Objective:We sought to understand the relative impact of fielding mode on response rate among public health alumni.Methods:As part of the 2021 Career Trends Survey of alumni from the University of ...

Objectives. To characterize the trends in degree conferrals, degree-associated debt, and employment outcomes among undergraduate public health degree (UGPHD) graduates. Methods. We reported administrative data on degree conferrals from 2001 to 2020 from the National Center for Education Statistics (NCES). For alumni graduating from 2015 to 2019, we also reported degree-associated debt and earnings 1 year after graduation compiled by NCES. Finally, we utilized a data set on 1-year postgraduation employment outcomes for graduates from 2015 to 2020 from the Association of Schools and Programs of Public Health. Results. As of 2020, more than 18 000 UGPHDs were awarded each year, more than 140 000 in total over the past 20 years. UGPHD graduates are highly diverse, with more than 80% being women and 55% being individuals from communities of color. We find alumni worked mostly in for-profit organizations (34%), health care (28%), nonprofits (11%), academic organizations (10%), government (10%), and other (6%). Degree-associated debt was $24 000, and the median first-year earnings were $34 000. Conclusions. While growth in UGPHD conferrals has slowed, it remains among the fastest-growing degree in the nation. However, the limited pathways into government remains a significant challenge. (Am J Public Health. 2023;113(1):115-123. https://doi.org/10.2105/AJPH.2022.307113).

Objectives. To understand the occupational risk associated with COVID-19 among civilian critical workers (aged 16-65 years) in Minnesota. Methods. We estimated excess mortality in 2020 to 2021 for critical occupations in different racial groups and vaccine rollout phases using death certificates and occupational employment rates for 2017 to 2021. Results. Excess mortality during the COVID-19 pandemic was higher for workers in critical occupations than for noncritical workers. Some critical occupations, such as transportation and logistics, construction, and food service, experienced higher excess mortality than did other critical occupations, such as health care, K-12 school staff, and agriculture. In almost all occupations investigated, workers of color experienced higher excess mortality than did White workers. Excess mortality in 2021 was greater than in 2020 across groups: occupations, vaccine eligibility tiers, and race/ethnicity. Conclusions. Although workers in critical occupations experienced greater excess mortality than did others, excess mortality among critical workers varied substantially by occupation and race. Public Health Implications. Analysis of mortality across occupations can be used to identify vulnerable populations, prioritize protective interventions for them, and develop targeted worker safety protocols to promote equitable health outcomes. (Am J Public Health. 2023;113(11):1219-1222. https://doi.org/10.2105/AJPH.2023.307395).

Introduction: Maternal and child health (MCH) services are critical for vulnerable populations. Workforce shortages, poor retention, and gaps in necessary trainings impede the capacity of public health systems to address needs. This manuscript characterizes the current MCH workforce, MCH program applicants and graduates, and describe findings within a national context to devise elements of a recruitment and retention strategy. Methods: Data were obtained for public health program applicants, first-destination employment outcomes, and worker perceptions and demographics. Data were stratified according to the MCH and total public health workforce and by local, state, and national totals. Data were characterized by degree type, discipline, demographics, and employment outcomes. Results: MCH staff constitute 11% of the state and local governmental public health workforce. MCH staff are approximately as diverse, have higher educational attainment, and are more likely to hold nursing degrees than the rest of the public health workforce. Yet, just 14% of MCH staff hold any type of public health degree. The MCH pipeline from academia appears modestly sized, with approximately 5% of applicants between 2017 and 2021 applying to a MCH master’s degree. Discussion: The MCH workforce has a lower proportion of formal training or degrees in public health, though trends seem to indicate improvements. However, it is critical that a multi-faceted recruitment and retention strategy be coordinated by a broad range of stakeholders. These efforts will serve to improve the capability and capacity of the public health system to address critical needs of increasingly diverse MCH populations. Significance: In order to modernize and reimagine the academic-public health pipeline, it is critical to better understand how many applicants and graduates exist within Maternal and Child Health programs across the US, and their characteristics. This manuscript connects that information with the most recently available public health workforce information on demographics, workplace perceptions, and intent to leave among staff at state and local health departments. Data presented in this paper allow the most comprehensive characterization of the MCH academia->practice pipeline to-date, identifies a fundamental disconnect in those career pathways, and offers options to repair that break.

