When 10,000 Public Health Professionals Speak Up

PH WINS Reveals Much About Our Workforce & Professional Lives

Now there’s a timely, one-of-its-kind data set that can generate specific insights into the national public health workforce from state health agency frontline professionals. In 2014, more than 10,000 workers from governmental public health agencies across the United States participated in the Public Health Workforce Interests and Needs Survey (PH WINS), the first-ever national survey of its kind. Another iteration of the assessment will roll out this fall.

Produced in partnership with the Association of State and Territorial Health Officials (ASTHO) and the de Beaumont Foundation, PH WINS gives public health leaders a unique opportunity to better understand the workforce. Thirty-seven state health agencies, 14 of the nation’s largest health departments, and over 50 other local health departments participated in 2014.

“PH WINS shows the enormity of our challenge, as well as pointing to opportunities,” said Edward L. Hunter, CEO of the de Beaumont Foundation. “We need to redouble our efforts to reinvent workforce strategies to reward creativity and innovation, provide opportunities for ongoing professional development, and engage with young and mid-level public health professionals in order to retain our best and brightest and build the workforce we need for the future.”

One startling PH WINS finding? Nearly 40 percent of the workforce said they were planning to leave their jobs by 2020. That’s a big problem, as public health agencies are only recently thinking about prioritizing succession planning to address that large-scale turnover in the workforce. Brian C. Castrucci is Chief Program and Strategy Officer at the de Beaumont Foundation and an architect of the PH WINS project. “As the workforce shrinks, so does the number of workers available to inspect the restaurant where you might eat tonight, to prepare for the impact of natural disasters, and to investigate whether your co-worker has the seasonal flu or the start of a nationwide or worldwide pandemic,” he wrote for Huffington Post.

Another major finding was that, while workforce members were generally satisfied with their jobs and organizations, 40 percent are dissatisfied with their pay. Public health is a popular undergraduate degree, and that’s great for the future. “However, given the cost of college and graduate education and the student debt crisis, perceived salary dissatisfaction among the governmental public health workforce may prove to be a recruitment barrier,” notes Castrucci. Women also earn less than men, though they dominate the public health workforce.

Findings from PH WINS Support these Recommendations and More:

  • Make succession planning a high priority. Devise a strategy to recruit young and mid-career professionals into the field, with particular emphasis on Hispanic/Latino staff, given their underrepresentation in the workforce.
  • Invest in training for the existing public health workforce. Training needs include policy analysis and development, business and financial management, systems thinking and social determinants of health, evidence-based public health practice, and collaborating with and engaging diverse communities.
  • Provide information about national public health trends. Although almost half of the workforce has yet to hear about using a Health in All Policies approach to improve health and health equity, they have heard about quality improvement, harnessing the influx of electronic health information from electronic health records, and integrating public health with healthcare. They believe these are important initiatives, and are ready to learn more and work harder to make these goals a reality.
  • Ensure that workplace policies and practices support job satisfaction and retention. The de Beaumont Foundation has made a $1 million investment in PH WINS and Research to Action, a partnership with ASTHO to strengthen workplace policies and practices through a community of practice. Health departments will use PH WINS data to drive improvements in workforce development.

Policy and regulatory decision-making are important tools to advance public health, such as with issues like housing and community safety, bans on trans fats, indoor air quality, calorie counts on restaurant menus, and requirements for green space in developments. Yet the survey found that one third of respondents reported little or no ability in policy-making.

PH WINS findings also identified systems thinking, communicating persuasively and change management as priorities for the workforce.

de Beaumont’s Hunter is hopeful. “It’s time to focus on rebuilding and retooling the workforce to match the needs of the future,” he writes. “We need institutions that move forward, adapt and transform to meet new needs. We need a workforce with technical skills, but also one that that can work in partnership and be politically savvy, innovative and adaptive.”

In addition to knowledge skills and attitudes, PH WINS also collected worker perspectives on Health in All Policies, quality improvement, electronic health records and workplace environments. Those perspectives will stimulate research and action. Findings are already being used to help state health agencies meet current challenges and evolve into even more effective organizations. With the data, funders can more effectively target workforce development in high impact areas. National initiatives can take advantage of information about attitudes towards quality improvement, Health in All Policies and electronic health information.

From Michael Fraser, ASTHO Executive Director

This fall, ASTHO and our partners will debut the next iteration of PH WINS. I’m confident it will be useful, valuable and essential in developing our next generation of public health leaders.

Until PH WINS, there was no national data about public health professional’s perspectives on training needs and job satisfaction. Many public health agencies conduct their own assessments, but they are state- or program area-specific. PH WINS provides data for decision-making at the national level and cross-cuts programmatic areas in an agency. This is exciting stuff!

PH WINS will help us understand better ways to recruit and retain the future public health workforce. As states struggle with their own fiscal situations, PH WINS can help inform what agencies can do more and less of to keep experienced professionals and recruit new ones.

2017 Additions Include a Revamped Training Needs Assessment

A revamped module at the core of the 2017 PH WINS survey will explore training needs in the workforce, for frontline and administrative staff, supervisors and managers and leadership. ASTHO and de Beaumont convened a diverse workgroup to prioritize topic areas and skills for inclusion, and develop and test the needs assessment. The workgroup is co-chaired by representatives from ASTHO, the National Association of County and City Health Officials, Nikki Rider, expert consultant and former NNPHI Associate Director, Research and Evaluation, and Jennifer McKeever, Director of Public Health Practice and Training at the National Coordinating Center for Public Health training at NNPHI. Several of the Public Health Learning Network’s regional public health training centers are also engaged to complete a tabletop review of the assessment before its release.

Drafts of the assessment will go out for cognitive and pilot testing and PH WINS and partners will finalize the assessment in September. “We are in the process of finalizing drafts for all three tiers,” reports Elizabeth Harper, DrPH, Senior Director, Research and Evaluation at ASTHO. “What training needs are out there? How do we develop programs for these needs? We’re looking at where public health is going, and we want to be responsive to those needs right away.”

The First-Ever Workforce Development Challenge

To highlight workforce innovations with a lasting impact on public health, ASTHO and de Beaumont is in the process of selecting the winners for the first-ever PH WINS Model Policies and Practices Challenge. State and territorial health agencies and local health departments can identify and submit successful policies and practices for recognition as model policies for a chance to win one of three $10,000 awards. According to ASTHO Director of Workforce Research Kyle Bogaert, all submissions for the challenge will be categorized by topic and included in an online resource to facilitate sharing.

Throughout history, data and analytics have been at the core of public health—identifying and tracking epidemics, providing evidence-based logic for programs and planning for the future. Public health demands change constantly and workforce development is a never-ending topic.

PH WINS carries on the tradition of big, smart data to drive high-priority training and education opportunities—now and for the future.

See the September 2017 edition of Elevate, your resource for lifelong learning »

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