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Assessment of Workforce Capacity for Local Health Departments in Nebraska: A Perspective From Public Health Programmatic Areas

Chen, Li-Wu MHSA, PhD; Nguyen, Anh T. MSPH; Jacobson, Janelle MPH, CHES; Palm, David PhD

Journal of Public Health Management and Practice: November/December 2012 - Volume 18 - Issue 6 - p 595–601
doi: 10.1097/PHH.0b013e3182602f1d
Original Articles

Objective: This study assessed the workforce capacity of Nebraska Local Health Departments (LHDs) from the perspective of public health programmatic areas.

Design and Outcomes Measures: We conducted a mail survey of 21 LHD directors in Nebraska and collected the information on LHD workforce capacity, training, and competency by public health programmatic areas (eg, environmental health, mental health). An FTE shortage index score for each public health programmatic area was calculated to estimate an LHD's current shortage in that area. Spearman correlation analysis was conducted to examine the relationships between LHD capacity, manpower shortage, and staff training and competency.

Results: Our results indicated that a significant proportion of the 18 responding LHDs in Nebraska did not have staff to cover the areas of mental health (66.7%), sexually transmitted diseases (44.4%), occupational safety and injury (38.9%), oral health (27.8%), and health disparities (22.2%). The results also suggest that Nebraska's LHDs experienced the greatest workforce shortages in environmental health (mean shortage index = 0.45), followed by chronic diseases (0.44), health disparities (0.41), and sexually transmitted diseases (0.41).

Conclusions: The identified shortage areas should be a high priority for federal and state policy makers to address through developing appropriate strategies and providing adequate funding for LHD workforce development in Nebraska. Using the public health programmatic area approach to collect workforce data may help fill some gaps in the current efforts of LHD workforce enumeration. Future research is needed to examine the validity and reliability of the workforce measures based on public health programmatic areas.

The aim of this study was to assess the workforce capacity of local health departments of Nebraska from the perspective of public health programmatic areas.

Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha (Dr Chen, Ms Nguyen, and Ms Jacobson); and Office of Community Health and Performance Management, Nebraska Department of Health and Human Services, Lincoln (Dr Palm).

Correspondence: Li-Wu Chen, MHSA, PhD, Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, 964350 Nebraska Medical Center, Omaha, NE 68198 (

The funding for this project was provided by the Robert Wood Johnson Foundation through the National Coordinating Center for Public Health PBRN (practice-based research network) program.

The authors thank the directors of Nebraska's local health departments for their participation in this study. They also thank the Nebraska Public Health Practice-Based Research Network for their guidance in this study. The authors also thank Sue Nardie for her help with editing this article.

The authors declare no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.