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Krasna H, Venkataraman M, Patino I. Salary Disparities in Public Health Occupations: Analysis of Federal Data, 2021‒2022. Am J Public Health 2024; 114:329-339. [PMID: 38271651 PMCID: PMC10882389 DOI: 10.2105/ajph.2023.307512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 01/27/2024]
Abstract
Objectives. To assess salary differences between workers within key public health occupations in local or state government and workers in the same occupations in the private sector. Methods. We used the US Department of Labor's Occupational Employment and Wage Survey (OEWS). Referencing previous studies matching Standard Occupational Classification (SOC) codes with health department occupations, we selected 44 SOC codes. We contrasted median salaries in OEWS for workers in each occupation within state or local government with workers in the same occupations outside government. Results. Thirty of 44 occupations paid at least 5% less in government than the private sector, with 10 occupations, primarily in management, computer, and scientific or research occupations paying between 20% and 46.9% less in government. Inspection and compliance roles, technicians, and certain clinicians had disparities of 10% to 19%. Six occupations, primarily in social work or counseling, paid 24% to 38.7% more in government. Conclusions. To develop a sustainable public health workforce, health departments must consider adjusting their salaries if possible, market their strong benefits or public service mission, or use creative recruitment incentives such as student loan repayment programs for hard-to-fill roles. (Am J Public Health. 2024;114(3):329-339. https://doi.org/10.2105/AJPH.2023.307512).
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Affiliation(s)
- Heather Krasna
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY
| | - Malvika Venkataraman
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY
| | - Isabella Patino
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY
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Krasna H, Venkataraman M, Robins M, Patino I, Leider JP. Standard Occupational Classification Codes: Gaps in Federal Data on the Public Health Workforce. Am J Public Health 2024; 114:48-56. [PMID: 38091570 PMCID: PMC10726939 DOI: 10.2105/ajph.2023.307463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objectives. To determine whether US Department of Labor standard occupational classification (SOC) codes can be used for public health workforce research. Methods. We reviewed past attempts at SOC matching for public health occupations and then used the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System (NIOCCS) to match the actual job titles for 26 516 respondents to the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) with SOC codes, grouped by respondents' choice of job category in PH WINS. We assessed the accuracy of the NIOCCS matches and excluded matches under a cutpoint using the Youden Index. We assessed the percentage of SOC matches with insufficient information and diversity of SOC matches per PH WINS category using the Herfindahl-Hirschman Index. Results. Several key public health occupations do not have a SOC code, including disease intervention specialist, public health nurse, policy analyst, program manager, grants or contracts specialist, and peer counselor. Conclusions. Without valid SOC matches and detailed data on local and state government health departments, the US Department of Labor's data cannot be used for public health workforce enumeration. (Am J Public Health. 2024;114(1):48-56. https://doi.org/10.2105/AJPH.2023.307463).
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Affiliation(s)
- Heather Krasna
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY. Moriah Robins is with the de Beaumont Foundation, Bethesda, MD. Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis
| | - Malvika Venkataraman
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY. Moriah Robins is with the de Beaumont Foundation, Bethesda, MD. Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis
| | - Moriah Robins
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY. Moriah Robins is with the de Beaumont Foundation, Bethesda, MD. Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis
| | - Isabella Patino
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY. Moriah Robins is with the de Beaumont Foundation, Bethesda, MD. Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis
| | - Jonathon P Leider
- Heather Krasna, Malvika Venkataraman, and Isabella Patino are with Columbia University Mailman School of Public Health, New York, NY. Moriah Robins is with the de Beaumont Foundation, Bethesda, MD. Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis
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Carvalho M, McCormick LC, Lloyd LM, Miner KR, Alperin M. Enhancing Public Health Practice Through a Regional Student Field Placement Program. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2373379917697068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Experiential learning links knowledge to real practice through seasoned mentor support, professional reflection, and hands-on experience in authentic work environments. While academic public health programs seek to train the future workforce, the current workforce has a critical need for training as well. The Region IV Public Health Training Center’s Pathways to Practice Scholar program gives public health students the opportunity to apply knowledge to competency-based experiences while fulfilling the current workforce’s short- and long-term human resource needs. Placements are offered in all eight states of the region to broaden opportunities for both agencies and student scholars. On completion of the program, scholars are required to submit an executive summary, reflection statement, photos of the experience, and a draft abstract suitable for submission to a professional conference. Since 2015, 36 scholars have been placed in positions across Region IV, 11 in states other than those of their home universities. Students were placed at state, local, and tribal health departments; area health education centers (AHECs); and other agencies (e.g., primary care settings), and the most common work plan domains selected by scholars were analytic/assessment, policy development/program planning, and leadership/systems thinking skills. Scholars’ perceived confidence increased across all domains with the highest increases in financial planning/management and cultural competency. Program implementation and evaluation findings are described, including types of projects, differences in confidence in performing competency domains, and confidence and interest in working with underserved populations. Evaluation findings indicate that the Region IV Public Health Training Center scholars increased their confidence in performing practice competencies while providing support for public health agencies serving underserved populations.
