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COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 28720

Special Issue Editors

Dr. J. P. Leider

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Guest Editor
School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
Interests: governmental public health; public health workforce; public health systems
Dr. Beth Resnick

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Guest Editor
Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD 21205, USA
Interests: public health workforce; governmental public health; public health systems
Dr. Heather Krasna

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Guest Editor
Mailman School of Public Health, Columbia University, New York, NY 10032, USA
Interests: public health workforce; public health graduates; employer perspectives; labor market competition
Dr. Katarzyna Czabanowska

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Guest Editor
1. Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6211 LK Maastricht, The Netherlands
2. Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, 31-007 Krakow, Poland
Interests: public health leadership; public health workforce development and planning; capacity building; competence-based education; competency self-assessment; public health system

Special Issue Information

Dear Colleagues,

COVID19 response has stressed the governmental public health enterprise across the world to its breaking point.  Public health practitioners across the world have been on the front line of COVID-19 response, working across various functions, including quarantine and isolation, contact tracing and case reporting, surveillance, scarce resource allocation, and direct care provision. Public health leaders have been responsible for enforcing public health interventions, such as mask mandates and business closures.  Impact on the workforce has been from external and internal sources. Reports of significant policymaker and public sentiment shifts have created political pressure on health department leadership. Additionally, preliminary evidence is showing that stress, extra COVID response duties, and “temporary” job shifts taking workers away from their primary jobs that have lasted for over a year are leading to high levels of turnover and burnout among the public health workforce. This represents a risk to continued public health response into the peri-COVID-19 period.

In this special issue of IJERPH, we invite submissions that characterize how across the globe the governmental public health workforce adapted to the COVID-19 pandemic, as well as how the pandemic has impacted the workforce. This issue seeks to highlight especially the work of practitioners and public health systems research as it relates to the COVID-19 pandemic. New research papers, practice reports, brief reports, reviews, and conference papers are welcome to this issue. We will accept submissions from researchers, academic-practice teams, and encourage submissions from public health practitioners and organizations supporting public health entities.

  1. Impact of COVID-19 response on governmental public health workforce
    • Workforce changes associated with COVID-19 response
    • Turnover and burnout at public health agencies associated with COVID-19 response
    • Succession planning / transfer of institutional knowledge associated with COVID-19 response
    • Harassment and threats of public health workforce
  2. Strategies and adaptations to workforce to respond to COVID-19
    • Evaluation of Incident Command or other employed response frameworks
    • Approaches to redeployment of resources / human capital for COVID-19 response
    • Development or expansion of partnerships and cross-sector initiatives for COVID-19 response
    • Shift in workforce focus on health inequities and disproportionate impact of COVID on specific populations
    • Evaluation of relative effectiveness of interventions (e.g., different contact tracing / ‘staffing up’ workforce models, etc.)
    • Evaluation of new units established to respond to COVID-19
    • Assessing how population-based versus direct service staffing models were differentially deployed in countries with unified or single payer health systems
  3. Assessment of future workforce needs associated with COVID-19 recovery or future response to an extended disaster
    • Workforce models for COVID-19 recovery
    • Political considerations around the ‘future of public health’
    • Forecasts or estimates around workforce needs for disaster planning into the future (i.e., ongoing workforce / staffing models, as well as ‘surge up’ needs)
    • Changes to resource allocation practices and public health sustainability planning

Dr. J. P. Leider
Dr. Beth Resnick
Dr. Heather Krasna
Dr. Katarzyna Czabanowska
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • governmental public health workforce
  • COVID-19 response
  • public health systems
  • workforce development
  • public health practice

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Published Papers (8 papers)

