Abstract
Objectives. To expand on previous enumerations by assessing the size and composition of the governmental public health workforce in the wake of the COVID-19 pandemic, identifying workforce trends, occupational distributions, and potential gaps in staffing. Methods. From 2023 to 2024, using 2022 data in the United States, we conducted 3 distinct analyses: (1) estimating the total workforce size, (2) profiling occupation-specific distributions, and (3) evaluating the role and prevalence of public health nurses using novel data sources. For total counts, we used multiple imputation by chained equations to develop robust agency-level estimates and address missingness from multiple data sets. Results. State and local public health agencies grew to approximately 239 000 staff in 2022, up from an estimated 206 500 in 2019. The largest occupation groups included office and administrative support workers (37 576) and public health or community health nurses (29 387). We found that 73 478 (1.8%) of registered nurses nationwide served in governmental public health roles. Conclusions. The size of the workforce during the COVID-19 response has returned to 2008 levels although temporary staff largely constitute the increase.
| Original language | English |
|---|---|
| Pages (from-to) | 707-715 |
| Number of pages | 9 |
| Journal | American Journal of Public Health |
| Volume | 115 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2025 |
Bibliographical note
Publisher Copyright:© 2025 American Public Health Association Inc.. All rights reserved.
Funding
This work was supported by the Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (HHS), National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce (grant OE22-2203: Strengthening US Public Health Infrastructure, Workforce, and Data Systems). We obtained Public Health Workforce Interests and Needs data from the Public Health Workforce Interests and Needs Survey, a project supported through a collaboration of the ASTHO and the de Beaumont Foundation. Our use of the data does not imply ASTHO’s or the de Beaumont Foundation’s endorsement of the research, research methods, or conclusions contained in this article. The authors thank the following data owners and contributors: the de Beaumont Foundation (Public Health Workforce Interests and Needs Survey), National Association of County and City Health Officials (NACCHO Profile), Association of State and Territorial Health Officials (ASTHO Profile), and the State Associations of County and City Health Officials and their members who participated in confirmation of their staffing levels. The authors also thank the Public Health Accreditation Board and the CDC for their partnership and the National Council of State Boards of Nursing for providing their data. The authors thank members of the Consortium for Workforce Research in Public Health for their feedback and guidance, including Heather Krasna, Beth Resnick, and Valerie Yeager. This work was supported by the Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (HHS), National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce (grant OE22-2203: Strengthening US Public Health Infrastructure, Workforce, and Data Systems).
| Funders | Funder number |
|---|---|
| State Associations of County | |
| Association of State and Territorial Health Officials | |
| Centers for Disease Control and Prevention | |
| ASTHO | |
| National Association of County and City Health Officials | |
| National Association of County and City Health Officials | |
| Public Health Accreditation Board | |
| U.S. Department of Health and Human Services | |
| de Beaumont Foundation | |
| Territorial Public Health Infrastructure and Workforce | OE22-2203 |
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
