Characterizing the Roles and Skill Gaps of the Environmental Health Workforce in State and Local Health Departments

By Heidari, Leila; Whitehead, Sandra et al. | Journal of Environmental Health, January-February 2019 | Go to article overview

Characterizing the Roles and Skill Gaps of the Environmental Health Workforce in State and Local Health Departments


Heidari, Leila, Whitehead, Sandra, Castrucci, Brian C., Dyjack, David T., Journal of Environmental Health


Introduction

Environmental health workers (EHWs) make up 8% of the local, state, and federal public health workforce and constitute the largest group of governmental public health workers, after administrative or clerical personnel and public health nurses (Beck, Boulton, & Coronado, 2014). EHWs ensure that the air we breathe, food we eat, and water we drink is safe. They work in the realms of land use, community design, and housing to create health-promoting environments (Srinivasan, O'Fallon, & Dearry, 2003). Their responsibilities are broad, including assessing, communicating, and managing risks related to air quality, drinking water and food safety, industrial hygiene, healthy housing, waste management and disposal, and vector control (National Center for Environmental Health, Centers for Disease Control and Prevention [CDC], & American Public Health Association, 2001). In addition, the duties of EHWs are increasing in scope to include developing programs for climate change adaptation planning; environmental health tracking, which involves monitoring and surveillance of environmental hazards and associated exposures and health effects (CDC, 2018); and conducting health impact assessments (Association of State and Territorial Health Officials, 2011). As the environmental health workload is broadening, however, it is necessary to evaluate the capacity of EHWs.

The environmental health workforce is strained by reductions in federal funding and decreasing capacity, especially in terms of workforce training (Association of State and Territorial Health Officials, 2011, 2014), as well as a dearth of leaders who are ready to fill newly vacated positions due to high rates of turnover, retirement, and voluntary turnover from the high percentage of workers who intend to leave their positions (Herring, 2006; Sellers et al., 2015). With a fluctuating workforce and changing scope of work, it is important to understand the skills and skill gaps of the workforce, as well as to explore potential differences by level of government, as environmental health agency functions can diverge in state versus local settings. Identifying skill gaps and potential training needs--and specifying these by level of government--enables application of relevant solutions to the appropriate setting.

Prior to the 2014 Public Health Workforce Interests and Needs Survey (PH WINS), little information has been available from the perspective of individual state and local health department workers on their tasks, responsibilities, and skill gaps (Sellers et al., 2015). This article, therefore, serves to address this gap in the literature by characterizing EHWs, and comparing and contrasting the following characteristics between state health agencies (SHAs) and local health departments (LHDs): 1) main roles of EHWs, 2) tasks that EHWs report as "very important" to their daily work, and 3) self-reported skill gaps of EHWs.

Methods

Public Health Workforce Interests and Needs Survey

Sampling and broader survey methodologies have been written about extensively elsewhere (Leider, Bharthapudi, Pineau, Liu, & Harper, 2015). In brief, PH WINS was conducted in three sampling frames: 1) a nationally representative sample of permanent, central office employees in SHAs; 2) employees of the Big Cities Health Coalition (BCHC), a membership group of the largest metropolitan health departments in the country (National Association of County and City Health Officials, n.d.); and 3) a pilot frame of local and regional health department employees. For BCHC and local and regional health department frames, the data have importance for the localities in which they were collected and were not intended to constitute a nationally representative sample (Leider, Bharthapudi, et al., 2015). The analyses presented were stratify by setting/sample frame and were also weighted by sample frame: SHAs (n = 910) and LHDs (n = 1,001). …

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