october 23, 2001 enumeration of the public health workforce in the united states, 2000 kristine...
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October 23, 2001
Enumeration of the Public Health Workforce in the United States, 2000
Kristine Gebbie, RN, DrPH,
Jacqueline Merrill, MPH, RN,C
Center for Health PolicyColumbia University School of Nursing
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
The Question
What is the size and composition of the public health workforce?
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
The Answer
448,254 workers in salaried positions
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
1970 vs. 2000
1970
• 1970 500,000 PH Workers
• 1: 457 workers to persons
• Estimated by different method
2000
• 2000 448,254 PH Workers
• 1: 635 workers to persons
• Include federal employees, salaried staff of limited volunteer agencies
• Supplemented by at least 2,864,825 volunteers
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Historic comparison
1923 27 workers/100,000 population
1933 22 workers/100,000 population
1958 32 workers/100,000 population
1979 219 workers/100,000 population(est)
2000 158 workers/100,000 population
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Public Health Worker Density
PH Workersto 100,000 Population
140 to 566 (16)77 to 140 (17)37 to 77 (17)
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Who are they?
Commonly identified health professions, many technical w/ backgrounds, some trained on the job.
Unidentified by education--advanced education, or a high school diploma and a willingness to learn
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
National Summary
448,254 salaried workers by occupational category
Clerical/Support13%
Category Unreported
25%
Administrative4%
Professional44%
Technical14%
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
National Summary (cont’d)
Local34%
Federal19%
Other14%
State33%
Percentage of 448,254 PH Workers by Location
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
National Summary (cont’d) The location of the workforce distributed within OPM occupational
categories
OPM CATEGORY
LOCAL
16,495
33,857
3,975
8,454
89,970
10,04511,410
56,958
38,331
29,217
11,902
58,897
1,152
13,360
443201
50,313
748
10,313
2,213
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
Administrative Professional Technical Clerical/Support CategoryUnreported
Nu
mb
er E
mp
loye
d
STATE
FEDERAL
OTHER
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
National Summary (cont’d)
Select professionals by location
533 6551,304
14,543
6,101
888
3,975 4,207
10,045 9,935
7,043
4,055
1,152
4,311
126
20,443
2,080
532748 1450
5000
10000
15000
20000
25000
Officials andAdministrators
PH Physician PH Nurse EnvironmentalProfessional
PH Educator
Nu
mb
er E
mp
loye
d
LOCAL
STATE
FEDERAL
OTHER
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
National Summary (cont’d)Estimated ratios of workers /100,000 population in DHHS Regions
118 128
174 179
76
116
7790
187200
I II III IV V VI VII VIII IX X
DHHS Region
Mea
n S
tate
an
d T
erri
tori
al R
atio
s
National Ratio
158
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
National Summary (cont’d)Range of workers to 100,000 population
Must understand PH systems to interpret
PA lowest—why?
SC highest—why?
National includes federal
Estimated Ratios of Public Health Workers per 100,000 Population
37
158
566
Pennsylvania National South Carolina
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Public Health Worker/Population Region IV
1:500
1:177
1:895 1:1096
1:1355
1:712
1:685
1:1003
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Worker distribution by Occupational Category -Region IV
STATE
9%5%
9%
45%
20%
46%27%
59% 52% 41%
13%
16%
14%26%
11%
4%
7%
11%
23%17%
29%
52%
12%4% 1% 2% 2%
47%
33%
1%
2%
20%
28%19% 19%
.01%.01%.04%
73%
2%
AL FL GA KY MS NC SC TN
Pe
rce
nta
ge
of
Wo
rke
rs
CategoryUnreported
Clerical/Support
Technical
Professional
Administrative
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Wisconsin vs. Arizona
Distribution of workers by occupational category at three Locations
Wisconsin OPM Workers by Location
6% 7%
1%2%
41%
.05%
7%4%5%
22%
.05%.7%4%
Admin
istra
tive
Profe
ssio
nal
Technic
al
Cleric
al/S
upport
Categ
ory U
nreporte
d
OPM CATEGORY
Nu
mb
er
Em
plo
ye
d
State
Local
Other
Admin
istra
tive
Arizona OPM Workers by Location
60%
2%
29%
0.06%6%3%
Profe
ssio
nal
Technic
al
Cleric
al/S
upport
Categ
ory U
nreporte
d
OPM CATEGORY
Nu
mb
er
Em
plo
ye
d State
Local
Other
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Wisconsin Percentage of PH Workers by Agency Source
Wisconsin Department of Agriculture, Trade & Consumer Protection
9%
Wisconsin Department of Natural Resources
16%
Wisconsin State Lab of Hygiene
7%ASTPHND Survey*
5%
March of Dimes
0.05%
Wisconsin Department of Health and Family
Services
63%
* Association of State and Territorial Public Health Nutrition Directors 1994 Survey Data-file.
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
About PH workforce data
Data are descriptive
Interpretation demands understanding PH system in each state
Different basis for analysis than general health workforce statistics
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Issues
Difference in PH structures resulted in varying types of information
states w/ centralized systems
states w/ decentralized systems
combination of both centralized and decentralized
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Issues
Data differed from jurisdiction to jurisdiction
Inconsistent time period Individual workers vs. full-time equivalents
Detail --some included every job title, others provided less detail
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Audience
Leadership of public health agencies
Evaluators of public health programs
Schools of public health, other health professions schools
Policy analysts in legislatures and executive branch policy offices
Workforce researchers, including Department of Labor
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Uses
Basis for developing policy for future enumeration
Distribution of workers compared w/ caution to other state’s or agencies
Specific program areas comparative analysis (nutritionists, PH educators)
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
WorkforceDatabase
Public Health
Community Consensus
HRSACDC
ASTHO
NALBOH NACCHO
Idea Players Practical Decisions
APHA
Reality
Who, Where, How to Count?
Official PH + ? Partners
How specific?
Details on professions?
Data Source?
Time Limits?
Pu
blic H
ealth W
orkforce D
atabase
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
Moving Forward
Range of governmental public health to include?
Range outside governmental public health to include?
What level of specificity?
Should any public health professions be reported in detail?
Who will provide data to the database?
What time period should be used to limit information?
October 23, 2001 Center for Health PolicyColumbia University School of Nursing
The Public Health Workforce:Enumeration 2000 online
Website:
http://cpmcnet.columbia.edu/dept/nursing/institute-centers/chphsr/
EnumMain.html