Journal of Public Health Management and Practice最新文献

Context: The Public Health Workforce Interests and Needs Survey (PH WINS) was fielded in 2014, 2017, and 2021. In the last 10 years, it has provided participating health departments and the field with data to improve recruitment and retention, strengthen workforce development efforts, guide strategic planning, and raise critical funds to improve public health infrastructure. It captures individual perspectives on engagement and satisfaction, intention to leave, training needs, and workplace infrastructure. This article describes the methods used for the 2024 administration of PH WINS.

Ph wins: PH WINS 2024 was fielded to a nationally representative sample of staff in State Health Agency Central Offices (SHA-CO) and local health departments (LHDs) from September 9, 2024, to January 17, 2025. The instrument was revised to improve the actionability of the results, reduce respondents' cognitive burden, and align with existing standards or survey questions. PH WINS 2024 had 12 sampling frames, compared with the 3 in previous years: SHAs, members of the Big Cities Health Coalition (BCHC), and LHDs in each of the 10 Health and Human Services (HHS) Regions. All participating agencies were surveyed using a census approach.

Participation: Overall, staff lists for 48 SHAs, 1,178 LHDs were collected, and the survey was sent to 159 627 individuals. PH WINS received a total of 56 595 responses, a 37% of eligible respondents. The SHA frame received responses from 29% of eligible respondents, BCHC members received 33%, and all other LHDs received 51%. The nationally representative SHA-CO frame included a total of 18 110 individuals, and the nationally representative LHD frame included 38 485 individuals from all 1178 LHDs. For the first time, the national sample of LHDs included small LHDs.

Reflections: With the 2024 administration of PH WINS, all state and local public health departments in the United States had the opportunity to participate, yielding a nationally representative sample of small LHDs for the first time. State and local health department leaders should be empowered to use the results for workforce development and other planning. Questions were modified to become more action-oriented, rigorous, and stable over time to maximize the utility of PH WINS for years to come. Given the changing public health landscape associated with new outbreaks, disasters, and the political environment, these changes are critical.

Context: Salary plays a crucial role in recruiting and retaining employees in public health; however, information about trends in compensation is limited.

Objective: To analyze trends in earnings among state and local governmental public health workers between 2017 and 2024.

Methods: Data used are from the Public Health Workforce Interests and Needs Survey for the years 2017, 2021, and 2024. The analytic sample comprised 34 379 full-time permanent employees with complete salary data in 2017, 32 862 in 2021, and 45 241 in 2024, representing state health agency (SHA) and local health department (LHD) public health workers in each respective year. We performed a multi-cross-sectional analysis using descriptive and bivariate analyses and interval-based regression techniques to explore relationships between annualized earnings and key individual and agency-level characteristics.

Results: Earning patterns in 2024 were largely consistent with historical patterns. Individual and agency-level characteristics continued to play a significant role in shaping salary. Higher salaries remained associated with higher supervisory status, longer tenure, higher educational attainment, salaried (versus hourly) employment, union/bargaining unit representation, and employment setting within SHAs versus LHDs. Between 2017 and 2024, annual earnings for full-time permanent employees increased from $57 817 in 2017 to $73 299 in 2024, representing a 27% average increase of $15 482. However, when adjusted for inflation, annual wages showed no real growth, indicating that earnings remained largely stable in terms of purchasing power during this timeframe. Subgroups that experienced declines in inflation-adjusted salaries between 2017 and 2024 include executives, employees with longer tenures, employees with doctoral degrees, and employees with public health degrees versus degrees in other fields.

Conclusions: The continued decline in inflation-adjusted earnings for certain groups and persistent gender and racial pay gaps indicate that without targeted interventions, public health agencies may face challenges in retaining experienced professionals, attracting new talent, and ensuring workforce stability.

Objective: This study aimed to enhance recruitment strategies of local health departments (LHDs) by examining worker preferences for compensation and organizational characteristics.

Study design: Data from a discrete choice experiment conducted in September 2022 were analyzed using a multinomial logit model to estimate the value of workplace characteristics including salary, contract length, flexible arrangements, employer type, and perks. The study included working-age adults (18-65 years) willing or able to work for pay, without prior experience in governmental public health departments.

Findings: All workers prioritized competitive salaries, flexible work arrangements, and jobs at nonprofit organizations with compelling missions. Some workers valued loan forgiveness programs and performance-based promotions. Finally, applicants generally did not avoid jobs in the public health sector.

Conclusions and implications: Competitive salaries are pivotal in attracting and retaining skilled workers in the public health sector. LHDs should conduct comprehensive salary studies benchmarked against other competing employers, effectively highlight the mission and public service responsibilities of jobs posted, and update internal policies, including flexible work hours and remote work options, to align with the preferences of the modern workforce.

