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Strategies to Address Public Health Worker Shortages
The following strategies to alleviate public health worker shortages were suggested by participants of the January 25, 2005 Council on Linkages Between Academia and Public Health Practice meeting. When available, links to resources—including relevant research and sample projects—from public health and other fields are listed. The strategies are organized by the following main categories:
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View additional information about worker recruitment and retention—including presentations, citations to research articles, and a list of research questions.
Download a printable PDF version of this document.
Contact Ruth Gelles if you have any questions or comments, or if you wish to suggest additional resources. |
Overarching Strategies
| General |
| Strategies |
Resources |
| Strengthen the career ladder for individuals already in public health and career paths for individuals from other fields or from the for-profit sector |
North Carolina Department of Health and Human Services, Division of Facility Services, "Results of a Follow-Up Survey to States on Career Ladder and Other Initiatives to Address Aide Recruitment and Retention in Long-Term Care Settings"
Department of Education and Department of Defense, Troops to Teachers program
Urban Institute, "Absence Unexcused: Ending Teacher Shortages"
JA Reardon, Journal of Psychosocial Nursing & Mental Health Services, “A Clinical Ladder for Milieu Counselors: An Opportunity to Contribute to Self-Esteem” (PubMed citation and abstract) |
| Support academic/practice linkages that advance worker recruitment and retention (identify effective and ineffective efforts) |
Council on Linkages Between Practice and Academia, Database of Academic / Practice Linkages
Kentucky Community & Technical College System - Workforce Network |
| Record best and unsuccessful practices in worker recruitment and retention |
Center for Medicare and Medicaid Services, “Promising Practices in Home and Community Based Services”
National Governors Association, Center for Best Practices
National Association of County and City Health Officials, Model Practices Database |
Identify roles—including teaching and mentoring—that retired workers can play to continue to serve the public health field (work with national membership organizations to highlight model programs) |
Civic Ventures and the MetLife Foundation, "New Face of Work Survey: Documenting the Desire for Good Work in the Second Half of Life"
Harvard School of Public Health and the MetLife Foundation, "Reinventing Aging: Baby Boomers and Civic Engagement"
National Council on the Aging, "RespectAbility Web Survey" |
| Funding |
| Promote stronger connections between public health, healthcare, fire and police departments, and others so that decisions about resource allocation are based on promoting the healthiest community, rather than focusing only on medical care |
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| Advocate greater funding for public health workforce development efforts – potentially tie funding for those efforts with another continually increasing expenditure (eg., devote equivalent of 1% of federal spending on Medicare to public health workforce) |
Nurse Reinvestment Act
Public Health Workforce Development Act of 2005
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| Research |
| Identify research needs related to recruitment and retention |
Council on Linkages Between Academia and Public Health Practice, "Research Questions on Public Health Worker Recruitment and Retention" |
| Enumerate the current public health workforce and the demand for public health workers in order to identify areas in which to focus recruitment and retention efforts |
Association of State and Territorial Health Officials, Council of State Governments, and National Association of State Personnel Executives, “State Public Health Employee Worker Shortage Report: A Civil Service Recruitment and Retention Crisis”
Health Resources and Services Administration National Center for Health Workforce Analysis, State Workforce Profiles and “Public Health Workforce Study” |
| Demonstrate the connection between workforce standards and health outcomes, in order to advocate greater investment in public health workforce |
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Strategies to Recruit Workers
| General |
| Strategies |
Resources |
| Target recruitment efforts towards workers in sectors where job security and or availability is poor in order to increase the diversity of professional backgrounds and race/ethnicity in public health |
Health Resources and Services Administration, “The Key Ingredient of the National Prevention Agenda: Workforce Development”
“Call Me Mister” program to recruit and support African-American male elementary school teachers
Sullivan Commission on Diversity in the Healthcare Workforce, “Missing Person: Minorities in the Health Professions”
The California Wellness Foundation, "Reflections on Increasing Diversity in the Health Professions"
