Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
J Public Health Manag Pract. 2012 Nov;18(6):595-601. doi: 10.1097/PHH.0b013e3182602f1d.
This study assessed the workforce capacity of Nebraska Local Health Departments (LHDs) from the perspective of public health programmatic areas. DESIGN AND OUTCOMES MEASURES: We conducted a mail survey of 21 LHD directors in Nebraska and collected the information on LHD workforce capacity, training, and competency by public health programmatic areas (eg, environmental health, mental health). An FTE shortage index score for each public health programmatic area was calculated to estimate an LHD's current shortage in that area. Spearman correlation analysis was conducted to examine the relationships between LHD capacity, manpower shortage, and staff training and competency.
Our results indicated that a significant proportion of the 18 responding LHDs in Nebraska did not have staff to cover the areas of mental health (66.7%), sexually transmitted diseases (44.4%), occupational safety and injury (38.9%), oral health (27.8%), and health disparities (22.2%). The results also suggest that Nebraska's LHDs experienced the greatest workforce shortages in environmental health (mean shortage index = 0.45), followed by chronic diseases (0.44), health disparities (0.41), and sexually transmitted diseases (0.41).
The identified shortage areas should be a high priority for federal and state policy makers to address through developing appropriate strategies and providing adequate funding for LHD workforce development in Nebraska. Using the public health programmatic area approach to collect workforce data may help fill some gaps in the current efforts of LHD workforce enumeration. Future research is needed to examine the validity and reliability of the workforce measures based on public health programmatic areas.
本研究从公共卫生计划领域的角度评估了内布拉斯加州地方卫生部门（LHD）的劳动力能力。
我们对内布拉斯加州的 21 名 LHD 主任进行了邮件调查，并收集了有关 LHD 劳动力能力、培训和各公共卫生计划领域（如环境卫生、心理健康）的能力的信息。为每个公共卫生计划领域计算了 FTE 短缺指数得分，以估计该地区 LHD 当前的短缺情况。进行 Spearman 相关分析，以检查 LHD 能力、人力短缺和员工培训和能力之间的关系。
我们的结果表明，内布拉斯加州 18 个回应的 LHD 中，有相当一部分没有工作人员来覆盖心理健康（66.7%）、性传播疾病（44.4%）、职业安全和伤害（38.9%）、口腔健康（27.8%）和健康差异（22.2%）等领域。结果还表明，内布拉斯加州的 LHD 在环境卫生方面面临最大的劳动力短缺（平均短缺指数=0.45），其次是慢性病（0.44）、健康差异（0.41）和性传播疾病（0.41）。
确定的短缺领域应成为联邦和州政策制定者的高度优先事项，通过制定适当的战略和为内布拉斯加州 LHD 劳动力发展提供充足资金来解决这些问题。使用公共卫生计划领域方法收集劳动力数据可能有助于填补当前 LHD 劳动力普查工作中的一些空白。需要进一步研究来检验基于公共卫生计划领域的劳动力衡量标准的有效性和可靠性。