This study examines entry pathways, motivations, and workforce characteristics of employees aged 35 years and under using data from the 2024 Public Health Workforce Interests and Needs Survey. The survey received 56 595 responses, including 12 839 from the 35 and underage group who completed tailored questions on entry and career motivations. Compared with older colleagues, a larger proportion of younger staff hold a public health degree (36% vs 17%) and work in public health sciences roles (54% vs 37%). Most entered the state and local government public health workforce from other jobs, with 60% coming from outside the public health field. Although many intend to remain in governmental public health long term, advancement barriers contribute to anticipated early departures. These findings suggest opportunities to strengthen and expand pathways into governmental public health, as well as leadership development strategies to retain this skilled and mission-driven segment of the workforce.

Policies that encourage supportive environments for walking and bicycling have been noted to be effective; however, the impact on health is not well documented. This study examined the relationship between state-level policies and markers of children and adolescent health and health-related behaviors. This policy review gathered information from sources on state-level active travel policies, funding, school activity policies from the 2024 Safe Routes to School State Report Cards (summary score), and child health outcomes by state. Overall scores were significantly associated with several physical activity variables, rate of children and adolescents with overweight/obesity, child chronic health conditions, poverty rates, and neighborhood access to activity resources, most in the hypothesized direction. Differences between the top and bottom scoring states were noted for several activity variables, health, and environmental variables. These findings provide a rationale for legislators to consider laws and policies within their own states to combat poor youth health outcomes.

Background: The frequency of hypertension in Ghana has risen dramatically in recent decades. Inadequate diagnosis and inappropriate care of diagnosed cases has led to increased mortality and morbidity from poor blood pressure control and associated consequences, especially in areas with low socioeconomic status. This study aimed to assess the prevalence of hypertension and its determinants in underserved coastal communities in Ghana.

Methods: This screening survey is part of a quasi-experimental initiative in 8 coastal towns to detect hypertension patients and connect them to local care. The initial survey examined 10 000 consenting individuals aged 18 years and older in these localities. Poisson regression model was used to determine the associations of socioeconomic factors with hypertension occurrence.

Results: The median age of the study participants was 38 years, majority being women (65.3%). The overall age-standardized hypertension rate was 26.0% (95% CI: 25.1-26.9), with significant variability across subdistricts and communities ranging from 22.0% (95% CI: 20.1-23.8) in Ga South to 32.7% (95% CI: 30.2-35.2) in Krowor. The prevalence of hypertension decreased with increasing levels of monthly income with those earning GHC 1501-2000 having the lowest adjusted prevalence ratio (aPR, 0.64; 95% CI: 0.49-0.84). Besides age, female sex (aPR, 1.18; 95% CI: 1.08-1.28), being married (aPR, 1.19; 95% CI: 1.05-1.35), and alcohol consumption (aPR, 1.23; 95% CI: 1.13-1.35), were significantly associated with increased prevalence of hypertension.

Conclusion: The coastal communities in Ghana are highly affected by hypertension with a remarkably high prevalence in women. Tailored public health strategies such as education on lifestyle modification, creation of recreational areas, use of telemedicine and mobile applications for monitoring, and follow-up may help to decrease the risk of hypertension and its complications in these communities.

Context: Trust in public health strongly influences the effectiveness of public health emergency preparedness and response (PHEPR) activities, particularly risk communication. However, trust in public health has declined, in part due to the growing influence of misinformation and disinformation. Resources for practitioners to anticipate and address these issues are limited.

Objective: To document expert and practitioner perspectives on how to successfully build trust in public health, address misinformation, and engage in risk communication activities during public health emergencies.

Design, setting, and participants: From November 2022 to December 2023, researchers conducted 38 interviews and 8 focus groups with 100 total participants from 21 states and the District of Columbia. Qualitative analysis of content documented experiences and lessons learned regarding trust, misinformation, and risk communication.

Main outcome measures: Analysis yielded the following themes: the importance of bolstering public health communication workforces, funding mechanisms, and other internal capabilities; successful partnerships with or use of secondary messengers; improving message reach through modern engagement tactics, evaluation, and tailoring; combatting uncertainty and distrust with health literacy and government transparency; the challenges of countering misinformation; and unique approaches to engaging populations with low trust in public health.

Results: Within the identified themes, key informants provided additional detail regarding these experiences and how local public health practitioners had or could initiate improvements or respond to challenges. To translate these findings to practice, researchers created a checklist of 5 prioritized strategies to build trust, anticipate misinformation, and improve risk communication for public health emergencies, including associated recommended tasks that health departments may enact before and throughout public health emergencies as they arise.

Conclusions: Health departments and partners can use the checklist, recommendations, and successes described to improve future public health practice. However, the challenges reported suggest the need for wider, proactive efforts to prioritize communication resources in PHEPR plans.