American Library Association, Recruitment for Diversity
Association of Research Libraries, Diversity Initiatives |
| Engage in succession planning to determine the skills, competencies, and abilities individuals will need in the next five years |
New York State Department of Civil Service, Governor’s Office of Employee Relations, “Work Force and Succession Planning – Planning Guide”
Council on Linkages Between Academia and Public Health Practice, “Core Competencies for Public Health Professionals”
Centers for Disease Control and Prevention, Office of Workforce and Career Development, List of competencies sets |
| Develop opportunities for public health workers to continue their education without leaving the workforce to complete masters or doctoral level training |
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| Investigate the effects of credentialing on improving worker recruitment and retention |
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| Investigate making benefits portable between health agencies and states |
AARP, "Pension Portability: Is this Europe's Future? An Analysis of the United States as a Test Case" |
| Make public health practice/academia a natural next step for people who have completed the National Health Service Corps |
Health Resources and Services Administration, National Health Service Corps |
| Personnel Issues |
| Work on improving personnel issues—streamlining job application process, instituting better bonus and merit scale systems, etc. (work with the National Governors Association, the National Conference of State Legislatures, and others on the national level) |
National Teacher Recruitment Clearinghouse |
| Offer salaries that are adequate to make jobs in public health a likely career choice |
North Carolina Department of Health and Human Services, Division of Facility Services, “Results of a Follow-Up Survey to States on Wage Supplements for Medicaid and Other Public Funding to Address Aide Recruitment and Retention in Long-Term Care Settings”
National Clearinghouse on the Direct Care Workforce, Practice Profile Database
American Library Association, Advocating for Better Salaries and Pay Equity Toolkit
Candace Howes, “Examining the effects wage and benefit differentials have on recruitment, retention, and hours of work among the home care workforce” project supported by The Robert Wood Johnson Foundation (HSRProj citation and abstract)
Labor Market Information Center, data about state and national wage trends |
| Include standards related to staffing levels or recruitment and retention as part of agency accreditation |
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| Raise Public Awareness and Increase Public Perception of Public Health Careers |
| Enhance the perception of governmental service as a good place to work |
Brookings Institution, Center for Public Service
Brookings Institution, "Now is the Time to Rebuild and Renew Public Service"
U.S. Office of Personnel Management, "Federal Human Capital Survey: 2004"
Partnership for Public Service
Student Gateway to the U.S. Government |
Develop a career guide for public health to help students and professionals in other sectors identify, learn about, apply for, and obtain jobs in public health practice settings |
Pfizer, “Advancing Healthy Populations: The Pfizer Guide to Careers in Public Health”
What Is Public Health website, developed by the Association of Schools of Public Health
ExploreHealthCareers website, a project of the Josiah Macy Jr. Foundation and the Association of Academic Health Centers
National Institutes of Health Office of Science Education, "LifeWorks"
Central Jersey Regional Library Cooperative, Become a Librarian website |
Increase image and awareness of public health |
U.S. Merit Systems Protection Board, “Managing Federal Recruitment: Issues, Insights, and Illustrations,” Chapter: “Improve Marketing Efforts”
University of Iowa Hygienic Laboratory, “Public Health – Science in Action” video
University of Minnesota, “Outbreak at Watersedge: A Public Health Discovery Game” |
| Programs Involving Students |
Work with career counselors in high schools, colleges, and universities to increase awareness of public health career and educational opportunities |
American College of Healthcare Executives, Careers in Healthcare Management website
Ferris State University, Career Institute, "Decisions Without Directions: National Study on Career Guidance and Decision-Making"
National Rural Health Association, Recruitment and Retention of a Quality Health Workforce in Rural Areas: Rural Health Careers Pipeline - Kindergarten to 12th Grade Education |
Develop and advertise summer jobs/internships in public health |
Connecticut Youth Health Service Corps
National Youth Leadership Forum |
Integrate information about current public health crises and issues into K-12 education system (eg., develop math and social studies curricula, include public health issues in text books) |
Centers for Disease Control and Prevention, EXCITE (Excellence in Curriculum Integration through Teaching Epidemiology)
Population Connection
National Institutes of Health Office of Science Education |
