The public health workforce (PHW) counts a great variety of professionals, and how services are delivered differs in every country. The complexity and the diversity of PHW professions also reflect structural problems of supply and demand of PHW in various organizations and health care systems. Therefore, credentialing, regulation, and formal recognition are essential for a competent and responsive PHW to address public health challenges. To ensure comparability of the credentialing and regulation systems for the PHW and to enable its collective action at the macro level in the event of a health crisis, we systematically analyzed documented evidence on the PHW. A systematic review was selected to answer the research questions: (1) what are the most effective aspects and characteristics in identified programs (standards or activities) in professional credentialing and regulation of the PHW and (2) what are common evidence-based aspects and characteristics for the performance standards to support a qualified and competent PHW? The identification of professional credentialing systems and available practices of the PHW was performed systematically using a systematic review of international resources in the specialized literature published in English. The PRISMA framework was used to verify the reporting of combined findings from three databases: Google Scholar (GS), PubMed (PM), and Web of Science (WoS). The original search covered the period from 2000 until 2022. Out of 4839 citations based on the initial search, 71 publications were included in our review. Most of the studies were conducted in the US, UK, New Zealand, Canada, and Australia; one study was conducted in an international context for professional credentialing and regulation of the PHW. The review presents specific professional regulation and credentialing approaches without favoring one of the proposed methods. Our review was limited to articles focused on professional credentialing and regulation of the PHW in the specialized literature published in English and did not include a review of primary PHW development sources from international organizations. The process and requirements are unique processes displaying knowledge, competencies, and expertise, regardless of the field of practice. Continuous education, self-regulatory, and evidence-based approach can be seen as common characteristics for the performance standards on both community and national levels. Certification and regulation standards should be based on competencies that are currently used in practice. Therefore, answering questions about what criteria would be used, what is the process operation, what educational background the candidate should have, re-examination, and training are essential for a competent and responsive PHW and could stimulate the motivation of the PHW.

The public health workforce has been instrumental in protecting residents against population health threats. The COVID-19 pandemic has highlighted the importance of the public health workforce and exposed gaps in the workforce. Public health practitioners nationwide are still coming to understand these gaps, impacts, and lessons learned from the pandemic. This study aimed to explore Minnesota’s local public health practitioners’ perceptions of public health workforce gaps, the impacts of these workforce gaps, and the lessons learned in light of the COVID-19 pandemic. We conducted seven concurrent focus groups with members of the Local Public Health Association of Minnesota (LPHA; n = 55) using a semi-structured focus group guide and a survey of the local agencies (n = 70/72 respondents, 97% response rate). Focus group recordings were transcribed verbatim and analyzed using deductive and inductive coding (in vivo coding, descriptive coding), followed by thematic analysis. The quantitative data were analyzed using descriptive analyses and were integrated with the qualitative data. Participants indicated experiencing many workforce gaps, workforce gaps impacts, and described improvement strategies. Overall, many of the workforce gaps and impacts resulting from COVID-19 discussed by practitioners in Minnesota are observed in other areas across the nation, making the findings relevant to public health workforce nationally.

Objective: Recruiting and retaining public health employees and ensuring they have the skills necessary to respond are vital for meeting public health needs. As the first study examining health department (HD) workforce development plans (WDPs), this study presents gaps and strategies identified in WDPs across 201 accredited HDs (168 initial/33 reaccreditation plans). Design: This cross-sectional study employed qualitative review and content analysis of WDPs submitted to the Public Health Accreditation Board (PHAB) between March 2016 and November 2021. Main Outcome Measures: Eight overarching workforce themes were examined: planning/coordination, leadership, organizational culture, workplace supports/retention, recruitment, planning for departmental training, delivery of departmental training, and partnership/engagement. Within each theme, related subthemes were identified. Coders indicated whether the WDP (1) identified the subtheme as a gap; (2) stated an intent to address the subtheme; and/or (3) identified a strategy for addressing the subtheme. Results: The most common gaps identified included prepare workforce for community engagement/partnership (34.3%, n = 69), followed by resource/fund training (24.9%, n = 50). The subtheme that had the most instances of an identified strategy to address it was assess training needs (84.1%, n = 169), followed by foster quality improvement (QI) culture/provide QI training (63.2%, n = 127). While both of these strategies were common among the majority of HDs, those subthemes were rarely identified as a gap. Secondary findings indicate that increase recruitment diversity/recruit from a more diverse applicant pool was rarely identified as a gap (6.0%, n = 12) and rarely had an identified strategy for addressing the subtheme (9.0%, n = 18). Conclusion: While HDs recognized many workforce gaps, HDs did not always propose a strategy for addressing them within the WDP. Conversely, some WDPs proposed strategies for subthemes that did not reflect recognized gaps. Such discrepancies between identified gaps and strategies in WDPs may suggest areas where HDs could use additional support and guidance.

Context: Governments at all levels work to ensure a healthy public, yet financing, organization, and delivery of public health services differ across the United States. A 2012 Institute of Medicine Finance report provided a series of recommendations to ensure a high-performing and adequately funded public health infrastructure. Objectives: This review examines the influence of the Finance report's 10 recommendations on public health policy and practice. Design: This review utilized peer-reviewed and gray literature published since 2012. Eligibility Criteria: Documents that address at least one of the Finance report's 10 recommendations and contain information on either official actions taken in response to the Finance report or evidence of the report's influence on the practice community. Results: Of 2394 unique documents found, a total of 56 documents met the eligibility criteria. Review of these 56 documents indicated that the most substantial activity related to the recommendations was focused on the “minimum package of public health services” concept and establishment of a uniform chart of accounts. Discussion: Progress has been mixed on the Finance report recommendations. Improved tracking and auditing of public health activity appears to be advancing, yet financial benchmarks remain unmet. Challenges remain in determining actual investment in public health and equitable resource allocation approaches. State and local health department use of cost estimation methodology and a uniform chart of accounts tool has contributed to an increase in understanding and improvement in public health spending. Conclusions: The Finance report has served as a strong impetus for advocating for an increased investment in governmental public health. Efforts are bolstered by informed public health practitioners and stakeholders but often stymied by policy makers who must balance complex competing issues and priorities. Although many successes have occurred, further work is needed toward improving investment in the nation's public health.

Voluntary separations can exact heavy tolls on organizations that affect their efficiency or effectiveness. This historical retrospective investigates how the COVID-19 pandemic may have influenced federal employees' intention to leave for reasons other than retirement. We examined the 2020 Federal Employee Viewpoint Survey (FEVS) with a particular focus on agencies likely heavily impacted by the pandemic, including the Departments of Agriculture (USDA), Health and Human Services (HHS), Homeland Security (DHS) and the US Environmental Protection Agency (EPA). We used inferential statistics and a logistic model to identify correlations for intent to leave, considering changes related to the pandemic. Intentions to leave notably increased after the pandemic for most respondents, and overall intentions to leave were lower for USDA, HHS, and EPA staff than for all federal employees. Reasons included perceived unavailability of protections from COVID-19 exposure, disruptions to work by the pandemic, and increased work demands due to the pandemic.