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Pozo-Martin F, Nove A, Lopes SC, Campbell J, Buchan J, Dussault G, Kunjumen T, Cometto G, Siyam A. Health workforce metrics pre- and post-2015: a stimulus to public policy and planning. HUMAN RESOURCES FOR HEALTH 2017; 15:14. [PMID: 28202047 PMCID: PMC5312527 DOI: 10.1186/s12960-017-0190-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 02/09/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Evidence-based health workforce policies are essential to ensure the provision of high-quality health services and to support the attainment of universal health coverage (UHC). This paper describes the main characteristics of available health workforce data for 74 of the 75 countries identified under the 'Countdown to 2015' initiative as accounting for more than 95% of the world's maternal, newborn and child deaths. It also discusses best practices in the development of health workforce metrics post-2015. METHODS Using available health workforce data from the Global Health Workforce Statistics database from the Global Health Observatory, we generated descriptive statistics to explore the current status, recent trends in the number of skilled health professionals (SHPs: physicians, nurses, midwives) per 10 000 population, and future requirements to achieve adequate levels of health care in the 74 countries. A rapid literature review was conducted to obtain an overview of the types of methods and the types of data sources used in human resources for health (HRH) studies. RESULTS There are large intercountry and interregional differences in the density of SHPs to progress towards UHC in Countdown countries: a median of 10.2 per 10 000 population with range 1.6 to 142 per 10 000. Substantial efforts have been made in some countries to increase the availability of SHPs as shown by a positive average exponential growth rate (AEGR) in SHPs in 51% of Countdown countries for which there are data. Many of these countries will require large investments to achieve levels of workforce availability commensurate with UHC and the health-related sustainable development goals (SDGs). The availability, quality and comparability of global health workforce metrics remain limited. Most published workforce studies are descriptive, but more sophisticated needs-based workforce planning methods are being developed. CONCLUSIONS There is a need for high-quality, comprehensive, interoperable sources of HRH data to support all policies towards UHC and the health-related SDGs. The recent WHO-led initiative of supporting countries in the development of National Health Workforce Accounts is a very promising move towards purposive health workforce metrics post-2015. Such data will allow more countries to apply the latest methods for health workforce planning.
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Affiliation(s)
- Francisco Pozo-Martin
- Instituto de Cooperación Social Integrare, calle Balmes 30, 3-1, 08007, Barcelona, Spain
| | - Andrea Nove
- Instituto de Cooperación Social Integrare, calle Balmes 30, 3-1, 08007, Barcelona, Spain.
| | - Sofia Castro Lopes
- Instituto de Cooperación Social Integrare, calle Balmes 30, 3-1, 08007, Barcelona, Spain
| | - James Campbell
- Health Systems and Innovations, WHO Headquarters, Geneva, Switzerland
- Global Health Workforce Network, WHO Headquarters, Geneva, Switzerland
| | - James Buchan
- School of Nursing Midwifery and Health, University of Technology Sydney, Sydney, Australia
| | - Gilles Dussault
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Teena Kunjumen
- Health Systems and Innovations, WHO Headquarters, Geneva, Switzerland
| | - Giorgio Cometto
- Global Health Workforce Network, WHO Headquarters, Geneva, Switzerland
| | - Amani Siyam
- Health Systems and Innovations, WHO Headquarters, Geneva, Switzerland
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Application of a Taxonomy to Characterize the Public Health Workforce. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 21 Suppl 6:S36-45. [PMID: 26422492 DOI: 10.1097/phh.0000000000000295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A public health workforce taxonomy was published in 2014 to provide a standardized mechanism for describing public health worker characteristics. The Public Health Workforce Interests and Needs Survey (PH WINS) used 7 of the taxonomy's 12 axes as a basis for its survey response choices, 3 of which are the focus of this analysis. The purpose of this study was to determine the relative utility, reliability, and accuracy of the public health workforce taxonomy in categorizing local and state public health workers using a survey tool. This specifically included the goal of reducing the number of responses classified as "other" occupation, certification, or program area by recoding responses into taxonomy categories and determining potential missing categories for recommendation to the advisory committee that developed the taxonomy. DESIGN Survey questions associated with the occupation, certification, and program area taxonomy axes yielded qualitative data from respondents who selected "other." The "other" responses were coded by 2 separate research teams at the University of Michigan Center of Excellence in Public Health Workforce Studies and NORC at the University of Chicago. MAIN OUTCOME MEASURES Researchers assigned taxonomy categories to all analyzable qualitative responses and assessed the percentage of PH WINS responses that could be successfully mapped to taxonomy categories. RESULTS Between respondent self-selection and research team recoding, the public health workforce taxonomy successfully categorized 95% of occupation responses, 75% of credential responses, and 83% of program area responses. Occupational categories that may be considered for inclusion in the taxonomy in the future include disease intervention specialists and occupations associated with regulation, certification, and licensing. CONCLUSIONS The public health workforce taxonomy performed remarkably well in categorizing worker characteristics in its first use in a national survey. The analysis provides some recommendations for future taxonomy refinement.
