No Slack in the System: Workforce Strain, Redistribution, and Recalibration in State and Local Government Public...

Area of Science:

• Public Health
• Epidemiology
• Health Workforce Studies

Background:

• The COVID-19 pandemic placed unprecedented demands on state and local public health agencies.
• The response required extensive adaptation across all facets of the public health workforce.
• Understanding the pandemic's impact on workforce size and overtime is crucial for future preparedness.

Purpose of the Study:

• To quantify the scale of COVID-19 response efforts within the public health workforce.
• To assess the contribution of overtime to public health service delivery during the pandemic.
• To analyze changes in agency size and program area distribution post-pandemic.

Main Methods:

• Utilized data from the Public Health Workforce Interests and Needs Survey (2021 and 2024).
• Analyzed responses from employees involved in COVID-19 response (n=30,914) and 214 participating agencies.
• Focused on the subset of employees serving in a COVID-19 response role.

Main Results:

• Overtime accounted for 25% of the total full-time equivalent (FTE) COVID-19 response workforce, equivalent to 25,000 FTEs.
• 41% of agencies experienced a decrease in overall staff size between 2021 and 2024.
• Shifts in primary program areas were influenced by changes in non-permanent employee proportions.

Conclusions:

• The pandemic significantly strained the capacity of an already underfunded and understaffed public health workforce.
• Many agencies are now smaller than at the pandemic's peak.
• Without infrastructural changes, the public health workforce may struggle to meet future crisis demands.