Workforce Initiativeppt - CALIFORNIA HEALTHCARE FORECAST 2007

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					THE PUBLIC HEALTH WORKFORCE CRISIS:
 THE NEED FOR A MORE PUBLIC-HEALTH-
       EDUCATED WORKFORCE


     Presentation by the ASPH Taskforce on the
              Public Health Workforce
              Dean Rosenstock, Chair

                  June 29, 2007
Definitions of the Public Health Workforce

   The public health workforce:
     -   includes all those responsible for providing the services identified in the Public Health in
         America statement regardless of the organization in which they work. This expansive
         definition does not include those who occasionally contribute to the effort in the course of
         fulfilling other responsibilities;

     -   focuses broadly on assurance, assessment and policy development, with activities
         including health surveillance, protection, promotion, planning, regulation, and health
         services organization, delivery, and evaluation;

     -   works in governmental public health agencies, community-based service organizations,
         academic and research institutions, private organizations, and hospitals, health plans and
         medical groups;

     -   is comprised of clinicians, occupational and environmental health specialists,
         epidemiologists, biostatisticians, health program administrators and educators, health
         economists, planners and policy analysts.

   Public Health Workforce Employment Settings (2000):
     -   19%   Federal government
     -   33%   State government (some may be local-level workers)
     -   34%   Local government (some may be state-level workers)
     -   14%   Other settings (including academia)
    Changing Roles and Responsibilities of
         Public Health Professionals
   Originally focused on prevention of transmission of
    communicable diseases, occupational health,
    environmental health
   Later, added reproductive health, chronic disease
    prevention, and injury prevention
   Currently, more additions: genetics, preventing
    bioterrorism and violence, handling and disposal of
    hazardous waste
   Shift from providing personal health services to
    population based services
   Increase in privatization of public services
   Implementation of performance standards for public
    health departments
          The Fundamental Shortage
   The public health workforce is doing more today (and likely in the
    future), with less people than in 1980, and with a smaller
    workforce-to-population ratio. In 2000, there were over 50,000
    fewer public health employees than in 1980
     - or, seen another way, 62 per 100,000 fewer

   To have the same ratio in 2000 as in 1980 (220 per 100,000),
    there would need to have been 619,128 public health workers, or
    170,874 more PH workers than the most recent count of 448,254
    in 2000.

   In 2020, to have the same ratio (220 to 100,000), the public health
    workforce would need to number 738,771, or 290,517 more than
    the most recent count.
            Educational Capacity

   Current estimates indicate that accredited
    programs graduate approximately 800 students
    per year and schools of public health graduate
    nearly 6,700.

   To reach 290,000 additional trained public
    health workers, production of graduates
    would have to increase three-fold over the
    next 13 years
    - 7,500 graduates per year = 97,500, x 3 = 292,500
    Addressing the Projected Public Health
             Workforce Crisis:
      Retirement of the Baby Boomers

   Impending Decrease in the Workforce: Retirement
     - 19% of local public health workers eligible for retirement in 5
       years (from 2005)
     - 24% of state public health workers eligible for retirement
       (2004)
     - 44% of the CDC’s workforce will be eligible to retire within 5
       years (from 2003)

   If we assume that the public health workforce
    numbered 450,000 in the years when the each of the
    retirement waves will occur (2003, 2008, 2010), then
    by 2010 a total of 102,330 public health workers will
    retire – 23% of the current workforce.
      Rectifying the Training Gap:
Providing Formal Training for the Current
        Public Health Workforce
   In 2001, the CDC estimated that up to 80% of
    the public health workforce does not have
    formal public health education or training.

   If the public health schools and programs were
    to address this deficit in the public sector
    alone, they would need to develop training
    programs for up to 309,600 current public
    health workers (minus those that retire and
    are replace by formally-educated workers).
Training a Portion of the International Public
             Health Workforce
    In 1995, SPH graduated 778 foreign nationals. Along
     with the increase in the number of SPH, the number of
     foreign national graduates increased to 1,075 in 2005,
     an increase of 297 graduates, or 38% percent.

    The size and capacity of the public health workforce
     outside of the United States and Europe is worse off,
     and multifaceted efforts are needed to increase the
     capacity of these countries’ workforces, for both their
     own health and safety and, given the increasingly easy
     cross-country transmission of disease, for our own.
           Public Health Physicians

   The IOM committee, Training Physicians for Public
    Health Careers, recently released it’s prepublication.
    “Based on numbers and sizes of agencies at all levels
    of government, the staffing patterns both reported and
    known to members of the committee and indications
    from the agencies at the level of vacancies, the
    committee’s estimate is that there are currently 10,000
    public health physicians.”

   The current ratio of public health physicians to US
    population is 3.5 per 100,000. The committee
    estimates that 20,000 physicians are currently
    needed in public health careers (7.1 per 100,000).
     Areas Where Sufficient Data Are Not
                 Available
   Addressing cultural competence and
    racial/ethnic parity

   Addressing need for public health workers in
    rural/underserved areas

   Others???
Feedback for Deans and the Committee

   Deans and the Committee would like feedback
    on:
    - General approach
    - Significant gaps or omissions in the general
      approach
    - What can be done to strengthen the basic argument

				
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