Leider Jonathon P, Shah Gulzar H, Castrucci Brian C, Leep Carolyn J, Sellers Katie, Sprague James B
de Beaumont Foundation, Bethesda, Maryland.
Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia.
Am J Prev Med. 2014 Nov;47(5 Suppl 3):S331-6. doi: 10.1016/j.amepre.2014.07.017. Epub 2014 Oct 16.
State and local public health department infrastructure in the U.S. was impacted by the 2008 economic recession. The nature and impact of these staffing changes have not been well characterized, especially for the part-time public health workforce.
To estimate the number of part-time workers in state and local health departments (LHDs) and examine the correlates of change in the part-time LHD workforce between 2008 and 2013.
We used workforce data from the 2008 and 2013 National Association of County and City Health Officials (n=1,543) and Association of State and Territorial Health Officials (n=24) profiles. We employed a Monte Carlo simulation to estimate the possible and plausible proportion of the workforce that was part-time, over various assumptions. Next, we employed a multinomial regression assessing correlates of the change in staffing composition among LHDs, including jurisdiction and organizational characteristics, as well measures of community involvement.
Nationally representative estimates suggest that the local public health workforce decreased from 191,000 to 168,000 between 2008 and 2013. During that period, the part-time workforce decreased from 25% to 20% of those totals. At the state level, part-time workers accounted for less than 10% of the total workforce among responding states in 2013. Smaller and multi-county jurisdictions employed relatively more part-time workers.
This is the first study to create national estimates regarding the size of the part-time public health workforce and estimate those changes over time. A relatively small proportion of the public health workforce is part-time and may be decreasing.
2008年经济衰退对美国州和地方公共卫生部门的基础设施产生了影响。这些人员配置变化的性质和影响尚未得到充分描述，尤其是对于兼职公共卫生工作队伍而言。
估计州和地方卫生部门（LHDs）的兼职工作人员数量，并研究2008年至2013年间兼职LHD工作队伍变化的相关因素。
我们使用了2008年和2013年全国县市卫生官员协会（n = 1543）以及州和领地卫生官员协会（n = 24）概况中的劳动力数据。我们采用蒙特卡洛模拟，在各种假设下估计劳动力中兼职人员的可能和合理比例。接下来，我们采用多项回归评估LHDs人员配置组成变化的相关因素，包括管辖范围和组织特征以及社区参与度指标。
具有全国代表性的估计表明，2008年至2013年间，地方公共卫生工作队伍从19.1万人减少至16.8万人。在此期间，兼职工作队伍占总数的比例从25%降至20%。在州一级，2013年回复的州中，兼职工作人员占劳动力总数的比例不到10%。规模较小和多县管辖的地区雇佣的兼职人员相对较多。
这是第一项针对兼职公共卫生工作队伍规模进行全国性估计并估计其随时间变化的研究。公共卫生工作队伍中兼职人员的比例相对较小，且可能在减少。
