Recruitment, Retention, and Training of the Local Health Department Workforce: Results from the 2005 National Profile of LHDs Study

Carolyn LeepNACCHO

2005 National Profile of Local Health Departments Study

Collaboration with CDC Fourth in the Profile series• Prior studies in 1989, 1992-3, and 1996-7

Census design – includes all LHDs in U.S. First National Profile to be conducted

as Web-based survey Source of all data in this presentation

Workforce Data from 2005 Profile

Data from core questionnaire (sent to all LHDs) published in main report• Size and composition of LHD workforce

Most data from module (sent to sample of LHDs) published in separate report • Race & ethnicity of LHD staff• Workforce shortages• Workforce training

Workforce Shortages

Included questions about current problems hiring and anticipated future shortages of five professions:• Public health nurses• EH specialists/scientists• Epidemiologists• Health educators• IT specialists

Current and Anticipated Hiring Problems

15%

18%

28%

29%

46%

22%

20%

39%

38%

59%

0% 10% 20% 30% 40% 50% 60%

IT specialists (n=200, 208)

Health educators (n=275, 294)

EH scientists/specialists (n=243, 249)

Epidemiologists (n=174, 188)

Nurses (n=402 402)

CurrentlyIn 3 years

Reasons for Current Hiring ProblemsReason FrequencyPay/benefits not competitive +++++Cannot hire due to budgetary restrictions +++Difficult to attract candidates to this geographic area +++Candidates have insufficient experience +++Candidates have insufficient education ++LHD hiring process is cumbersome ++Candidates have insufficient cultural and linguistic competency +

Public Health Nurses

Current Hiring Problems:Pay/benefits (91%)Geographic area (45%)Budget restrictions (39%)

Reasons for Anticipated Future Shortage:Retirement (66%)Attrition (60%)

EH Specialists/ScientistsCurrent Hiring Problems: Pay/benefits (74%) Geographic area (54%) Budget restriction (46%) Insufficient experience (44%)Reasons for Anticipated Future Shortage: Retirement (49%) Attrition (40%) Program expansion (35%)

Epidemiologists

Current Hiring Problems: Pay/benefits (61%) Geographic area (56%) Budget restriction (52%) Insufficient experience (46%)

Reasons for Anticipated Future Shortage: Program expansion (55%) Some other reason (42%)

Health Educators

Current Hiring Problems: Pay/benefits (64%) Budget restriction (44%) Geographic area (40%)

Reasons for Anticipated Future Shortage: New programs (44%) Program expansion (39%)

IT Specialists

Current Hiring Problems: Pay/benefits (82%) Budget restriction (58%) Insufficient experience (34%)

Reasons for Anticipated Future Shortage: Other reason (55%) Program expansion (43%)

Staff Training

Module included questions on Sources of training for LHD staff Learning methods that LHD leaders would

support for their staff

Sources of Training for LHD Staff

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

State Health Agency

LHD in-house training

Professional associations

Other state agency(ies)

Schools of Public Health

Colleges or universities

Public health institutes

Community colleges

Other source

Medical schools

Preferred Learning Methods

Ranked Highest Ranked LowestClassroom or workshop with knowledgeable speaker

One-on-one training with an experienced professional

Use of self-paced CD ROM materials

Distance learning courses and programs

Hybrid approach (face-to-face classroom plus distance-based)

Use of audiotapes or videotapes

Real time exercises, drills, or simulations Teleconferencing

Self-study using printed materials

LHD Staff by Race and Ethnicity

White BlackOther Races Hispanic

All LHDs 74% 15% 10% 12%Population Served<50,000 92% 6% 2% 3%50,000 - 499,999 81% 12% 7% 11%500,000+ 55% 25% 20% 18%RegionNortheast 74% 15% 11% 12%Midwest 86% 9% 10% 5%South 66% 22% 8% 12%West 78% 5% 17% 23%

Diversity of LHD Staff and Population Served

15%

16%

42%

26%

Staff more diverse (>2% difference)Staff and population served similar (difference within 2%)Staff less diverse (2 to 10% difference)Staff much less diverse (>10% difference)