A brand new US Authorities Accountability Workplace (GAO) report identifies a scarcity of public well being staff throughout a number of occupations and areas that restricts the flexibility to carry out important features comparable to illness investigation and mitigation, hazard detection, and emergency response.
The US Division of Well being and Human Providers (HHS) and different organizations have taken actions (eg, job coaching and placement, higher pay) to alleviate the shortages, which started with the 2008-2009 recession and worsened throughout public well being emergencies such because the COVID-19 pandemic, the authors mentioned.
Monitoring outbreaks, speaking with public
The GAO reviewed 69 public-health workforce analysis research and studies and interviewed officers from HHS and 11 stakeholder organizations comparable to these representing jurisdictions, public well being professionals, or schooling; public well being coverage and analysis; and public well being apply and inhabitants well being.
FAO officers additionally interviewed officers in 11 jurisdictions (4 states, 1 territory, 2 tribes, and 4 native governments) with completely different buildings, funding, and proportion of inhabitants dwelling in rural areas.
Public well being staff carry out key features comparable to monitoring illness outbreaks, monitoring water high quality, and speaking with the general public about well being threats, the report famous.
“Nonfederal jurisdictions throughout the U.S. (states, territories, Tribes, and localities, comparable to counties and cities) have major duty for public well being of their geographic areas, and these jurisdictions make use of many of the public well being workforce—greater than 200,000 staff,” the authors wrote. “The federal authorities, significantly the Division of Well being and Human Providers (HHS), helps these jurisdictions’ workforces and in addition employs its personal public well being workforce.”
Gaps in vital expertise, rural public well being
The GAO recognized shortages in occupations comparable to nursing, epidemiology, and operations; expertise comparable to management and informatics; areas comparable to rural areas; and instances comparable to public well being emergencies.
Public well being funding will be restricted to restricted time frames or particular actions, which makes it troublesome to make use of the funding for hiring.
Contributing elements embody employee recruitment and retention challenges, which the authors mentioned are troublesome to unravel and more likely to be long-term. “For instance, public well being funding will be restricted to restricted time frames or particular actions, which makes it troublesome to make use of the funding for hiring,” they wrote.
Employers additionally face stiff market competitors for staff from different entities that may supply larger pay and higher job safety and adaptability, a extra manageable workload, and fewer stress. Jurisdictions may additionally have cumbersome hiring processes attributable to difficult-to-change state or native civil-service necessities, the GAO mentioned.
In response to those challenges, HHS has supplied employers extra flexibility in utilizing some grant funds for hiring and help, and a few organizations have supplied monetary incentives and made hiring processes extra environment friendly. Maine, as an illustration, elevated pay for public well being nurses and expedited hiring processes, which helped the state absolutely meet its workforce wants.
“The general public well being workforce encompasses quite a few jurisdictions throughout the U.S., lots of which face numerous persistent challenges in recruiting and retaining public well being staff,” the authors concluded. “Nonetheless, the HHS and jurisdictional actions we’ve got described, amongst others, have helped allow jurisdictions to take care of the challenges, and helped start to handle gaps within the public well being workforce.”
