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Title page

Contents

Highlights 2

Letter 5

Background 9

Public Health and Jurisdictions 9

Public Health Workforce 11

HHS Agencies Involved in Jurisdictional Public Health 12

Jurisdictions Face Multiple Workforce Gaps, and Recruitment and Retention Challenges, Including Those Related to Market Competition and Hiring Processes 14

Public Health Workforce Gaps Are Found in Multiple Occupations and Skills, and Vary by Location 14

Recruitment and Retention Challenges Related to Funding Restrictions, Market Competition, Hiring Processes, and Work Environment Contribute to Workforce Gaps 22

Although Some Recruitment and Retention Challenges Are Pervasive and Systemic, HHS and Selected Jurisdictions Have Taken Some Steps to Mitigate Them 28

Systemic Factors Make Gaps and Recruitment and Retention Challenges Difficult to Fully Address 28

HHS and Selected Jurisdictions Use a Broad Range of Actions Aimed at Reducing Recruitment and Retention Challenges That Contribute to Workforce Gaps 31

Agency Comments 37

Appendix I: Examples of HHS Efforts to Identify and Address Gaps in Its Public Health Workforce 38

Appendix II: Methodology for Review of Studies and Reports 43

Appendix III: GAO Contact and Staff Acknowledgements 46

Related GAO Products 47

Figures

Figure 1. Percent of City and County Health Departments Serving Small, Medium, or Large Populations 11

초록보기

The public health workforce protects community health by tracking disease, inspecting water quality, and more.

But there aren't enough public health workers in some occupations, e.g., nursing. The workforce also needs more skills—like data analytics—for complex tasks such as monitoring disease outbreaks.

It's tough for public health departments to hire and retain these workers for many reasons, including stiff competition from other employers.

To address these challenges, the Department of Health and Human Services supports job training and placement programs in state, local, and other areas. Some areas increased pay and training support.