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Characterization of the federal workforce at the Centers for Disease Control and Prevention. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2015; 20:432-41. [PMID: 23963253 DOI: 10.1097/phh.0b013e3182a3e972] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Studies characterizing the public health workforce are needed for providing the evidence on which to base planning and policy decision making both for workforce staffing and for addressing uncertainties regarding organizing, financing, and delivering effective public health strategies. The Centers for Disease Control and Prevention (CDC) is leading the enumeration of the US public health workforce with an initial focus on CDC as the leading federal public health agency. OBJECTIVE To characterize CDC's workforce, assess retirement eligibility and potential staff losses, and contribute these data as the federal component of national enumeration efforts. METHODS Two sources containing data related to CDC employees were analyzed. CDC's workforce was characterized by using data elements recommended for public health workforce enumeration and categorized the occupations of CDC staff into 15 standard occupational classifications by using position titles. Retirement eligibility and potential staffing losses were analyzed by using 1-, 3-, and 5-year increments and compared these data across occupational classifications to determine the future impact of potential loss of workforce. RESULTS As of the first quarter of calendar year 2012, a total 11 223 persons were working at CDC; 10 316 were civil servants, and 907 were Commissioned Corps officers. Women accounted for 61%. Public health managers, laboratory workers, and administrative-clerical staff comprised the top 3 most common occupational classifications among CDC staff. Sixteen percent of the workforce was eligible to retire by December 2012, and more than 30% will be eligible to retire by December 2017. CONCLUSIONS This study represents the first characterization of CDC's workforce and provides an evidence base upon which to develop policies for ensuring an ongoing ability to fulfill the CDC mission of maintaining and strengthening the public's health. Establishing a system for continually monitoring the public health workforce will support future efforts in understanding workforce shortages, capacity, and effectiveness; projecting trends; and initiating policies.
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Jambroes M, van Honschooten R, Doosje J, Stronks K, Essink-Bot ML. How to characterize the public health workforce based on essential public health operations? environmental public health workers in the Netherlands as an example. BMC Public Health 2015; 15:750. [PMID: 26246254 PMCID: PMC4527300 DOI: 10.1186/s12889-015-2095-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 07/24/2015] [Indexed: 11/28/2022] Open
Abstract
Background Public health workforce planning and policy development require adequate data on the public health workforce and the services provided. If existing data sources do not contain the necessary information, or apply to part of the workforce only, primary data collection is required. The aim of this study was to develop a strategy to enumerate and characterize the public health workforce and the provision of essential public health operations (EPHOs), and apply this to the environmental public health workforce in the Netherlands as an example. Methods We specified WHO’s EPHOs for environmental public health and developed an online questionnaire to assess individual involvement in these. Recruitment was a two-layered process. Through organisations with potential involvement in environmental public health, we invited environmental public health workers (n = 472) to participate in a national survey. Existing benchmark data and a group of national environmental public health experts provided opportunities for partial validity checks. Results The questionnaire was well accepted and available benchmark data on physicians supported the results of this study regarding the medical part of the workforce. Experts on environmental public health recognized the present results on the provision of EPHOs as a reasonable reflection of the actual situation in practice. All EPHOs were provided by an experienced, highly educated and multidisciplinary workforce. 27 % of the total full-time equivalents (FTEs) was spent on EPHO ‘assuring governance for health’. Only 4 % was spent on ‘health protection’. The total FTEs were estimated as 0.66 /100,000 inhabitants. Conclusions Characterisation of the public health workforce is feasible by identification of relevant organisations and individual workers on the basis of EPHOs, and obtaining information from those individuals by questionnaire. Critical factors include the operationalization of the EPHOS into the field of study, the selection and recruitment of eligible organisations and the response rate within organisations.. When existing professional registries are incomplete or do not exist, this strategy may provide a start to enumerate the quantity and quality of the public health within or across countries.
