Background State and local public health department infrastructure in the U.S. was impacted by the 2008 economic recession. The nature and impact of these staffing changes have not been well characterized, especially for the part-time public health workforce.
Purpose To estimate the number of part-time workers in state and local health departments (LHDs) and examine the correlates of change in the part-time LHD workforce between 2008 and 2013.
Methods We used workforce data from the 2008 and 2013 National Association of County and City Health Officials (n=1,543) and Association of State and Territorial Health Officials (n=24) profiles. We employed a Monte Carlo simulation to estimate the possible and plausible proportion of the workforce that was part-time, over various assumptions. Next, we employed a multinomial regression assessing correlates of the change in staffing composition among LHDs, including jurisdiction and organizational characteristics, as well measures of community involvement.
Results Nationally representative estimates suggest that the local public health workforce decreased from 191,000 to 168,000 between 2008 and 2013. During that period, the part-time workforce decreased from 25% to 20% of those totals. At the state level, part-time workers accounted for less than 10% of the total workforce among responding states in 2013. Smaller and multi-county jurisdictions employed relatively more part-time workers.
Conclusions This is the first study to create national estimates regarding the size of the part-time public health workforce and estimate those changes over time. A relatively small proportion of the public health workforce is part-time and may be decreasing.
Bibliographical noteFunding Information:
Publication of this article was supported by the U.S. Centers for Disease Control and Prevention (CDC), an Agency of the Department of Health and Human Services, under the Cooperative Agreement with the Public Health Foundation and University of Michigan Center of Excellence in Public Health Workforce Studies (CDC RFA-OT13-1302). The ideas expressed in the articles are those of the authors and do not necessarily reflect the official position of CDC.
The authors would like to thank Donald Peterson, Rivka Liss-Levinson, and Philippa J. Benson for their assistance. Data collection for the National Association of County and City Health Officials and Association of State and Territorial Health Officials Profiles were supported by the CDC and Robert Wood Johnson Foundation.
© 2014 American Journal of Preventive Medicine.