Redefining the Public Health Workforce: Embracing a More Inclusive and Broader Framework

As public health challenges in the United States become increasingly complex, experts emphasize the need to rethink how we define and utilize the public health workforce. A recent publication from Columbia University Mailman School of Public Health highlights this necessity, proposing a more comprehensive approach that transcends traditional boundaries.

Published in the American Journal of Public Health, the study argues that solely considering government employees or specific occupational titles limits our understanding of those contributing to public health efforts. For instance, simply counting all nurses does not reveal how many are engaged specifically in public health activities.

To address this, the researcher Heather Krasna, Ph.D., EdM, MS, recommends an intersectional framework that categorizes the workforce into two primary tiers:

• A core workforce, including employees from federal, state, local, tribal, and territorial health departments.
• A broader public health workforce, encompassing individuals across various sectors who dedicate at least half of their work to services aligned with the CDC’s 10 Essential Public Health Services or Foundational Public Health Services.

The 10 Essential Public Health Services provide a structure for protecting and promoting community health, while the Foundational Public Health Services specify minimum capabilities for government health departments. Krasna suggests that this broader framework shifts focus from job titles to the actual impact of work, allowing policymakers and researchers to better identify who contributes to public health, regardless of their organizational affiliation.

This expanded view is crucial for evaluating outsourcing practices, identifying workforce gaps, shaping targeted training programs, and strengthening public health resilience. Without accurate, inclusive assessments, it remains challenging to ensure the effective delivery of public health services during crises or health emergencies.

Adopting this comprehensive approach promotes a deeper understanding of the public health ecosystem, ensuring that all contributors are recognized and supported, ultimately fostering a more resilient and effective public health infrastructure.