APHA: More Federal Spending Needed to Avoid Public Health Staffing Crisis

If current staffing trends continue, the United States in the next few years could be facing "critical shortages" of public health workers who respond to major disasters such as 9/11, Hurricane Katrina and disease pandemics, according to the American Public Health Association (APHA).

The number of public health workers dropped from 220 workers per 100,000 Americans in 1980 to 158 workers per 100,000 Americans in 2000, according to APHA. In the next few years, state and federal public health agencies could lose up to half of their work force to retirement, the private sector and other opportunities, according to APHA.

Unless those trends are reversed, "the nation will experience a major staffing shortage" that could leave Americans more vulnerable in the face of a major disaster, APHA said in a statement.

"Our emerging public health work force crisis comes at a time when Americans are facing a host of risks to their health and safety, from bioterrorism to pandemic influenza and environmental disasters," said Georges Benjamin, M.D., FACP, executive director of APHA. "We must build our supply of trained professionals who will staff the frontlines in responding to public health threats and emergencies."

States should evaluate their work force needs and establish programs to identify development and training opportunities, Benjamin said.

"Medical devices and disease tracking instruments are ineffectual without adequately educated and trained workers," he added.

Asserting that the nation's public health system already is overburdened by increasing demands and responsibilities heaped on employees, Benjamin said "we must plan now for the next emergency."

"At the same time, we risk losing ground on responding to ongoing health problems, such as obesity, heart disease and cancer," Benjamin said. "Federal funding for recruiting and retaining public health workers must increase exponentially to protect Americans."

APHA Calls for Scholarship, Loan Repayment Programs

APHA recently released an issue brief - "The Public Health Workforce Shortage: Left Unchecked, Will We Be Protected?" - "which explores the precipitous decline in public health professionals and resources and the impact on the health of Americans," in the words of APHA.

In the brief, APHA calls on the federal government to take a number of policy and legislative actions to avoid a "major public health work force crisis," including:

  • Establish federally funded public health work force scholarship and loan repayment programs. Such programs should be modeled after those outlined in the Public Health Preparedness Workforce Development Act, introduced by Sens. Chuck Hagel, R-Neb., and Richard Durbin, D-Ill., according to APHA;
  • Make a renewed investment in programs under the auspices of the Health Resources and Services Administration (HRSA) that fulfill the objectives of Titles VII and VIII of the Public Health Service Act. Such programs would rebuild, strengthen and diversify such professions as epidemiology, environmental health, maternal and child health and nursing, according to APHA;
  • Increase core financial support for the public health infrastructure;
  • Enhance leadership development programs for the public health work force; and
  • Expand internship and fellowship programs in the public health professions, in such agencies as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).

Public Health Work Force is Aging

Citing a study by the Association of State and Territorial Health Officials and the Council of State Governments, the APHA brief points out that the average age of state public health workers is about 47 years, which is 7 years older than the average age of the nation's work force.

Current vacancy rates are as high as 20 percent in some state public health agencies and turnover rates have reached 14 percent in some parts of the country, according to the same study.

The most severe work force shortages are found in such vital fields as epidemiology, nursing, laboratory science and environmental health professions that are essential to successfully track the spread of flu and mumps, provide immunizations and community education, protect our air and water supply and detect health problems in newborns, the APHA brief points out.

The full text of the public health work force policy brief is available on APHA's Web site.

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