Zhang Na, Wu Qiong, Li Shaoqiong, Wang Chongyi, Mao Ayan, Guo Qing, Qiu Wuqi
Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Information Center, Chinese Center for Disease Control and Prevention, Beijing, China.
Front Public Health. 2025 Apr 16;13:1553314. doi: 10.3389/fpubh.2025.1553314. eCollection 2025.
The public health workforce plays a crucial role in the development of health systems, particularly in enhancing the capacity of public health infrastructure. Understanding the current status of human resources in the Centers for Disease Control and Prevention (CDC) is essential for establishing future development goals. This study aims to assess the quantity and equity of the human resources in China's CDCs since the outbreak of COVID-19, with the goal of promoting a more equitable distribution of the CDC workforce and enhancing the capacity to respond effectively to major public health emergencies.
Using nationwide administrative data from China CDC (2019-2023), we conducted a two-stage analysis: First, we conducted a descriptive analysis of the current status and trends of the CDC workforce. Second, we performed an equity assessment through multilevel decomposition (1) Calculated Gini coefficients across three dimensions (geography, Gross Domestic Product per capita, population density); (2) Applied Theil T/L index to partition inequalities into within-region and between-region components.
Between 2019 and 2023, the CDC workforce in China increased to 230,594 employees, with workforce density rising from 1.3 to 1.64 per 10,000 residents, 76.26% being health professionals, a majority of whom were female, and the 25-34 age group comprising the largest segment (29.06%). Additionally, while the proportion with less than 5 years of service grew, staff with over 30 years of service formed the largest tenure group (30.69%). The Gini coefficient revealed extreme spatial inequality, indicating that geographic distribution was significantly exceeding those based on economic and population distributions, with values of 0.5815, 0.3866, and 0.1843, respectively, in 2023. Decomposition of inequality indicated that both general staff and health professionals were primarily affected by within-region disparities, with an increasing trend of within-region inequity from 2019 to 2023. In 2023, Theil T analysis showed that within-region inequality accounted for 76.67% of staff disparities, while for health professionals, this figure was 64.21%.
The human resource landscape in China's CDCs faces challenges related to both underfunding and an aging workforce. Inequities in workforce distribution persisted from 2019 to 2023, with significant disparities within regions. Strengthening the CDC workforce, particularly in underdeveloped and sparsely populated areas, is essential for addressing these challenges.
公共卫生人力在卫生系统发展中发挥着关键作用，尤其是在提升公共卫生基础设施能力方面。了解疾病预防控制中心（CDC）的人力资源现状对于制定未来发展目标至关重要。本研究旨在评估自新冠疫情爆发以来中国疾病预防控制中心人力资源的数量和公平性，以促进疾病预防控制中心工作人员更公平的分配，并提高有效应对重大突发公共卫生事件的能力。
利用中国疾病预防控制中心的全国行政数据（2019 - 2023年），我们进行了两阶段分析：首先，我们对疾病预防控制中心工作人员的现状和趋势进行了描述性分析。其次，我们通过多层次分解进行公平性评估：（1）计算三个维度（地理、人均国内生产总值、人口密度）的基尼系数；（2）应用泰尔T/L指数将不平等分解为区域内和区域间成分。
2019年至2023年期间，中国疾病预防控制中心的工作人员增加到230,594人，工作人员密度从每万名居民1.3人上升到1.64人，76.26%为卫生专业人员，其中大多数为女性，25 - 34岁年龄组占比最大（29.06%）。此外，虽然服务年限不足5年的人员比例有所增加，但服务年限超过30年的人员构成了最大的任期组（30.69%）。基尼系数显示出极端的空间不平等，表明地理分布明显超过基于经济和人口分布的不平等，2023年的值分别为0.5815、0.3866和0.1843。不平等分解表明，一般工作人员和卫生专业人员主要受区域内差异的影响，2019年至2023年区域内不平等呈上升趋势。2023年，泰尔T分析表明，区域内不平等占工作人员差异的76.67%，而对于卫生专业人员，这一数字为64.21%。
中国疾病预防控制中心的人力资源状况面临资金不足和劳动力老龄化的挑战。2019年至2023年期间，劳动力分布存在不平等，区域内存在显著差异。加强疾病预防控制中心的人力，特别是在欠发达和人口稀少地区，对于应对这些挑战至关重要。
