Recruiting New Talent for Public Health Jobs With Evidence-Based Job Descriptions and Attractive Job Postings

A holistic and sustainable approach to public health staffing and workforce development

Public health in the United States faces a continuous cycle of "neglect, panic, repeat." As seen with 9/11, H1N1, and COVID-19, public health emergencies create a flurry of attention and resources, but once the crisis passes, focus quickly shifts to other matters until the next emergency, when the cycle repeats. This leaves the nation's public health system chronically under-resourced and ill-equipped to respond, resulting in a strained workforce that must remain nimble. Maintaining responsiveness to community needs requires a sustainable system with adequate worker supports. This perspective discusses findings from an assessment of short-term COVID-19 investments on long-term U.S. public health workforce needs, highlighting the need for a holistic approach to staffing and workforce development. Temporary staffing addressed immediate response needs, but presented challenges such as difficulties transitioning temporary staff into permanent roles and cohesively integrating temporary staff into ongoing agency operations, which often inadvertently increased administrative burdens on existing staff, exacerbating burnout and dampening morale. Ensuring a sustainable workforce necessitates innovative recruitment and retention strategies. Recommended strategies include holistic recruitment efforts in collaboration with community and academic partners, enhanced leadership training, staff compensation reviews, flexible work arrangements, and worker wellbeing initiatives. These findings guided the creation of the Putting Our People First Discussion Guide to empower agencies to engage workers in collective dialogue to improve workforce mental health, wellbeing, and retention. Bolstering a culture of worker wellbeing and retention alongside sustained funding and infrastructure is critical for the nation's public health agencies to effectively address current and future challenges.

Employer Demand and Desired Skills for Public Health Graduates: Evidence From Job Postings

Objectives. To determine whether job postings from employers seeking master of public health (MPH) graduates require skills aligning with Council on Education in Public Health (CEPH) competencies. Methods. I analyzed a data set of 70 343 job postings in the United States for MPH graduates from Lightcast, a data vendor that collects, cleans, and analyzes millions of job postings per year. I contrasted skills from the postings with CEPH competencies. Results. Most postings were from for-profit industry, academia and research, or hospitals and health care, with only 12% from government. The skills from job postings aligned well with CEPH competencies, but some CEPH competencies did not appear in the top skills in job postings. Conclusions. Although accredited public health degree programs provide key competencies demanded by employers, they can improve graduate employability by ensuring that their graduates also obtain specific technical skills listed in job postings. (Am J Public Health. 2024;114(12):1388-1393. https://doi.org/10.2105/AJPH.2024.307834).

The Critical Role of Health Educators: Findings from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS)

OBJECTIVE

This analysis of governmental health educators from the 2021 Public Health Workforce Interest and Needs Survey (PH WINS) examines demographic and workplace characteristics, COVID-19 pandemic activities and beliefs, job satisfaction, training needs, mental health, and engagement in health equity.

SETTING AND PARTICIPANTS

Participants were public health staff in public health agencies who completed the 2021 PH WINS.

DESIGN AND MAIN OUTCOME MEASURES

Chi-square and means tests were used to compare job satisfaction, mental health status, training needs, and health equity concepts between health educators and other disciplines in the governmental public health workforce.

RESULTS

Like PH WINS 2017 findings, health educators were significantly younger, more likely to be female, more diverse, and more likely to work in regional/local health departments than the national governmental public health workforce. About 70% of health educators played a role in responding to the pandemic. Only 46.1% of health educators rated their mental health as excellent or very good as compared to 48.2% of other disciplines. About 31% considered leaving the organization due to stress, unsatisfactory opportunities, and lack of mentoring. Health educators expressed the need for training in financial and change management. Both health educators and other governmental workers expressed high levels of awareness of and confidence in addressing social determinants of health and health equity, but less confidence in addressing environmental justice. Certified health education specialists (CHES(R)) were significantly more likely to be aware of concepts of health equity, social determinants of health (SDOH), and structural racism than non-CHES(R).

CONCLUSION

Overall, the training needs and job satisfaction of health educators changed little between the two surveys. However, COVID-19 had a significantly greater impact on their mental health status compared to other public health disciplines. They also are addressing racism in their communities and are more aware of health equity concepts than other public health disciplines. Implications for strengthening public health infrastructure, as well as recruitment/retention, professional preparation, and practice are provided.

When Money Is Not Enough: Reimagining Public Health Requires Systematic Solutions To Hiring Barriers

Public health departments in the US have experienced workforce shortages and challenges in recruiting new employees for decades. Reimagining the public health system will require sufficiently staffed health departments. This Commentary summarizes what is known about the issues that state and local health departments face during the hiring process, with a focus on civil service and merit-based hiring barriers. Although health departments have recently received funding to recruit new employees, they still struggle to hire them. Recommendations for change include tracking hiring process metrics; implementing formal quality improvement to strategically resolve delays; developing formal pathways for converting fellows, interns, and contractors into staff positions; and initiating workarounds in the short term and legal changes to hiring rules as necessary and feasible.

Salary Disparities in Public Health Occupations: Analysis of Federal Data, 2021‒2022

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).

The Need for Responsive Workforce Development During the Pandemic and Beyond: A Case Study of the Regional Public Health Training Centers

CONTEXT

The COVID-19 pandemic underscored the importance of a strong public health infrastructure for protecting and supporting the health of communities. This includes ensuring an adaptive workforce capable of leading through rapidly changing circumstances, communicating effectively, and applying systems thinking to leverage cross-sector partnerships that help promote health equity. The 10 Regional Public Health Training Centers (PHTCs) advance the capacity of the current and future public health workforce through skill development and technical assistance in these and other strategic areas.

PROGRAM

This study examines activities through which the Regional PHTCs and their partners supported the public health workforce during the pandemic. Representatives of the 10 Regional PHTCs completed a survey in the spring of 2022. The survey included (1) pulling trends in training usage from 2018-2021 annual performance reports and (2) questions assessing the type, content, and reach of training needs assessments, training and technical assistance, student placements, and PHTC Network collaborative activities that occurred from January 1, 2020, to December 31, 2021. Respondents also reflected on trends in use, challenges, lessons learned, stories of impact, and future PHTC practice.

EVALUATION

During the pandemic, the Regional PHTCs engaged in numerous efforts to assess needs, provide training and technical assistance to the practice community, facilitate projects that built student competency to support public health agency efforts, and collaborate as the PHTC Network on national-level initiatives. Across these activities, the Regional PHTCs adjusted their approaches and learned from each other in order to meet regional needs.

DISCUSSION

The Regional PHTCs provided student and professional development in foundational public health knowledge and skills within their regions and nationally while being flexible and responsive to the changing needs of the field during the pandemic. Our study highlights opportunities for collaboration and adaptive approaches to public health workforce development in a postpandemic environment.

Standard Occupational Classification Codes: Gaps in Federal Data on the Public Health Workforce

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).