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Affiliation(s)
- M Jambroes
- Department of Public Health, J2-216, Academic Medical Center/University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - R van Honschooten
- Department of Public Health, J2-216, Academic Medical Center/University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - J Doosje
- National Association of Public Health Services (GGDGHOR-Nederland),, Zwarte Woud 2, 3524 SJ, Utrecht, The Netherlands.
| | - K Stronks
- Department of Public Health, J2-216, Academic Medical Center/University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - M L Essink-Bot
- Department of Public Health, J2-216, Academic Medical Center/University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
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Beck AJ, Boulton ML. Trends and characteristics of the state and local public health workforce, 2010-2013. Am J Public Health 2015; 105 Suppl 2:S303-10. [PMID: 25689210 DOI: 10.2105/ajph.2014.302353] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed state and local public health workforce characteristics by occupational category from 2010 to 2013. We also examined health department characteristics to determine whether workforce size and composition varied across these domains. METHODS We analyzed Association of State and Territorial Health Officials (2010, 2012) and National Association of County and City Health Officials (2010, 2013) profile study data, including 47 state health departments and 2005 and 1953 local health departments (LHDs) in 2010 and 2013, respectively. We determined number of workers and percentage of change by occupation, population size, geographic region, and governance structure. RESULTS The LHD workforce remained stable between 2010 and 2013. In states, the workforce decreased by 4%, with notable decreases in public information (-33%) and public health informatics (-29%); state health departments in small (-9%), New England (-13%), and centralized (-7%) states reported the largest decrease in number of workers. CONCLUSIONS Study findings provide evidence of a shifting public health workforce profile, primarily at the state level. Future research should seek to explain changing workforce patterns and determine whether they are planned or forced responses to changing budgets and service priorities.
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Affiliation(s)
- Angela J Beck
- Angela J. Beck is with the Center of Excellence in Public Health Workforce Studies, Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor. Matthew L. Boulton is with the School of Public Health and the Division of Infectious Disease, School of Medicine, University of Michigan, Ann Arbor
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Beck AJ, Boulton ML, Coronado F. Enumeration of the governmental public health workforce, 2014. Am J Prev Med 2014; 47:S306-13. [PMID: 25439250 PMCID: PMC6944190 DOI: 10.1016/j.amepre.2014.07.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 07/07/2014] [Accepted: 07/16/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Regular assessment of the size and composition of the U.S. public health workforce has been a challenge for decades. Previous enumeration efforts estimated 450,000 public health workers in governmental and voluntary agencies in 2000, and 326,602 governmental public health workers in 2012, although differences in enumeration methodology and the definitions of public health worker between the two make comparisons problematic. PURPOSE To estimate the size of the governmental public health workforce in 14 occupational classifications recommended for categorizing public health workers. METHODS Six data sources were used to develop enumeration estimates: five for state and local public health workers and one for the federal public health workforce. Statistical adjustments were made to address missing data, overcounting, and duplicate counting of workers across surveys. Data were collected for 2010-2013; analyses were conducted in 2014. RESULTS The multiple data sources yielded an estimate of 290,988 (range=231,464-341,053) public health workers in governmental agencies, 50%, 30%, and 20% of whom provide services in local, state, and federal public health settings, respectively. Administrative or clerical personnel (19%) represent the largest group of workers, followed by public health nurses (16%); environmental health workers (8%); public health managers (6%); and laboratory workers (5%). CONCLUSIONS Using multiple data sources for public health workforce enumeration potentially improves accuracy of estimates but also adds methodologic complexity. Improvement of data sources and development of a standardized study methodology is needed for continuous monitoring of public health workforce size and composition.
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Affiliation(s)
- Angela J Beck
- Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan; Center of Excellence in Public Health Workforce Studies, University of Michigan, Ann Arbor, Michigan.
| | - Matthew L Boulton
- Center of Excellence in Public Health Workforce Studies, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Fátima Coronado
- Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia
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Boulton ML, Beck AJ, Coronado F, Merrill JA, Friedman CP, Stamas GD, Tyus N, Sellers K, Moore J, Tilson HH, Leep CJ. Public health workforce taxonomy. Am J Prev Med 2014; 47:S314-23. [PMID: 25439251 PMCID: PMC7004229 DOI: 10.1016/j.amepre.2014.07.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 07/07/2014] [Accepted: 07/21/2014] [Indexed: 11/28/2022]
Abstract
Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.
