Public Health Employees' Perceptions about the Impact of Emerging Public Health Trends on Their Day-to-Day Work: Effects of Organizational Climate and Culture

Understanding and Supporting the Health Education Specialist Role in Clinical Settings

There is a persistent misunderstanding in the interdisciplinary field of public health, particularly regarding the roles and titles associated with health education specialists. The confusion necessitates a focus on collaboration, professional development, and standardizing terms within the realm of public health, health education, and health education specialists. To contribute to clarifying these roles, a qualitative exploratory case study was conducted, specifically examining the challenges and skills of health education specialists in clinical care or hospital settings. During three virtual focus group discussions, 13 participants who were selected through convenience sampling from the National Commission for Health Education Credentialing expressed their perspectives. Thematic analysis revealed key themes associated with challenges that included respect, buy-in, and prioritization. Concerning skills, the data indicated an overlap when assessing the most and least utilized skills of health education specialists. The application of skills correlated to size of the health care system or clinical care setting as well as the title and function of the health education specialist. Those working in larger health care systems primarily utilized fewer skills as their tasks and efforts were more concentrated. The implications for practice suggest that health care organizations can fully utilize and integrate health education specialists with concerted efforts on buy-in from executive leadership, professional growth, and clear communication to promote awareness of the role. These efforts will empower health education specialists to elevate their expertise, bring awareness to the profession, and enhance the quality of patient education.

Turnover, COVID-19, and Reasons for Leaving and Staying Within Governmental Public Health

BACKGROUND AND OBJECTIVES

Public health workforce recruitment and retention continue to challenge public health agencies. This study aims to describe the trends in intention to leave and retire and analyze factors associated with intentions to leave and intentions to stay.

DESIGN

Using national-level data from the 2017 and 2021 Public Health Workforce Interests and Needs Surveys, bivariate analyses of intent to leave were conducted using a Rao-Scott adjusted chi-square and multivariate analysis using logistic regression models.

RESULTS

In 2021, 20% of employees planned to retire and 30% were considering leaving. In contrast, 23% of employees planned to retire and 28% considered leaving in 2017. The factors associated with intentions to leave included job dissatisfaction, with adjusted odds ratio (AOR) of 3.8 (95% CI, 3.52-4.22) for individuals who were very dissatisfied or dissatisfied. Odds of intending to leave were significantly high for employees with pay dissatisfaction (AOR = 1.83; 95% CI, 1.59-2.11), those younger than 36 years (AOR = 1.58; 95% CI, 1.44-1.73) or 65+ years of age (AOR = 2.80; 95% CI, 2.36-3.33), those with a graduate degree (AOR = 1.14; 95% CI, 1.03-1.26), those hired for COVID-19 response (AOR = 1.74; 95% CI, 1.49-2.03), and for the BIPOC (Black, Indigenous, and people of color) (vs White) staff (AOR = 1.07; 95% CI, 1.01-1.15). The leading reasons for employees' intention to stay included benefits such as retirement, job stability, flexibility (eg, flex hours/telework), and satisfaction with one's supervisor.

CONCLUSIONS

Given the cost of employee recruitment, training, and retention of competent employees, government public health agencies need to address factors such as job satisfaction, job skill development, and other predictors of employee retention and turnover.

IMPLICATIONS

Public health agencies may consider activities for improving retention by prioritizing improvements in the work environment, job and pay satisfaction, and understanding the needs of subgroups of employees such as those in younger and older age groups, those with cultural differences, and those with skills that are highly sought-after by other industries.

Seven Years, 3 Surveys, a Changed World: The State Public Health Workforce 2014-2021

CONTEXT

The COVID-19 pandemic and other public health challenges have increased the need for longitudinal data quantifying the changes in the state public health workforce.

OBJECTIVE

To characterize the state of governmental public health workforce among state health agency (SHA) staff across the United States and provide longitudinal comparisons to 2 prior fieldings of the survey.

DESIGN

State health agency leaders were invited to have their workforce to participate in PH WINS 2021. As in prior fieldings, participating agencies provided staff lists used to send e-mail invitations to employees to participate in this electronic survey.

SETTING AND PARTICIPANTS

State health agency staff.

MAIN OUTCOME MEASURES

PH WINS 2021 maintains the 4 primary domains from 2014 and 2017 (ie, workplace engagement, training needs assessment, emerging public health concepts, and demographics) and includes new questions related to the mental and emotional well-being; the impact of the COVID-19 pandemic on staff retention; and the workforce's awareness of and confidence in emerging public health concepts.

RESULTS

The percentage of SHA staff who self-identify as Black, Indigenous, and people of color increased from 30% (95% confidence interval [CI]: 29%-32%) to 35% (95% CI: 35%-37%) between 2014 and 2021. Staff younger than 31 years accounted for 11% (95% CI: 10%-12%) of the SHA workforce in 2021 compared with 8% in 2014 (95% CI: 8%-9%). From 2014 to 2021, staff who self-identify as a woman increased from 72% (95% CI: 71%-74%) to 76% (95% CI: 75%-77%). Overall, 22% (95% CI: 21%-23%) of the SHA workforce rated their mental health as poor/fair.

CONCLUSION

The 2021 PH WINS results represent unique and current perspectives on the SHA workforce and can inform future public health infrastructure investments, research, and field practice to ensure a strong public health system.