CDC's “Flexible” Epidemiologist: A Strategy for Enhancing Health Department Infectious Disease Epidemiology Capacity

Chung, Christina Lee; Fischer, Leah S.; O'Connor, A.; Shultz, Alvin

doi:10.1097/phh.0000000000000429

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…The recent increase in infectious disease and injury positions and decrease in preparedness positions might reflect changes in funding sources and priorities. In the past 2 decades, the Epidemiology and Laboratory Capacity and Public Health Emergency Preparedness cooperative agreements have provided funding to health departments for many infectious disease and preparedness epidemiology positions ( 2 , 3 ) in response to emerging and reemerging threats ( 4 , 5 ). However, funding recently has decreased for preparedness ( 6 ) and increased for infectious diseases, and some epidemiologists previously working in preparedness might have shifted to infectious disease positions.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Epidemiology Capacity in State Health Departments — United States, 2017

Arrazola¹,

Binkin²,

Israel³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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In 2017, the Council of State and Territorial Epidemiologists performed its sixth periodic Epidemiology Capacity Assessment, a national assessment that evaluates trends in workforce size, funding, and epidemiology capacity among state health departments. A standardized web-based questionnaire was sent to the state epidemiologist in the 50 states, the District of Columbia (DC), and the U.S. territories and the Federated States of Micronesia inquiring about the number of current and optimal epidemiologist positions; sources of epidemiology activity and personnel funding; and each department’s self-perceived capacity to lead activities, provide subject matter expertise, and obtain and manage resources for the four Essential Public Health Services (EPHS)* most closely linked to epidemiology. From 2013 to 2017, the number of state health department epidemiologists† increased 22%, from 2,752 to 3,369, the greatest number of workers since the first full Epidemiology Capacity Assessment enumeration in 2004. The federal government provided most (77%) of the funding for epidemiologic activities and personnel. Substantial to full capacity (50%–100%) was highest for investigating health problems (92% of health departments) and monitoring health status (84%), whereas capacity for evaluating effectiveness (39%) and applied research (29%) was considerably lower. An estimated additional 1,200 epidemiologists are needed to reach full capacity to conduct the four EPHS. Additional resources might be needed to ensure that state health department epidemiologists possess the specialized skills to deliver EPHS, particularly in evaluation and applied epidemiologic research.

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Section: Discussionmentioning

confidence: 99%

Assessment of Epidemiology Capacity in State Health Departments — United States, 2017

Arrazola¹,

Binkin²,

Israel³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

View full text Add to dashboard Cite

show abstract

“…Of the 14 states, 13 (93%) noted the importance of complete and timely surveillance, and 11 (79%) mentioned the value of flexible epidemiologists (ie, ELC-supported epidemiology staff capable of working on a cross-section of infectious diseases). 8 These flexible epidemiologists assisted in outbreak investigations and responses and participated in outreach to providers and healthcare facilities.…”

Section: Resultsmentioning

confidence: 99%

Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015

Santibañez¹,

Bellis²,

Bay³

et al. 2019

Southern Medical Journal

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“…A potential solution to these challenges is the use of "flexible epidemiologists," who are trained across program areas to respond to emerging threats and unanticipated events. 13 Federal funding for flexible epidemiologists is one way to strengthen epidemiology capacity in state health departments. Unless consistently funded, however, such positions could lead to poor staff morale and uncertain job security, 12 which may further contribute to the challenges of recruitment and retention.…”

Section: Discussionmentioning

confidence: 99%

Applied Epidemiology Workforce Growth and Capacity Challenges: The Council of State and Territorial Epidemiologists 2017 Epidemiology Capacity Assessment

2019

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Objectives: To better understand the current status and challenges of the state public health department workforce, the Council of State and Territorial Epidemiologists (CSTE) assessed the number and functions of applied public health epidemiologists at state health departments in the United States. Methods: In 2017, CSTE emailed unique online assessment links to state epidemiologists in the 50 states and the District of Columbia (N = 51). The response rate was 100%. CSTE analyzed quantitative data (27 questions) on funding, the number of current and needed epidemiologists, recruitment, retention, perceived capacity, and training. CSTE coded qualitative data in response to an open-ended question that asked about the most important problems state epidemiologists face. Results: Most funding for epidemiologic activities came from the federal government (mean, 77%). State epidemiologists reported needing 1199 additional epidemiologists to achieve ideal capacity but noted challenges in recruiting qualified staff members. Respondents cited opportunities for promotion (n = 45, 88%), salary (n = 41, 80%), restrictions on merit raises (n = 36, 70%), and losses to the private or government sector (n = 33, 65%) as problems for retention. Of 4 Essential Public Health Services measured, most state epidemiologists reported substantial-to-full capacity to monitor health status (n = 43, 84%) and diagnose and investigate community health problems (n = 47, 92%); fewer respondents reported substantial-to-full capacity to conduct evaluations (n = 20, 39%) and research (n = 11, 22%). Conclusions: Reliance on federal funding negatively affects employee retention, core capacity, and readiness at state health departments. Creative solutions for providing stable funding, developing greater flexibility to respond to emerging threats, and enhancing capacity in evaluation and applied research are needed.

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CDC's “Flexible” Epidemiologist: A Strategy for Enhancing Health Department Infectious Disease Epidemiology Capacity

Abstract: Our findings have practical implications for addressing the overall decline in the public health workforce, as well as the current context and environment of public health funding at both state and federal levels.

Cited by 6 publications

References 10 publications

Assessment of Epidemiology Capacity in State Health Departments — United States, 2017

Assessment of Epidemiology Capacity in State Health Departments — United States, 2017

Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015

Applied Epidemiology Workforce Growth and Capacity Challenges: The Council of State and Territorial Epidemiologists 2017 Epidemiology Capacity Assessment

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