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Affiliation(s)
- Matthew L Boulton
- Department of Epidemiology University of Michigan, Ann Arbor, Michigan; Center of Excellence in Public Health Workforce Studies University of Michigan, Ann Arbor, Michigan; Department of Health Management and Policy University of Michigan, Ann Arbor, Michigan.
| | - Angela J Beck
- Center of Excellence in Public Health Workforce Studies University of Michigan, Ann Arbor, Michigan; Department of Health Management and Policy University of Michigan, Ann Arbor, Michigan
| | - Fátima Coronado
- Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia
| | - Jacqueline A Merrill
- Laboratory for Informatics, Complexity and Organizational Study, Center for Health Policy, School of Nursing, Columbia University, New York
| | - Charles P Friedman
- Department of Health Management and Policy University of Michigan, Ann Arbor, Michigan
| | - George D Stamas
- U.S. Bureau of Labor Statistics (formerly), Washington, District of Columbia
| | - Nadra Tyus
- National Center for Health Workforce Analysis, Health Resources and Services Administration, Rockville, Maryland
| | - Katie Sellers
- Association of State and Territorial Health Officials, Arlington, Virginia
| | - Jean Moore
- Center for Health Workforce Studies, University of Albany-State University of New York, Albany, New York
| | - Hugh H Tilson
- the Public Health Leadership Program, University of North Carolina Gillings School of Global Public Health (Tilson), Chapel Hill, North Carolina
| | - Carolyn J Leep
- National Association of County and City Health Officials, Washington, District of Columbia
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Assessment of workforce capacity for Local Health Departments in Nebraska: a perspective from public health programmatic areas. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2012; 18:595-601. [PMID: 23023285 DOI: 10.1097/phh.0b013e3182602f1d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study assessed the workforce capacity of Nebraska Local Health Departments (LHDs) from the perspective of public health programmatic areas. DESIGN AND OUTCOMES MEASURES: We conducted a mail survey of 21 LHD directors in Nebraska and collected the information on LHD workforce capacity, training, and competency by public health programmatic areas (eg, environmental health, mental health). An FTE shortage index score for each public health programmatic area was calculated to estimate an LHD's current shortage in that area. Spearman correlation analysis was conducted to examine the relationships between LHD capacity, manpower shortage, and staff training and competency. RESULTS Our results indicated that a significant proportion of the 18 responding LHDs in Nebraska did not have staff to cover the areas of mental health (66.7%), sexually transmitted diseases (44.4%), occupational safety and injury (38.9%), oral health (27.8%), and health disparities (22.2%). The results also suggest that Nebraska's LHDs experienced the greatest workforce shortages in environmental health (mean shortage index = 0.45), followed by chronic diseases (0.44), health disparities (0.41), and sexually transmitted diseases (0.41). CONCLUSIONS The identified shortage areas should be a high priority for federal and state policy makers to address through developing appropriate strategies and providing adequate funding for LHD workforce development in Nebraska. Using the public health programmatic area approach to collect workforce data may help fill some gaps in the current efforts of LHD workforce enumeration. Future research is needed to examine the validity and reliability of the workforce measures based on public health programmatic areas.
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Sumaya CV. Enumeration and composition of the public health workforce: challenges and strategies. Am J Public Health 2012; 102:469-74. [PMID: 22390509 PMCID: PMC3487663 DOI: 10.2105/ajph.2011.300388] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2011] [Indexed: 11/04/2022]
Abstract
The field of public health needs a comprehensive classification data system that provides a better assessment of the size and composition of its workforce. Such a data system is necessary for understanding the capacity, trend projections, and policy development critical to the future workforce. Previous enumeration and composition studies on the public health workforce have been helpful, but the methodology used needs further improvements in standardization, specificity, data storage, and data availability. Resolving this issue should follow a consensus-based course of action that includes public and private stakeholders at the national, state, and local level. This prime issue should be addressed now, particularly in the current environment of comprehensive health care reform.
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Affiliation(s)
- Ciro V Sumaya
- School of Rural Public Health, Texas A&M Health Science Center, College Station, TX 77843-1266, USA.
