As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, we explored reasons for the (lack of) interest in working in the PHS by conducting two cross-sectional surveys among 3019 medical students (MS), public health students, and students from other PHS-relevant fields (PH&ONM) in Germany right before (wave 1, 2019/2020) and during the COVID-19 pandemic (wave 2, 2021). While interest in working in the PHS among MS was low, it was considerably higher among PH&ONM. The prevalent underestimation of the importance of public health and low levels of knowledge about the PHS were identified as potential barriers. Although core activities of the PHS were often considered attractive, they were repeatedly not attributed to the PHS. A negative perception of the PHS (e.g., it being too bureaucratic) was prevalent among students with and without PHS interest, indicating that both a negative image and potentially structural deficits need to be overcome to increase attractiveness. Based on the findings, we propose approaches on how to sustainably attract and retain qualified personnel.

The Public Health Service (PHS) in Germany has had difficulties in recruiting enough qualified staff for years, but there is limited research on what factors drive decisions to (not) join the PHS workforce. We explored reasons for this perceived (lack of) attractiveness. We conducted two cross-sectional surveys among medical students (MS), public health students and students from other PHS-relevant fields (PH&ONM) in Germany before (2019/2020) and during the COVID-19 pandemic (2021). Both waves surveyed self-reported reasons for why students did (not) consider working in the PHS as attractive and how this could be improved, using open-question items. Qualitative and quantitative content analyses were conducted according to Mayring. In total, 948 MS and 445 PH&ONM provided valid written responses. Reasons for considering the PHS as attractive were, among others, the perception of a good work-life balance, high impact, population health focus, and generally interesting occupations. Suggestions to increase attractiveness included reducing bureaucracy, modernization/digitalization, and more acknowledgement of non-medical professionals. Among MS, reasons against were too little clinical/patient-related activities, low salary, and occupations regarded as boring. Our findings indicate areas for improvement for image, working conditions in, and institutional structures of the PHS in Germany to increase its attractiveness as an employer among young professionals.

Zusammenfassung Ziel der Arbeit Der Öffentliche Gesundheitsdienst kann als administrativer politiknaher Akteur essenziell für die Umsetzung von Health in All Policies auf kommunaler Ebene sein. Die landesgesetzlich verankerte kommunale Gesundheitsberichterstattung als Grundlage für Planungsprozesse kann hierfür eine potenziell zentrale Rolle spielen. Untersucht werden soll, inwieweit kommunale Gesundheitsberichte durch Integration weiterer Themenfelder und administrative Intersektoralität einer solchen übergreifenden Rolle gerecht werden. Methoden Auf Basis einer bundesweiten nonreaktiven Datenerhebung zur kommunalen Gesundheitsberichterstattung wird eine quantitative Dokumentenanalyse veröffentlichter Berichte durchgeführt (Zufallsstichprobe; n=53). Der Integrationsgrad wird hinsichtlich methodisch-inhaltlicher und intersektoraler Aspekte eingeordnet. Eine stratifizierte Analyse erfolgt nach Gebietskörperschaftstyp, administrativer Ansiedlung des Öffentlichen Gesundheitsdienstes sowie Berichtstyp. Ergebnisse Integration in Form von Daten mindestens zweier weiterer Themenfelder findet sich in 29 Berichten (55%). Intersektoralität ist in neun Berichten (17%) explizit erkennbar und dabei überdurchschnittlich häufig in kreisfreien Städten und Kinder-/Jugendberichten. Berichte zum Infektionsschutz/Impfen sind unterdurchschnittlich integriert. Die organisationale Ansiedlung mit den Handlungsfeldern Soziales und/oder Jugend ist positiv mit dem Integrationsgrad assoziiert. Schlussfolgerung Integrationsgrad und Intersektoralität der kommunalen Gesundheitsberichterstattung sind aus der Perspektive von Health in All Policies bisher als zu gering einzuschätzen. Entwicklungspotentiale ergeben sich durch eine günstige organisationale Ansiedlung sowie die Themenwahl, speziell im Feld Kinder- und Jugendgesundheit.

No abstract