Emerging infectious diseases, the increasing threat of terrorist events, and a rapidly aging general population are placing greater demands on local health departments (LHDs). At the same time, a greater number of public health employees are reaching retirement age, and LHDs are unable to recruit and retain enough qualified workers to take their places. To address the shortages, LHDs are working with educational institutions, hospitals, non-profits and other government agencies to develop programs that train more qualified health care workers.

A 2007 State Public Health Workforce report from the Arlington, Va.-based Association of State and Territorial Health Officials (ASTHO), indicates that, nationwide, nurses are in highest demand, followed by epidemiologists. Epidemiologists typically work for LHDs to create community health profiles that help drive decisions about the types of health programs that communities need, says Cambridge, Mass., Chief Public Health Officer Claude-Alix Jacob. Unfortunately, two out of five health departments in the United States do not have enough epidemiologists on staff to collect, analyze and disseminate the data, Jacob says.

To support the epidemiology needs in the Cambridge Health Department (CHD) in 2006, the department worked with Boston University students and the locally based Institute for Community Health in a year-long grant-funded Academic Health Department program. The students collected and analyzed data needed by the regional epidemiologist's office in Cambridge and the 26 surrounding communities. The program also trained students in emergency preparedness, says Susan Kilroy-Ames, CHD's epidemiology and data services manager. “The work would still have been completed [without the program, but] it would have taken longer to complete because there would have been less staff to focus on it,” she says. Also, the students received hands-on experience in the public health department infectious disease area that often is lacking in graduate school training.

In 2005, Baltimore officials focused on finding permanent replacements for the city's health care work force, forming the Baltimore Alliance for Careers in Healthcare (BACH), a non-profit workforce consortium that includes the Mayor's Office of Employment Development (OED), educational institutions and eight local hospitals. BACH secured more than $925,000 in grants from various foundations, the U.S. Department of Labor and Baltimore's OED to establish programs to help underemployed and unemployed workers move up health care career ladders or develop skills needed to handle the academic rigors of health care education.

For example, BACH's 1st Span Program, a partnership with the Community College of Baltimore County with partial funding from the Mayor's OED, seeks to promote incumbent hospital workers, such as dietary aides and housekeepers, into nursing assistants and nurse extenders through a customized education, training, mentoring and coaching program. Hospitals allow employees to take time during their workdays to participate in the coaching portion of the program.

BACH has become the nexus between local health care industry needs and public employment needs, says Karen Sitnick, OED director. “This [initiative] is no walk in the park,” says BACH's Executive Director Ron Hearn. “This is about structural capacity building at local colleges to get more seats and establishing instructional models at the schools. There is a lot of clinical work involved that requires a great deal of commitment from schools and hospitals, and it's also about leveraging some public and private dollars to help support training.”

Hearn says hospitals have embraced the multi-faceted approach to building a health care worker pipeline to address worker shortages and relieve competition for the same small pool of existing workers. While the programs are still in the early stages, BACH reports that more than 400 lower level hospital employees have taken advantage of the career coaching, with 40 percent advancing on to find new health care jobs.
— Annie Gentile is a Vernon, Conn.-based freelance writer.