health students, of whom a healthy proportion are Strivers (academically well-prepared, but with limited financial resources).

• Emphasize strengths and differentiators of the following content in your marketing material: academic programs and offerings (internships, thesis, etc.); application requirements; faculty research and expertise; and tuition and cost of living, especially if scholarship, teaching assistantships, and other financial aid opportunities are available.

• Reinforce your brand marketing on web-based platforms as public health students predominantly use university websites and web search when researching potential schools. Utilize virtual fairs, including your institutional webinar and those through SOPHAS, as a supplementary channel to expand your reach.

• Drive word-of-mouth endorsements from alumni and current students as the influence of word-of-mouth is powerful for this new and emerging field. In particular, publicize alumni’s educational experiences and how their public health degrees have expanded their career and life opportunities. Get faculty involved to showcase the research and academic rigor of the school or program of public health, in virtual fairs and videos on the departmental or program webpage.

International student numbers at U.S. schools of public health have steadily increased over the last decade, but this growth has been slower than among domestic students, and enrollments are disproportionate across institutions. Moreover, scarce budgets for marketing and recruitment hinder institutions’ efforts to internationalize.

To overcome these hurdles, U.S. schools and programs of public health should avoid a cookie-cutter approach to international recruitment, and employ a marketing and outreach plan based on in-depth research and segmentation of the very students they are targeting. In particular, higher education institutions that develop and carry out tactics based on a holistic understanding of international students’ profiles, aspirations, needs, and behaviors and their differences by field of study will maximize exposure and yield results.

1. Analysis is based on Association of Schools of Public Health (ASPH). Annual Data Report 2010. http://buff.ly/1geXlZm. ASPH. Student Data Report 2012. http://buff.ly/O5tACY.
Enrollment data from ASPPH are conservative and must be interpreted with caution. ASPPH conducts an annual survey of their member schools. This survey excludes schools of public health that are not members of ASPPH and programs of public health. International student data from ASPPH include those holding non-immigrant and permanent resident status.

2. SOPHAS stands for Schools of Public Health Application Service.

3. In January of 2014, WES sent a survey to deans, directors, and program heads listed on the website of CEPH-accredited U.S. schools and programs of public health. Thirty-one professionals who oversee international enrollment management, primarily deans and directors of schools and programs of public health, responded to the survey.

4. This article focuses on master’s students for two reasons: 1) schools and programs of public health have more capacity to take in master’s than doctoral students, and 2) doctoral students’ profile and needs differ significantly from their peers at the master’s level and thus are referred to for comparative purposes only.
From October 2013 to February 2014, 3,198 international master’s-degree seeking students who used WES’ credential evaluation service in the process of applying to U.S. institutions completed our survey. Of this number, 217 were applying to public health degree programs. Our public health respondents come from 48 countries, of which the top three were: India (21%), China (15%), and Nigeria (13%)—mirroring the top international sources of SOPHAS 2013 applicants. A little over half of the respondents are female (54%), and the median age is 26. Almost all public health respondents (89%) plan to start their program in Fall 2014.

5. We utilized a weighted ranking method to analyze influencers in the study abroad decision-making process. We assigned ‘7’ to the most influential person and ‘1’ to the least. Thus, the higher the score on a scale from to 1 to 7, the greater their influence.