Further Insight from CSTE’s 2021 Epidemiology Capacity Assessment (ECA): Accelerating Applied Epidemiology to Advance Public Health Infrastructure

CSTE is leading national efforts to recruit and retain the applied epidemiology workforce. An additional 8000 epidemiologists with specialized skills and expertise are needed at state, territorial, local and tribal health agencies to adequately conduct epidemiology activities.

In 2021, CSTE conducted its Epidemiology Capacity Assessment (ECA) to enumerate and describe the applied epidemiology workforce. Despite the additional resources available through the COVID-19 response, major gaps in the workforce remained. While respondents reported the most epidemiologists working in state and territorial health departments since enumeration began in 2001, the practical challenges and work left incomplete and/or not started informed our estimate of needing an additional 8,000 applied epidemiologists to work across state, territorial, local and tribal (STLT) health departments. Beyond growing the workforce, CSTE recognized a need for specialized skills to handle large volumes of data, reporting demands, and cross-sector collaboration. Additional expertise is needed in the areas of informatics, genomics, mental health, and syndromic surveillance among others to support transforming applied epidemiology practice using modernized public health data systems. While we can recruit new talent to address these skill gaps, we are challenged with short-term funding limitations, hiring restrictions and a lack of competitive pay to attract candidates.

CSTE reviewed the ECA data which included qualitative feedback from epidemiologists on their experiences in the field. Despite the investment in epidemiology services and staffing, additional support through training and communities of practice were needed. As a result, CSTE developed a strategy to look holistically at the epidemiology workforce needs and CSTE activities. As we look ahead at prioritizing programming at CSTE, we are focusing on the who and the how to support applied epidemiologists to advance public health transformation. We are promoting the profession by updating the Applied Epidemiology Competencies and exploring partnerships to expand experiential learning opportunities. We are facilitating recruitment activities through scholarships and mentorship. CSTE strives to facilitate the retention of institutional knowledge by administering communities of practice, networking opportunities, peer-to-peer learning collaboratives, and promoting workforce resiliency activities to address burnout and moral injury. CSTE provides training opportunities for recent graduates and the current workforce on topics of epidemiology, informatics, leadership and more. Lastly, CSTE will continue to advocate for sustained and adequate funding for epidemiology personnel and activities. Effective public health surveillance cannot be done without skilled staff, modern systems, and sufficient resources to support operations.

In November 2022, the Centers for Disease Control and Prevention awarded $3.2 billion to 107 public health departments and three national public health non-profit partners through the Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant. This grant aims to enhance the public health infrastructure in particular by supporting the workforce, strengthening foundational capabilities, and advancing data modernization. CSTE is excited to support our partners and the STLT jurisdictions in this effort with this unprecedented funding.

The next ECA is planned for 2024. Future ECA data will provide insight into how the Public Health Infrastructure investment is yielding early returns to support applied epidemiology practice. Additionally, CSTE will collaborate with partners on activities to support the recruitment and retention of the workforce and surveillance practice. Overall, we will continue to focus on the who and the how of applied epidemiology to improve the field of applied epidemiology.

Read Our Article in the Journal of Public Health Management and Practice:

Jessica Arrazola, DrPH, MPH, MCHES® is the Director of Educational Strategy at the Council of State and Territorial Epidemiologists. She provides subject matter expertise on educational design and workforce development. Dr. Arrazola is passionate about helping people to have the right tools and resources they need to succeed.

Sarah Auer, MPH, CHES® is a Program Analyst II at the Council of State and Territorial Epidemiologists. Her portfolio focuses on workforce development, including the Epidemiology Capacity Assessment (ECA) and CSTE LEAD, a leadership program for mid-career epidemiologists. Sarah received her MPH from Emory University Rollins School of Public Health.