Lankau Emily W, Chiang Monica, Dudley Julie, Miller Kimberly, Shields Ann Marie, Alongi Jeanne, Macchi Marti, Hohman Katherine H
Author Affiliations: National Association of Chronic Disease Directors, Decatur, Georgia (Dr Lankau, Mss Dudley, Miller, and Shields, Dr Alongi, Ms Macchi, and Dr Hohman); and Public Health Associate Program, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Chiang).
J Public Health Manag Pract. 2025;31(3):392-398. doi: 10.1097/PHH.0000000000002083. Epub 2024 Nov 12.
The National Association of Chronic Disease Directors (NACDD) is a nonprofit organization that supports state and territorial chronic disease prevention and health promotion efforts through capacity building and technical assistance. Each year, NACDD surveys health department leaders who oversee chronic disease prevention and health promotion (hereafter, Chronic Disease Directors). We have previously used the annual survey results to inform strategic planning and resource allocation but have not historically published key findings in the peer-reviewed literature. In this paper, we report on NACDD's 2023 survey outcomes and place those findings into the broader public health policy context.
State Chronic Disease Directors completed a survey about their organizational capacity and development needs. Responses were summarized in aggregate and by jurisdiction size.
State chronic disease units have varied staffing and responsibilities, but most address diabetes, cardiovascular diseases, and cancer screening and prevention. Chronic Disease Directors generally reported strong or improving capacity in most practice areas but ranked workforce development lower. Staffing increased slightly during 2023 compared with the 2020 baseline (median of 1.3 and 1.1 employees per 100 000 jurisdiction population, respectively). However, Chronic Disease Directors expressed ongoing concerns about turnover, hiring, and training of inexperienced staff, as well as about funding limitations and uncertainty. Looking forward to 2024, many Chronic Disease Directors expressed intentions to focus on supporting their workforce with training and development opportunities and addressing health equity.
During this period of pandemic recovery, turnover, hiring, and training-particularly of the many new public health staff-remain key areas of concern for many chronic disease units. Continued stabilization of public health funding and increased prioritization of organizational capacity development-particularly workforce development, chronic disease data systems, and tools for addressing health equity-could help ensure chronic disease units can better address current and emerging challenges in chronic disease prevention and health promotion.
美国国家慢性病主任协会（NACDD）是一个非营利组织，通过能力建设和技术援助来支持州和地区的慢性病预防及健康促进工作。每年，NACDD都会对负责慢性病预防和健康促进工作的卫生部门领导（以下简称慢性病主任）进行调查。我们此前曾利用年度调查结果为战略规划和资源分配提供参考，但历来未在同行评审文献中发表关键调查结果。在本文中，我们报告了NACDD 2023年的调查结果，并将这些结果置于更广泛的公共卫生政策背景中。
州慢性病主任完成了一项关于其组织能力和发展需求的调查。对回复进行了汇总，并按辖区规模进行了分类总结。
州慢性病单位的人员配备和职责各不相同，但大多数都涉及糖尿病、心血管疾病以及癌症筛查与预防。慢性病主任普遍报告称，在大多数业务领域能力较强或有所提升，但对劳动力发展的排名较低。与2020年基线相比，2023年人员配备略有增加（每10万辖区人口的员工中位数分别为1.3人和1.1人）。然而，慢性病主任对人员流动、招聘、无经验员工的培训以及资金限制和不确定性仍持续表示担忧。展望2024年，许多慢性病主任表示打算专注于通过培训和发展机会来支持其员工队伍，并解决健康公平问题。
在这一疫情恢复期，人员流动、招聘和培训，尤其是众多新公共卫生人员的培训，仍然是许多慢性病单位关注的关键领域。持续稳定公共卫生资金，并提高对组织能力发展的重视程度，特别是劳动力发展、慢性病数据系统以及解决健康公平问题的工具，有助于确保慢性病单位能够更好地应对慢性病预防和健康促进方面当前和新出现的挑战。