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Research

Jump to: Review, Other

15 pages, 791 KiB  
Article
Reasons for Turnover of Kansas Public Health Officials during the COVID-19 Pandemic
by Cristi Cain, D. Charles Hunt, Melissa Armstrong, Vicki L. Collie-Akers and Elizabeth Ablah
Int. J. Environ. Res. Public Health 2022, 19(21), 14321; https://doi.org/10.3390/ijerph192114321 - 2 Nov 2022
Cited by 1 | Viewed by 2194
Abstract
Public health officials played a critical role in COVID-19 mitigation and response efforts. In Kansas, 51 local health department (LHD) administrators and/or local health officers left their positions due to the pandemic between 15 March 2020 and 31 August 2021. The purpose of [...] Read more.
Public health officials played a critical role in COVID-19 mitigation and response efforts. In Kansas, 51 local health department (LHD) administrators and/or local health officers left their positions due to the pandemic between 15 March 2020 and 31 August 2021. The purpose of this study was to identify factors that led to turnover of Kansas local public health officials during the COVID-19 pandemic. Those eligible to participate in this study included former LHD administrators and/or health officers who were employed at or contracted by a Kansas LHD on 15 March 2020 and resigned, retired, or were asked to resign prior to 31 August 2021. Researchers used a demographic survey, a focus group, and key informant interviews to collect data. Twelve former LHD leaders participated in this study. Four themes emerged from phenomenological analysis: politicization of public health; a perceived lack of support; stress and burnout; and the public health infrastructure not working. The findings of this study can guide the Kansas public health system to address the issues leading to turnover of leadership and prevent future turnover. Future research must explore strategies for mitigating leadership turnover and identify alternative public health structures that could be more effective. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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14 pages, 2685 KiB  
Article
Enumeration of the Public Health Workforce in New York State: Workforce Changes in the Wake of COVID-19
by Isaac Michaels, Sylvia Pirani, Molly Fleming, Mayela M. Arana, Emily D’Angelo, Cristina Dyer-Drobnack, Margaret DiManno, Sarah Ravenhall and Christian T. Gloria
Int. J. Environ. Res. Public Health 2022, 19(20), 13592; https://doi.org/10.3390/ijerph192013592 - 20 Oct 2022
Cited by 6 | Viewed by 2996
Abstract
The governmental public health workforce in the United States has faced staffing shortages for over a decade that have been exacerbated by the COVID-19 pandemic. To assess this critical issue, the Region 2 Public Health Training Center collaborated with the New York State [...] Read more.
The governmental public health workforce in the United States has faced staffing shortages for over a decade that have been exacerbated by the COVID-19 pandemic. To assess this critical issue, the Region 2 Public Health Training Center collaborated with the New York State Association of County Health Officials to enumerate the city and county public health workforce in New York State. The organizations used an online survey to: (1) count employees and full-time equivalent (FTEs) staff in local health departments in 2021; (2) assess workforce trends since the COVID-19 pandemic; and, (3) identify challenges local health departments encounter in recruiting and retaining qualified public health workers. To assess trends, findings were compared with secondary data from 2019. Despite playing a central role in COVID-19 mitigation, local health departments experienced no overall increase in staffing in 2021 compared to 2019, with many health departments experiencing large increases in vacant positions. Recruitment challenges include noncompetitive salaries, difficulties finding qualified candidates, and lengthy hiring processes. This study complements accumulating evidence indicating that long-term investment in local public health infrastructure is needed to bolster the workforce and ensure that communities are protected from current and future health threats. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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13 pages, 564 KiB  
Article
Public Health Workforce Gaps, Impacts, and Improvement Strategies from COVID-19
by Chelsey Kirkland, Kari Oldfield-Tabbert, Harshada Karnik, Jason Orr, Skky Martin and Jonathon P. Leider
Int. J. Environ. Res. Public Health 2022, 19(20), 13084; https://doi.org/10.3390/ijerph192013084 - 12 Oct 2022
Cited by 15 | Viewed by 3468
Abstract
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, [...] Read more.
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. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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14 pages, 735 KiB  
Article
COVID-19 Vaccine Administration: Phase 2 of an in Progress Review in New York State Local Health Departments
by Sarah Bloomstone, Molly Fleming, Mayela Arana, Emily D’Angelo, Sarah Ravenhall and Marita Murrman
Int. J. Environ. Res. Public Health 2022, 19(20), 13030; https://doi.org/10.3390/ijerph192013030 - 11 Oct 2022
Cited by 4 | Viewed by 2140
Abstract
Since the onset of the COVID-19 pandemic in New York State (NYS), local health departments (LHDs) have worked to mitigate the highly infectious disease. As lead public health experts in their communities, LHDs are responsible for providing communicable disease control, emergency response, and [...] Read more.
Since the onset of the COVID-19 pandemic in New York State (NYS), local health departments (LHDs) have worked to mitigate the highly infectious disease. As lead public health experts in their communities, LHDs are responsible for providing communicable disease control, emergency response, and establishing immunization programs, including leading large-scale vaccine distribution efforts. The aim of this qualitative study was to understand the processes used by LHDs in NYS to administer COVID-19 vaccines, as well as identify successes and challenges, and highlight lessons learned to improve future mass vaccination campaigns. Data were collected in two phases: (1) extant data collection of public communications; and (2) discussion groups with public health leaders across the state. Notable themes from both phases include: partnerships, programmatic elements, communication, role of LHD, State-LHD coordination, and human and physical resources. Analysis of both public and internal communications from LHDs across NYS revealed several core challenges LHDs faced during COVID-19 vaccine rollout and identified innovative solutions that LHDs used to facilitate vaccine access, administration, and uptake in their communities. Findings from this multi-phase qualitative analysis support the need to bolster the capacity and training of the local public health workforce to ensure preparedness for future public health emergencies. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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9 pages, 1485 KiB  
Article
Epidemic Intelligence Service Alumni in Public Health Leadership Roles
by Marvin So, Andrea Winquist, Shelby Fisher, Danice Eaton, Dianna Carroll, Patricia Simone, Eric Pevzner and Wences Arvelo
Int. J. Environ. Res. Public Health 2022, 19(11), 6662; https://doi.org/10.3390/ijerph19116662 - 30 May 2022
Cited by 2 | Viewed by 2318
Abstract
Since 1951, the Epidemic Intelligence Service (EIS) of the U.S. Centers for Disease Control and Prevention (CDC) has trained physicians, nurses, scientists, veterinarians, and other allied health professionals in applied epidemiology. To understand the program’s effect on graduates’ leadership outcomes, we examined the [...] Read more.
Since 1951, the Epidemic Intelligence Service (EIS) of the U.S. Centers for Disease Control and Prevention (CDC) has trained physicians, nurses, scientists, veterinarians, and other allied health professionals in applied epidemiology. To understand the program’s effect on graduates’ leadership outcomes, we examined the EIS alumni representation in five select leadership positions. These positions were staffed by 353 individuals, of which 185 (52%) were EIS alumni. Among 12 CDC directors, four (33%) were EIS alumni. EIS alumni accounted for 29 (58%) of the 50 CDC center directors, 61 (35%) of the 175 state epidemiologists, 27 (56%) of the 48 Field Epidemiology Training Program resident advisors, and 70 (90%) of the 78 Career Epidemiology Field Officers. Of the 185 EIS alumni in leadership positions, 136 (74%) were physicians, 22 (12%) were scientists, 21 (11%) were veterinarians, 6 (3%) were nurses, and 94 (51%) were assigned to a state or local health department. Among the 61 EIS alumni who served as state epidemiologists, 40 (66%) of them were assigned to a state or local health department during EIS. Our evaluation suggests that epidemiology training programs can serve as a vital resource for the public health workforce, particularly given the capacity strains brought to light by the COVID-19 pandemic. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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13 pages, 636 KiB  
Article
The Impact of Student Debt on Career Choices among Doctor of Public Health Graduates in the United States: A Descriptive Analysis
by Chulwoo Park and Eric Coles
Int. J. Environ. Res. Public Health 2022, 19(8), 4836; https://doi.org/10.3390/ijerph19084836 - 15 Apr 2022
Cited by 9 | Viewed by 4302
Abstract
(1) Background: As gaps in the public health workforce grow in the wake of the COVID-19 pandemic, graduates of the schools of public health, especially Doctors of Public Health (DrPH), are poised to offer relief. While there are some known recruitment issues, student [...] Read more.
(1) Background: As gaps in the public health workforce grow in the wake of the COVID-19 pandemic, graduates of the schools of public health, especially Doctors of Public Health (DrPH), are poised to offer relief. While there are some known recruitment issues, student debt and debt impact on career choices are understudied. (2) Methods: In the present study, we perform a descriptive analysis of the potential impact of student debt on career choices among DrPH students and alumni in the United States using a cross-sectional national online survey. A total of 203 participants (66: alumni and 137: current students) completed the survey. Descriptive statistics, a chi-squared test of independence, and content analysis were used to analyze the funding situation and its impact on career choices. (3) Results: We found that (1) 72% of current DrPH students have zero funding support for their degree, (2) scholarship opportunities for a DrPH degree are limited, especially when compared to PhD programs, and (3) student debt impacts 59% of DrPH students’ and 29% of DrPH graduates’ career choices (about 49% of all respondents). (4) Conclusions: Student debt and a misunderstanding of DrPH are likely impediments to DrPH graduates participating in the public health workforce. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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Review

