The Hollowing Out of New York’s Public Health Workforce By Molly Fleming, Senior Program Manager, NYSACHO and Sarah Ravenhall, Executive Director, NYSACHO
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he public health workforce in the United States has faced staffing shortages for over a decade, with one estimate by the Association of State and Territorial Health Officials (ASTHO) finding that the national public health workforce decreased by almost 10% between 2012 and 2019, while at the same time the United States population increased.1 New York State’s public health workforce has not been immune from this phenomenon, and these issues have only been further exacerbated by the COVID-19 pandemic. New York’s local health departments (LHD) promote and protect the health of the populations living in each of New York’s 62 counties. They serve as the first line of defense against all new and potentially widespread public health crises. To assess whether the LHD workforce has been impacted by national shortages, the Region 2 Public Health Training Center (PHTC) collaborated with the New York State Association of County Health Officials (NYSACHO) to study the local health workforce for New York State. The goals of the study were to quantify New York’s LHD workforce, assess how the workforce has changed since the COVID-19 pandemic began, and identify challenges to recruit and retain qualified public health workers in LHDs. NYSACHO and Region 2 PHTC developed the study questionnaire using validated questions from the National Association of City and County Health Officials (NACCHO) 2019 National Profile of Local Health Departments, to enable longitudinal comparison between 2019 and 2021.
At first glance, the LHD workforce appears to have remained stagnant, with a slight increase in all FTEs employed (2%) since 2019. This alone would be alarming given that during this time, LHDs were responding to the largest public health threat in nearly a century. However, when looking at the data broken down by employee type (full-time, part-time, contractual, and seasonal), this finding becomes even more worrying. Between 2019 and 2021, the full-time LHD workforce decreased by 26%, while contractual employees saw a huge increase, 12,210% (Figure 1). This large influx of contractual employees partly comes from COVID-19 funding provided by the state and federal governments for LHDs to hire contracted staff to assist with COVID-19 mitigation activities such as case-investigation, contact tracing, and vaccination. However, these employees are not permanent and when funding runs out, they will leave
The survey collected information on individuals and full-time equivalents (FTEs) employed, specific occupational titles, duration of vacancies, reasons for workforce reductions, barriers to hiring, and upcoming retirements. In late 2021, NYSACHO distributed the survey to leadership at all 58 of New York State’s LHDs, with 52 LHD’s (90%) responding. Among its key determinations, this study found that New York State’s LHD workforce has seen a marked decline in the number of full-time staff employed since 2019. 30
NYSAC News | Fall 2022
Figure 1: Changes in FTEs Employed in LHDs from 2019 to 2021, By Employee Type