INTRODUCTION Recent research underscores the exceptionally young age distribution of Covid-19 deaths in the United States compared with international peers. This brief characterizes how high levels of Covid mortality at midlife ages (45-64) are deeply intertwined with continuing racial inequity in Covid-19 mortality. METHODS Mortality data from Minnesota in 2020-2022 were analyzed in June 2022. Death certificate data and published vaccination rates in Minnesota allow vaccination and mortality rates to be observed with greater age and temporal precision than national data. RESULTS Black, Hispanic, and Asian adults under age 65 were all more highly vaccinated than white populations of the same ages during most of Minnesota's substantial and sustained Delta surge and all of the subsequent Omicron surge. However, white mortality rates were lower than those of all other groups. These disparities were extreme; at midlife ages (ages 45-64), during the Omicron period, more highly-vaccinated populations had COVID-19 mortality that was 164% (Asian-American), 115% (Hispanic), or 208% (Black) of white Covid-19 mortality at these ages. In Black, Indigenous, and People of Color (BIPOC) populations as a whole, Covid-19 mortality at ages 55-64 was greater than white mortality at 10 years older. CONCLUSIONS This discrepancy between vaccination and mortality patterning by race/ethnicity suggests that, if the current period is a "pandemic of the unvaccinated," it also remains a "pandemic of the disadvantaged" in ways that can decouple from vaccination rates. This result implies an urgent need to center health equity in the development of Covid-19 policy measures.

This research brief provides one of the first examinations of the impact of COVID-19 mortality on immigrant communities in the United States. In the absence of national data, we examine COVID-19 deaths in Minnesota, historically one of the major U.S. refugee destinations, using individual-level death certificates obtained from the Minnesota Department of Health Office of Vital Records. Minnesota’s foreign-born crude COVID-19 death rates were similar to rates for the US-born, but COVID-19 death rates adjusted for age and gender were twice as high among the foreign-born. Among foreign-born Latinos, in particular, COVID-19 mortality was concentrated in relatively younger, prime working age men. Moreover, the place-based and temporal patterns of COVID-19 mortality were quite distinct, with the majority of US-born mortality concentrated in long-term care facilities and late in 2020, and foreign-born mortality occurring outside of residential institutions and earlier in the pandemic. The disparate impacts of COVID-19 for foreign-born Minnesotans demonstrate the need for targeted public health planning and intervention in immigrant communities.

COVID-19 mortality increases dramatically with age and is also substantially higher among Black, Indigenous, and People of Color (BIPOC) populations in the United States. These two facts introduce tradeoffs because BIPOC populations are younger than white populations. In analyses of California and Minnesota--demographically divergent states--we show that COVID vaccination schedules based solely on age benefit the older white populations at the expense of younger BIPOC populations with higher risk of death from COVID-19. We find that strategies that prioritize high-risk geographic areas for vaccination at all ages better target mortality risk than age-based strategies alone, although they do not always perform as well as direct prioritization of high-risk racial/ethnic groups. One-sentence summary Age-based COVID-19 vaccination prioritizes white people above higher-risk others; geographic prioritization improves equity.

Substantial racial and ethnic disparities in COVID-19 mortality have been observed at the state and national levels. However, less is known about how race and ethnicity and neighborhood-level disad...

The authors discuss the article "The State of the US Governmental Public Health Workforce, 2014–2017" by Katie Sellers and others which was published in the same issue. They comment on data suggesting significant numbers of senior public health officials will retire in coming years which could destabilize organizational leadership. They recommend in investing in future leadership through incentives in public health education and establishing senior management positions on the federal level.

Public health workforce development efforts during the past 50 years have evolved from a focus on enumerating workers to comprehensive strategies that address workforce size and composition, training, recruitment and retention, effectiveness, and expected competencies in public health practice. We provide new perspectives on the public health workforce, using data from the Public Health Workforce Interests and Needs Survey, the largest nationally representative survey of the governmental public health workforce in the United States. Five major thematic areas are explored: workforce diversity in a changing demographic environment; challenges of an aging workforce, including impending retirements and the need for succession planning; workers' salaries and challenges of recruiting new staff; the growth of undergraduate public health education and what this means for the future public health workforce; and workers' awareness and perceptions of national trends in the field. We discussed implications for policy and practice.