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24 pages, 1150 KiB  
Review
A Systematic Review on Professional Regulation and Credentialing of Public Health Workforce
by Olga Gershuni, Jason M. Orr, Abby Vogel, Kyeongki Park, Jonathon P. Leider, Beth A. Resnick and Katarzyna Czabanowska
Int. J. Environ. Res. Public Health 2023, 20(5), 4101; https://doi.org/10.3390/ijerph20054101 - 24 Feb 2023
Cited by 7 | Viewed by 4441
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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Other

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11 pages, 361 KiB  
Commentary
Insecure Employment Contracts during the COVID-19 Pandemic and the Need for Participation in Policy Making
by Maryam Maleki, Abbas Mardani and Mojtaba Vaismoradi
Int. J. Environ. Res. Public Health 2021, 18(23), 12548; https://doi.org/10.3390/ijerph182312548 - 28 Nov 2021
Cited by 16 | Viewed by 4474
Abstract
Job security influences the ability of nurses to provide high-quality nursing care. The Iranian health system has always faced nursing shortages, and the COVID-19 pandemic has worsened this situation. Although nurses have been labelled ‘heroes’ across the globe, many of them have been [...] Read more.
Job security influences the ability of nurses to provide high-quality nursing care. The Iranian health system has always faced nursing shortages, and the COVID-19 pandemic has worsened this situation. Although nurses have been labelled ‘heroes’ across the globe, many of them have been hired using insecure employment contracts. This commentary aims to describe issues surrounding job contracts for Iranian nurses during the COVID-19 pandemic and discusses how the current situation can be improved. Iranian nurses are at the frontline of the fight against COVID-19 and need to receive better support in terms of job security and dignity. They should participate more in policymaking activities to improve their job condition and prevent the development and implementation of the short-term and insecure job contracts that lead to job insecurity. Full article
(This article belongs to the Special Issue COVID-19 and the Governmental Public Health Workforce: Adaptation, Response, and Recovery to Staffing a Global Pandemic)
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