As Public Health Agencies Transform, ASTHO Launches a New Interactive Data Visualization Tool to Track Progress and Trends
ASTHO profile data indicates the public health workforce has more temporary and vacant positions than ever before
December 21, 2023
ARLINGTON, VA— The Association of State and Territorial Health Officials (ASTHO) today released data from its ASTHO Profile of State and Territorial Public Health (Profile), the only source of comprehensive information on resources and trends in state and territorial public health agencies. The profile provides a look at the infrastructure and work overseen by the public health workforce across all states, the District of Columbia, U.S. territories, and freely associated states.
Results from the 2022 profile survey are presented in a new dashboard that provides viewers with interactive data elements, stories connecting the data to actions, new information focused on health equity and informatics, as well as individual state profile pages. The dashboard also includes a feature which allows agencies to identify states and territories with specific characteristics or that are working on similar projects.
“The information in the ASTHO profile dashboard is critical to understanding state and territorial public health infrastructure and how that has changed overtime across the country,” says Michael Fraser, PhD, ASTHO CEO. “The 2022 data reveal that public health agencies have more temporary positions than ever before, a trend that is certainly unsettling as agencies seek to staff up post-pandemic.”
Key Findings
Growth of Vacant Positions and Temporary and Contract Workers Outpaces Employment
The rate of non-temporary employees per 100,000 population was stable; however, the ratio of temporary workers to regular employees increased by 39% from 2019 to 2022, with 2.2 temporary or contract workers to every 10 regular employees. The rate of vacant positions per 100,000 population increased and now represents over 11% of all public health positions.
Public Health Spending Grows After COVID-19
Over the past decade, the average expenditures and per capita expenditures for public health agencies have fluctuated. Sizeable increases in public health spending were observed in fiscal year 2021 as a direct response to the COVID-19 pandemic. While COVID-19 represented approximately one third of 2021 total state public health agency expenditures, expenditures decreased across many public health expenditure categories.
Agencies Show Commitment to Addressing Health Inequities
Nearly all agencies are engaged in health equity activities, and findings highlight the potential benefits of having a full-time health equity director. State health agencies with a full-time health equity director more frequently reported having established priorities for racial/ethnic population groups who have experienced avoidable inequities. In addition, agencies with a full-time health equity director more frequently reported offering specific training on key health equity topics.
Agencies Are Modernizing Data Systems While Struggling to Hire Informatics Talent
Many health agencies reported having an informatics-related strategic plan (e.g., data modernization plan) and receiving capacity funding from the CDC. Although the average number of public health professionals serving an informatics specialist function has increased since 2019, many agencies report significant challenges in recruiting and retaining personnel to fulfill the role. An informatics career series may help. State agencies without an informatics career series more often reported finding recruitment and retainment very challenging. Most agencies collaborate with private and academic partners to support their ongoing informatics work.
More in-depth information on the Profile results can be found on the dashboard, as well as in data briefs on public health agency activities, financial resources, and workforce at www.astho.org/profile.
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ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.
The Profile of State and Territorial Public Health survey and dashboard was supported by funding from the Centers for Disease Control and Prevention cooperative agreement number NU38OT000290, and Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems Grant (NE11OE000066), as well as the Robert Wood Johnson Foundation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the Department of Health and Human Services or the Foundation.