Introduction: Workforce development is one of the ten essential public health services. Recent studies have better characterized individual worker perceptions regarding workforce interests and needs, but gaps remain around workforce needs from program managers’ perspectives. This study characterized management perspectives regarding subordinate's abilities and training needs and perceived challenges to recruitment and retention. Methods: In 2017, the Directors Assessment of Workforce Needs Survey was sent to 574 managers at state health agencies across the U.S. Respondents were invited based on the positions they held (i.e., to be included, respondents had to be employed as managers and oversee specific program areas). In 2018, descriptive statistics were calculated, including Fisher's exact for inferential comparisons and Tukey's test for multiple comparisons, as appropriate. Results: Response rate was 49% after accounting for undeliverable e-mails; 226 respondents met the inclusion criteria. The largest perceived barriers to staff recruitment were wages or salaries (74%) and private sector competition (56%). Similarly, wages or salaries were identified as the main cause of turnover by 70% of respondents, followed by lack of opportunities for advancement (68%), and opportunities outside the agency (67%). Conclusions: The Directors Assessment of Workforce Needs Survey fills important knowledge gaps and complements previously identified evidence to guide refinement of workforce development efforts. Although competition from the private sector remains challenging, these findings indicate that recruitment and retention must be top priorities in state health agencies nationwide. Prioritizing individual state health agency workforce gaps and committing to provide specific local-level interventions to those priorities is crucial for individual health agencies.

CONTEXT: More than 80% of Americans live in urban areas. Over the past 20 years, an increasing number of local governmental public health departments, particularly those in big cities, have taken pioneering action to improve population health. This article focuses on members of the Big Cities Health Coalition (BCHC) who participated in the 2017 Public Health Workforce Interest and Needs Survey (PH WINS). If the impact of these health departments is to be sustained, they will require a workforce prepared for the challenges of 21st-century public health practice. OBJECTIVE: To characterize workforce interests and needs among staff in 26 large, urban health departments who are BCHC members. DESIGN: Administered PH WINS survey to staff in BCHC member health departments to assess perceptions about the workplace environment and job satisfaction; training needs; awareness of national trends; and demographics. SETTING: In total, 26 of 30 BCHC member health departments, United States. PARTICIPANTS: In total, 7453 of 17 613 staff members (response rate 43.4%) from participating departments. RESULTS: The workforce consists predominantly of women (75%) and people of color (68%). Staff is satisfied with their job (81%), the organization (71%), and pay (59%), but more than a quarter are considering leaving within the year. The agency's mission drives staff, but it lacks an environment fostering creativity and innovation. Training needs include budgeting/financial management, change management, and strategic thinking. CONCLUSIONS: BCHC departments must improve retention, provide opportunities for advancement, enhance communication between leadership and staff, foster creativity and innovation, and align labor allocation with disease burden in local communities. Findings from the second iteration of PH WINS allow a comprehensive, comparable analysis of the workforce across the 26 BCHC member health departments that participated. These data expand upon the ability to assess and monitor improvement in the workforce environment, job satisfaction, awareness of national trends, and training needs.

CONTEXT This article examines factors related to earnings in the context of the governmental public health system's urgent need to recruit and retain trained public health workers as many in the existing workforce move toward retirement. METHODS This article characterizes annualized earnings from state and local public health practitioners in 2017, using data from the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), which was fielded in fall/winter 2017 to more than 100 000 state and local public health practitioners in the United States. The response consisted of 47 604 public health workers for a response rate of 48%.We performed descriptive statistics, bivariate analyses, and interval-based regression techniques to explore relationships between annualized earnings, supervisory status, gender, years of experience, highest degree (and whether it was a public health degree), job classification, race/ethnicity, union/bargaining unit, paid as salary or hourly wage, setting, and region. RESULTS Higher supervisory status, higher educational attainment, white non-Hispanic race/ethnicity, male gender, salaried employment, bargaining unit (labor union) position, certain geographic regions, having a clinical/laboratory/other scientific position, and working in either a state health agency (SHA) or a large local health department (LHD) setting are all associated with higher salary. Having a public health degree versus a degree in another area did not appear to increase earnings. Being a person of color was associated with earning $4000 less annually than white peers (P < .001), all else being equal. The overall regression model showed a gender wage gap of about $3000 for women (P = .018). Supervisors, clinical and laboratory staff, public health sciences staff, and union staff also earned more than their counterparts. DISCUSSION As multiple factors continue to shape the public health workforce, including increasing racial/ethnic diversity, continued retirements of baby boomers, and the growth of bachelor's-level public health education, researchers should continue to monitor the gender and racial/ethnic pay gaps. This information should help the field of governmental public health as it endeavors to rebuild its capacity while current workers, many at the highest level of leadership, move on to retirement or other jobs. Public health leaders must prioritize equitable pay across gender and race/ethnicity within their own departments as they build their organizations' capacity to achieve health equity.