Inform K-12 students about types of public health jobs available and solicit volunteers to speak during “career days” |
Health Professions Partnership Initiative
Health Resources and Services Administration, Kids Into Health Careers
Job Shadowing
I Could Be, online mentoring program
South Carolina Center for Educator Recruitment, Retention, and Advancement |
Develop organized structures to foster internship programs |
Health Career Connection
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Establish internships with graduate programs in public health, as well as in business, law, etc., to help workers develop skills identified in needs assessments of public health organizations |
Rollins School of Public Health, Emory University, Student Outreach and Response Team |
Incorporate public health opportunities into high school community service requirements |
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Study the job choices of MPH graduates to determine what would influence their decision to work in public health and to make the case for greater funding for scholarships |
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Strategies to Retain Workers
| General |
| Strategies |
Resources |
Identify and publicize opportunities for people who begin at entry level to advance in public health organizations |
National Clearinghouse on the Direct Care Workforce, Practice Profile Database |
Investigate how to best use resources related to emergency preparedness to strengthen public health systems as a whole |
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Increase collaboration with other community-based organizations to accomplish equal or greater health improvements without overburdening understaffed agencies |
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Improve induction programs (work with the National Association of State Personnel Executives) |
California Commission on Teacher Credentialing, “Standards of Quality and Effectiveness for Beginning Teacher Support and Assessment Programs” |
Encourage people with less training to enter public health professions and provide training necessary to help them advance (para professional to career model) |
Urban Institute, “Absence Unexcused: Ending Teacher Shortages” |
| Personnel Issues |
Increase the flexibility of civil service systems to reward good performance and allow flexibility to remove low performers |
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Implement merit increases concurrent with signing bonuses, loan repayment, etc., so current employees do not feel excluded |
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| Work Environment |
Alleviate stresses in work environment – lack of administrative support, poor physical facilities, emphasis on politics |
D. Snuttjer, Radiology Management, “Employee Retention Tools: Looking Beyond Radiology” (PubMed citation and abstract) |
Address ineffective managerial practices |
National Public Health Leadership Institute
University of North Carolina, Management Academy for Public Health
CS Kleinman, Journal of Continuing Education in Nursing, “Leadership: A Key Strategy in Staff Nurse Retention” (PubMed citation and abstract) |
Measure and make available evaluations of working conditions at public health organizations, to increase incentive for individual organizations to improve their working environment |
Teacher Working Conditions Initiative |
Strategies to Train Workers to Best Equip Current Workforce
| Strategies |
Resources |
Strengthen partnerships with the Centers for Disease Control and Prevention’s Centers for Public Health Preparedness and the Health Resources and Services Administration’s Public Health Training Centers to leverage their capability to provide continuing education for a large number of public health workers |
Centers for Disease Control and Prevention, Centers for Public Health Preparedness
Health Resources and Services Administration, Public Health Training Centers |
Cultivate a culture of learning/continuing education by working with elected officials to assure funding for this training; addressing issues of both time and money; and addressing staffing patterns |
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Provide professional education credits for courses/training |
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Offer salary incentives for continuing education units |
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Study the effectiveness of worker education and training projects |
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Offer training that allows workers to revisit/renew existing skills; learn new skills; and adapt to changing environment, through individual ongoing needs assessment |
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Address faculty shortages in nursing (particularly among those with practice experience) |
Association of Academic Health Centers, “Best Practices in Faculty Recruitment, Retention, and Development in Academic Health Centers” |
Cross train workers to be skilled in a range of public health settings and tasks |
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