摘要：Objectives. We assessed state and local public health workforce characteristics by occupational category from 2010 to 2013. We also examined health department characteristics to determine whether workforce size and composition varied across these domains. Methods. We analyzed Association of State and Territorial Health Officials (2010, 2012) and National Association of County and City Health Officials (2010, 2013) profile study data, including 47 state health departments and 2005 and 1953 local health departments (LHDs) in 2010 and 2013, respectively. We determined number of workers and percentage of change by occupation, population size, geographic region, and governance structure. Results. The LHD workforce remained stable between 2010 and 2013. In states, the workforce decreased by 4%, with notable decreases in public information (−33%) and public health informatics (−29%); state health departments in small (−9%), New England (−13%), and centralized (−7%) states reported the largest decrease in number of workers. Conclusions. Study findings provide evidence of a shifting public health workforce profile, primarily at the state level. Future research should seek to explain changing workforce patterns and determine whether they are planned or forced responses to changing budgets and service priorities. A highly trained, competent public health workforce is an essential component of effective public health service delivery. 1–3 However, aside from periodic attempts to enumerate the public health workforce, 4–10 modest investments have been made on a national level to systematically monitor the size, composition, demographics, training, and educational background of our nation’s public health workforce. 11–15 Job loss in state and local public health departments has been of considerable concern given the recent economic recession, with budget cuts linked to reduced services and workforce capacity 16,17 ; workforce implications associated with Patient Protection and Affordable Care Act (ACA) mandates have also been of interest. 18,19 The Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) regularly collect comprehensive enumeration data on the state and local public health workforce, respectively, through their profile surveys. 20,21 Workforce enumeration estimates are generated from these reports, although no published study has concurrently analyzed NACCHO and ASTHO data to characterize workforce trends over time. We assessed characteristics of the state and local public health workforce by occupational category from 2010 to 2013. We also examined health department characteristics, including geographic region, governance structure, and population size of the state or local jurisdiction, to determine whether workforce size and composition varied across these domains during the study period.
