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Alignment of Public Health Agency Demographics With Populations Served
McKenzie D Campbell1, Gina M Pannell, J Mac McCullough
1Author Affiliation: School of Public and Population Health, Boise State University, Boise, Idaho.
Objectives:
To advance the public health system's understanding and ability to measure the extent to which agencies reflect the communities they serve, our objective was to develop and deploy an agency-level representation index. This measure will quantify the extent to which each agency's workforce demographics align with the demographics of the agency's catchment area.
Design:
Data for this analysis came from the 2024 Public Health Workforce Interests and Needs Survey (PH WINS), US Census Bureau American Community Survey (ACS), the Association of State and Territorial Health Officials Profile, and the National Association of County and City Health Officials Profile.
Setting:
Representation index was calculated for 48 state health agency central offices and for 34 Big City Health Coalition (BCHC) member agencies.
Participants:
The 2024 PH WINS was distributed online to state and local government public health workers across 48 state health agencies and 1178 local health departments in 49 states, with a total of 56 595 employees completing the survey, representing a 37% response rate of eligible employees.
Main Outcome Measures:
Representation index was calculated, with demographic categories and agency characteristics explored for agencies and the populations they serve.
Results:
Representation varied for state health agency central offices and BCHC agencies across the US. In general, greater demographic representation was found for ethnicity and race than for age and gender. We found few agency characteristics that were significantly associated with representation index values, although substantively important variation across agencies was noted.
Conclusions:
Representativeness varies across state and big city health departments. Substantively large variation across settings, coupled with the lack of significant agency characteristic correlations, suggests a potential opportunity for improvement and for further research. Findings may inform public health practitioners in assessing current staff composition and provide insight into organizational strategies to increase diversity in the public health workforce.
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