Methods. Onsite surveys were conducted in one urban and 93 rural Kentucky public health agencies during 2005 and 2006. Categorical data were analyzed using univariate and multivariate analysis techniques. The author compared responses to the level of confidence (LOC) and need for training (NFT) among the seven workgroup classifications.Results. One thousand nine hundred ninety-four public health workers completed the surveys. Of these, 1,813 workers represented 55% of the state's rural local public health workforce. Kentucky's rural public health workforce can be described as predominantly Caucasian, female, and not planning to retire within the next five years. There were significant differences among workgroups for LOC and NFT for each competency examined. Across all workgroups, there was a mean LOC (58%) in the ability to describe the actions to take and procedures to follow in an emergency. There was a correspondingly higher mean perceived NFT (73%) for this competency.Conclusion. This study raises the question of whether we are adequately prepared to monitor our communities' health status. Further research that minimizes the limitations of self-reports and, instead, requires the worker to demonstrate the competency may provide a more accurate assessment of emergency preparedness.