Assessment of the epidemiologic capacity in state and territorial health departments--United States, 2001.

Epidemiology is essential for the detection, control, and prevention of major health problems. Described as the foundation of all public health functions, epidemiology provides information needed to perform the 10 essential public health services. One of the national health objectives for 2010 calls for increases in the proportion of tribal, state, and local public health agencies that provide or ensure comprehensive epidemiology services to support essential public health services (objective 23-14). Although national infectious disease capacity has been assessed, no comprehensive national assessment of epidemiologic capacity has been conducted. To assess core epidemiology and infectious disease capacity of public health departments, the Council of State and Territorial Epidemiologists (CSTE) surveyed state and territorial health departments in November 2001, immediately before the release of approximately 1 billion dollars in federal funding to state health departments for terrorism and public health emergency preparedness. This report summarizes the results of that survey, which indicate that the national epidemiology infrastructure in state and local health departments is far below optimal capacity and that approximately 42% of epidemiologists working in public health have no formal epidemiologic training. Although recent terrorism preparedness initiatives have improved capacity in infectious disease epidemiology, increased resources are needed to build epidemiologic capacity necessary to address the major causes of morbidity and mortality.