The Health Resources and Services Administration (HRSA) applauds the efforts of the de Beaumont Foundation and the Association of State and Territorial Health Officials (ASTHO) for their strategic leadership and tireless efforts to conceive, conduct, and communicate the results of the Public Health Workforce Interests and Needs Survey (PH WINS). Their efforts highlight the importance of partnership, transparency, and innovation to gather data that can be used to inform programs, policy, and practice to improve the health of the population. HRSA is excited to review and incorporate these data into our work to improve health and achieve health equity through access to quality services, a skilled health workforce, and innovative programs, especially for those who are geographically isolated or economically or medically vulnerable.
As one of HRSA's four strategic goals, strengthening the health workforce includes training to provide culturally and linguistically appropriate quality care for individuals, families, communities, and populations; increasing the number and diversity of practicing providers to address shortages; supporting the development of interdisciplinary teams to improve efficiency and effectiveness; developing ongoing strategies to monitor, forecast, and meet long-term health workforce needs; and establishing partnerships and systems to enhance rapid, real-time communications to address emerging and urgent public health issues such as infectious disease, integration of health care and public health, delivery system reform, implementation of new legislation, and others.
The relevance of the aforementioned workforce priority focus areas is corroborated by findings in PH WINS. HRSA values these data as a complement to the national-level analysis we support through the National Center for Health Workforce Analysis, which examines issues that impact the supply, demand, distribution, and education of the nation's health workforce and provides policy makers with the information necessary to make informed decisions regarding the health professions workforce and provision of care.
With specific regard to the public health workforce, periodic characterization is necessary for ensuring a workforce large enough and skilled enough to deliver essential public health services to the population. This periodic characterization also provides the data required for monitoring the impact of investment and advocating for additional resources; assessing gaps in workforce development; developing recruitment, retention, and competency compliance and credentialing efforts; permitting improved alignment of academic resources with workforce needs; and allowing for an improved understanding between workforce infrastructure and specific health outcomes.
Regularly assessing the size and composition of the US public health workforce has been a challenge for public health officials and public health systems and services researchers for decades because of the breadth of the field, its multidisciplinary nature, the diverse settings for employment, and the lack of any standardized system for regularly and systematically collecting data.
Despite these challenges, in 2012, HRSA and the Centers for Disease Control and Prevention (CDC) collaborated with the Public Health Foundation to enumerate the public health workforce. The resulting report, Strategies for Enumerating the US Governmental Public Health Workforce,1 was prepared by the Centers of Excellence in Public Health Workforce at the University of Michigan and the University of Kentucky. The report describes:
* Building consensus among stakeholders for developing an enumeration plan;
* Developing a case definition of the public health workforce focused on workers employed in local, state, and federal government agencies;
* Evaluating 15 distinct data sources from different workforce surveys and assessing their usability for an enumeration and future surveillance-like system;
* Concluding that data from different sources, when used in conjunction, have the potential to provide the data necessary for counting and characterizing the public health workforce;
* Providing recommendations for developing a sustainable, systematic, and replicable surveillance-like system for enumerating and characterizing the nation's public health workforce on an ongoing basis;
* Establishing and implementing a common public health workforce taxonomy;
* Identifying specific methods for implementing additional or modified data collection with the help of national public health professional organizations, including the Association of State and Territorial Health Officials and the National Association of County & City Health Officials;
* Working with the Bureau of Labor Statistics to understand the characteristics of the data generated by the Bureau of Labor Statistics and defining strategies for how we can prospectively use the data for enumeration of public health workers;
* Obtaining estimates of the federal public health workforce with an initial focus on the CDC workforce;
* Acquiring estimates of laboratorians and environmental health professionals working in state and local public health settings; and
* Producing preliminary public health enumeration estimates.
Later in 2012, the HRSA and the CDC issued the Public Health Workforce Enumeration, 2012, prepared by the Center of Excellence in Public Health Workforce Studies at the University of Michigan. This follow-up report describes methods, results, and conclusions of a study to characterize size and composition of the public health workforce using existing data sources, most of which were publicly available.2
Despite attempts to correct for integration among data sets and differences in occupational case definitions, these enumeration estimates still undercount the state workforce and overcount the federal workforce, although these estimates are believed to represent an improvement over the simple use of raw data from the data sources. Efforts such as PH WINS are a key component of further understanding the public health workforce, especially at the state and local levels. This first-ever nationwide survey and its unprecedented response provide invaluable insight into the interests and needs of the workforce so that limited resources can be most effectively directed to address issues of highest impact—such as pipeline programs, real-time/on-the-job/just-in-time learning, succession planning, infrastructure, and budgeting HRSA applauds the de Beaumont Foundation and its partners for actively leading this effort.