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Applied Epidemiology Workforce Update: |
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Author:
Madeline Roberts, PhD, MPH There are currently 5,706 epidemiologists employed in the 50 state health departments, 38% more than the last ECA in 2021 and the highest number recorded by the ECA. However, to meet essential public health needs, 2,537 additional epidemiologists are needed. In lower capacity areas such as tribal and oral health, the absolute number of additional required epidemiologists was comparatively small, but the percentage increase was striking. For example, tribal health needs to increase capacity from 9 to 30 epidemiologists—a 242% increase in workforce capacity. States report substantial capacity for monitoring and assessing health problems but need more support for research and evaluation. A prime example of this is access to peer-reviewed literature, which in many instances is not open-access and often requires these epidemiologists to wait between 24 and 72 hours to be granted access. Seven of eight territories are unable to access peer-reviewed literature. What skills can be built within the workforce? Data analytics remains the top training need across departments, as reported by 43 states, consistent with previous years' ECA findings. Specifically, there is consensus that outbreak forecasting and disease transmission modeling are critical for future public health emergencies and decision-making. Still, most states currently need more staff capacity to support this work. Building persuasive communication skills was also noted as a development area, a vital skill as public health shifts attention to messaging and mitigating misinformation. Funding Public health is bracing for a forecasted loss of approximately 1,000 staff members (nearly 20%) with the termination of pandemic funding. Currently, federal funding comprises 83% of financing for all epidemiologic activities and 84% of funding for personnel; states contribute, on average, approximately 15% of funds. Consistently sustained funding is one of the primary concerns for public health. Top priorities for funds include modernizing data infrastructure and data skills training for staff. How can we help retain epidemiologists? A study from 2017 to 2021 found that by 2021, 49% of all state and local public health workers staff left their posts, and turnover was highest among those with the shortest tenure (5 years or less). For younger workers, pay was the primary impetus for considering job separation. Other factors contributing to job separation included job-related stress, burnout, and hostility toward public health workers. The ECA found that cultivating job interest and fulfillment, offering opportunities to work remotely, and providing job benefits were advantageous for recruitment and retention. Key strategies for mitigating burnout were similar and included allowing remote work, a flexible work schedule, and fostering supportive relationships within the workplace. Conversely, state, county, and territorial epidemiologists are historically underpaid at every point in their career trajectories: “Like previous years, epidemiologists are starting at inadequate base salaries and often not receiving regular increases to cope with inflation and the increased cost of living. In an era of increasing education costs and student debt, the salaries offered by health departments are likely to be even less competitive than in the past.” Offering competitive salaries to qualified individuals remains a daunting challenge within constrained budgets. Recommendations The ECA noted that partnerships and pipelines with academic institutions can create pathways for skilled public health workers to make an impact in public health departments where they are greatly needed. EpiMonitor has previously reported on such partnership programs at Yale, UC Berkeley, and Emory. One point of interest for The Rollins Epidemiology Fellowship at Emory is that it achieved consistent funding primarily through philanthropic foundations, and the program successfully contributed to reinvigorating Georgia’s public health workforce. Achieving sustainable funding, creating a comprehensive data science curriculum, and providing on-the-job training for current staff would all contribute to a public health workforce ready to meet the demands of emerging disease threats. The future of the applied epidemiology workforce may seem tenuous given recent diminished funding, but the work remains essential to prepare for future outbreaks. ■ |
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