Strategic Workforce Analysis: Identifying Skills and Gaps among Frontline Public Health Workers Amidst Transformation

Objective: Recent shifts in public health (PH) include consistent budget cuts, workforce attrition, and loss of vital skills and institutional knowledge followed by heightened pandemic-driven attention, new responsibilities, and renewed funding. This study investigates whether frontline employees working in different types of public health departments have different educational characteristics and whether these characteristics are associated with differentials in skill gaps toward informing targeted interventions to nurture a competitive workforce. Methods: Utilizing 2021 Public Health Workforce Interests and Needs Survey (PH WINS) data, we document variations in educational qualifications, skill gaps, and workforce characteristics among frontline workers in different sizes of health departments and examine attributes associated with skill gaps: level and field of education, years of experience, program areas, and job classifications using a negative binomial model. Results: Skill gaps in resource management, systems and strategic thinking, and change management persist across all local health departments (LHDs), but the extent of these gaps is greater in small LHDs. Small LHDs also have few employees with graduate and public health degrees. Additionally, whereas public health degrees were not associated with fewer skill gaps, tenure in public health was, suggesting people learn on the job. Conclusion: The results highlight the role regional training centers can play in emphasizing the need for strategic skills and foundational public health concepts, as well as customizing training content by agency size and educational levels to improve accessibility, particularly for small LHDs with resource constraints.