This work describes the public health workforce and training needs of rural local public health agencies (LPHAs) in comparison with suburban and metropolitan LPHA jurisdictions. A survey was sent to 1,100 LPHAs nationwide. The rural urban commuting area codes (RUCAs) defined LPHAs as rural or urban, and the Standard Occupational Classification system enumerated the workforce. Most occupational classifications had significantly fewer staff in rural LPHAs. Public health nurses ranked as the most needed staff and serve in various important capacities in rural LPHAs. In terms of training, job-specific or programmatic continuing education was identified as the most important training need. Developing leadership and public health workforce capacity within rural public health is an essential agenda item for rural America. Decision makers may need to consider different organizational structures while balancing the need for local input and control. Regionalization and collaborative approaches to difficult workforce issues may present potential solutions to workforce challenges.
Anjum Hajat, MPH, was formerly a Senior Research Associate at the National Association of County and City Health Officials, Washington, D.C. She is currently with the New York City Department of Health and Mental Hygiene.
Karen Stewart, MPH, CHES, is a Presidential Management Intern, Office of Rural Health Policy, Health Resources and Services Administration, Department of Health and Human Services, Rockville, Maryland.
Kathy L. Hayes, DMD, MPH, is a Captain, U.S. Public Health Service, Office of Rural Health Policy, Health Resources and Services Administration, Department of Health and Human Services, Rockville, Maryland.
Corresponding author: Anjum Hajat, MPH, 125 Worth St, Room 315, CN 6, New York, NY 10013.
This article was written with the support of the Office of Rural Health Policy, Health Resources and Services Administration.
Disclaimer: The views in this article represent those of the authors and may not fully represent the views of the Department of Health and Human Services, the Health Resources and Services Administration or the National Association of County and City Health Officials.