Staffing Up Our Public Health Workforce: The Critical Need for Substantial Investment and the Tools to Get Us There

This entry is part 37 of 42 in the series Focus on Accreditation and Innovation

The Public Health Workforce Calculator is a tool to help local health departments with workforce planning efforts by utilizing information provided about the local health department to estimate the number of full-time equivalents needed to ensure the provision of the FPHS.

The public health workforce has long been understaffed for the needs of our communities across the country. The COVID-19 pandemic highlighted the health disparities experienced by our underserved and under-resourced communities, exacerbated by a chronically underfunded and minimally staffed public health system. An historic influx of funds and resources during the pandemic allowed health departments to staff up to respond quickly to the pandemic. However, as we transition from this COVID-related surge, how will we ensure an adequate, well-trained public health workforce remains?

A strong public health infrastructure and workforce are essential to our communities’ health, well-being, and safety. Yet, as funds run out to maintain staffing levels, and burnout and direct attacks on public health workers force people out of the field, our communities suffer from a lack of access to critical public health services when there are not enough staff to deliver them.

In October 2021, the Public Health Accreditation Board’s (PHAB’s) Public Health National Center for Innovations (PHNCI) and the de Beaumont Foundation released a national estimate of staffing needed to perform the Foundational Public Health Services (FPHS). The analysis found that more than 80,000 additional full-time equivalents (FTEs) are needed in state and local health departments to implement the FPHS, in addition to replacements for staff leaving or retiring. That is an 80% increase in the public health workforce just to provide basic community services.

In response to this estimate, PHAB’s PHNCI, the de Beaumont Foundation, the University of Minnesota School of Public Health Center for Public Health Systems, and the Centers for Disease Control and Prevention, Center for State, Tribal, Local and Territorial Support partnered to develop a Public Health Workforce Calculator. The Calculator is a tool to help local health departments with workforce planning efforts by utilizing information provided about the local health department to estimate the number of full-time equivalents (FTEs) needed to ensure the provision of the FPHS. 

The Calculator provides a starting point for health department workforce planning efforts and helps departments understand how much staff is needed to provide the FPHS. The new FPHS Capacity & Cost Assessment takes it a step further to explore the department’s current capacity to deliver the FPHS and assess what additional resources may be needed to provide them fully. Health departments can use information from the Assessment to:

  • determine how best to allocate resources to meet the needs of their jurisdictions and communities;
  • consider options to shift resources within the organization;
  • identify opportunities to share resources and/or services across agencies; and
  • advocate for needed funding.

The new research report, Staffing Up and Sustaining the Public Health Workforce, explains the Staffing Up initiative and explores ways to not only fill the public health workforce shortage, but fund it.

A substantial and sustained investment in our public health workforce is necessary to deliver just the bare minimum of public health services. We must build the right public health workforce by focusing on ways to update outdated policies and procedures, strengthen the workforce pipeline and training and retention strategies, and ensure the workforce comprises people with lived and learned experiences and expertise that reflect the communities they serve. Not only do we need the right workforce, but they need the right tools and adequate resources to implement and surpass the FPHS for our communities to thrive. PHAB has several tools and resources, including the Public Health Workforce Calculator and the FPHS Capacity & Cost Assessment, to support health departments in building their workforce and infrastructure, maximizing resources, and transforming public health.

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