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Boulton ML, Hadler J, Beck AJ, Ferland L, Lichtveld M. Assessment of epidemiology capacity in state health departments, 2004-2009. Public Health Rep 2011; 126:84-93. [PMID: 21337933 DOI: 10.1177/003335491112600112] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the number of epidemiologists and epidemiology capacity nationally, the Council of State and Territorial Epidemiologists surveyed state health departments in 2004, 2006, and 2009. This article summarizes findings of the 2009 assessment and analyzes five-year (2004-2009) trends in the epidemiology workforce. METHODS Online surveys collected information from all 50 states and the District of Columbia about the number of epidemiologists employed, their training and education, program and technologic capacity, organizational structure, and funding sources. State epidemiologists were the key informants; 1,544 epidemiologists provided individual-level information. RESULTS The number of epidemiologists in state health departments decreased approximately 12% from 2004 to 2009. Two-thirds or more states reported less than substantial (< 50% of optimum) surveillance and epidemiology capacity in five of nine program areas. Capacity has diminished since 2006 for three of four epidemiology-related Essential Services of Public Health (ESPHs). Fewer than half of all states reported using surveillance technologies such as Web-based provider reporting systems. State health departments need 68% more epidemiologists to reach optimal capacity in all program areas; smaller states (< 5 million population) have higher epidemiologist-to-population ratios than more populous states. CONCLUSIONS Epidemiology capacity in state health departments is suboptimal and has decreased, as assessed by states' ability to carry out the ESPHs, by their ability to use newer surveillance technologies, and by the number of epidemiologists employed. Federal emergency preparedness funding, which supported more than 20% of state-based epidemiologists in 2006, has decreased. The 2009 Epidemiology Capacity Assessment demonstrates the negative impact of this decrease on states' epidemiology capacity.
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Affiliation(s)
- Matthew L Boulton
- Center of Excellence for Public Health Workforce Studies, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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Abstract
The Centers for Disease Control and Prevention Office of Workforce and Career Development is committed to developing a competent, sustainable, and diverse public health workforce through evidence-based training, career and leadership development, and strategic workforce planning to improve population health outcomes. This article reviews the previous efforts in identifying priorities of public health workforce research, which are summarized as eight major research themes. We outline a strategic framework for public health workforce research that includes six functional areas (ie, definition and standards, data, methodology, evaluation, policy, and dissemination and translation). To conceptualize and prioritize development of an actionable public health research agenda, we constructed a matrix of key challenges in workforce analysis by public health workforce categories. Extensive reviews were conducted to identify valuable methods, models, and approaches to public health workforce research. We explore new tools and approaches for addressing priority areas for public health workforce and career development research and assess how tools from multiple disciplines of social sciences can guide the development of a research framework for advancing public health workforce research and policy.
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Merrill J, Keeling J, Gebbie K. Toward standardized, comparable public health systems data: a taxonomic description of essential public health work. Health Serv Res 2009; 44:1818-41. [PMID: 19686248 PMCID: PMC2758408 DOI: 10.1111/j.1475-6773.2009.01015.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To identify taxonomy of task, knowledge, and resources for documenting the work performed in local health departments (LHDs). DATA SOURCES Secondary data were collected from documents describing public health (PH) practice produced by organizations representing the PH community. STUDY DESIGN A multistep consensus-based method was used that included literature review, data extraction, expert opinion, focus group review, and pilot testing. DATA EXTRACTION METHODS Terms and concepts were manually extracted from documents, consolidated, and evaluated for scope and sufficiency by researchers. An expert panel determined suitability of terms and a hierarchy for classifying them. This work was validated by practitioners and results pilot tested in two LHDs. PRINCIPAL FINDINGS The finalized taxonomy was applied to compare a national sample of 11 LHDs. Data were obtained from 1,064 of 1,267 (84 percent) of employees. Frequencies of tasks, knowledge, and resources constitute a profile of PH work. About 70 percent of the correlations between LHD pairs on tasks and knowledge were high (>0.7), suggesting between-department commonalities. On resources only 16 percent of correlations between LHD pairs were high, suggesting a source of performance variability. CONCLUSIONS A taxonomy of PH work serves as a tool for comparative research and a framework for further development.
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Affiliation(s)
- Jacqueline Merrill
- Department of Biomedical Informatics, Columbia University, Vanderbilt Clinic, New York, NY 10034, USA.
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Assessment of Epidemiology Capacity in State Health Departments, 2001–2006. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2009; 15:328-36. [DOI: 10.1097/phh.0b013e3181a01eb3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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