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.

Background: Cultural competence is a difficult skill to teach, as it has several operational definitions as well as limited and unstandardized training procedures. Currently, there is no formal cultural competency training at the undergraduate level for students who seek to become a medical doctor. The purpose of this study is to explore perceptions of cultural competence among premedical undergraduates by assessing how they define and understand cultural competency and their knowledge (and sources thereof) of sociocultural realities in health and medicine. Methods: Structured in-depth interviews took place in 2016 and 2017 at a medium-sized private college in the Midwestern United States. Twenty premedical students were interviewed. The interviews were transcribed and thematically coded following an inductive, iterative, and systematic process. Results: Most students can provide a definition of cultural competence that includes at least one component of how it is conceptualized by the Association of American Medical Colleges. However, students focus largely on defining cultural competence as individual attitudes and interaction rather than systemic or structural realities that produce inequalities in health care. When explicitly asked, students varied in the level of detail provided in explaining the social determinants of health (such as race or ethnicity, sex, gender, and socioeconomic status) and varied in the accuracy of their definitions of traditional health practices. Each student noted the importance of training on cultural competence and many placed patients’ health at the center of their reason for doing so rather than focusing on their own training as a motivation. Students discussed various aspects of sociocultural differences and the need for physicians to understand patients’ outlooks on health care and be able to communicate to patients the purpose of suggested medical treatment, as well as the inherent tension in balancing patients as individuals and members of sociocultural groups. Premedical undergraduate students see their own cultural competence as an informal skill that is gained through social interactions across various areas of life, such as work, family, friends, and school. Conclusion: This study traces the sources of sociocultural information that premedical students will bring to their medical training as well as places where cultural competence can be further explored, practiced, and formally integrated in premedical education.

The University of Minnesota (UMN) School of Public Health (SPH) asked graduates about their experiences as students and as alumni. Of 1186 respondents indicating gender, 140 were women who self-identified as members of a marginalized group. Fifty-one percent of these respondents were White women. Compared with White women, Black, Indigenous, and people of color (BIPOC) women were more likely to report that they felt they did not belong, were uncomfortable, or experienced bias and/or discrimination in their program, although the results were not statistically significantly different at P < .05. Survey results show a clear difference in experience between White and BIPOC alumni. The results indicate a need to improve cultural competence/humility, along with a need to move away from what may be construed as White-centered events, pedagogy, and leadership. With this evidence, the UMN SPH has an opportunity to improve our outreach strategies and initiatives.