128: Epidemiologists Needed

Chrissie Juliano, Executive Director of the Big Cities Health Coalition, explains the critical need to hire hundreds of epidemiologists in public health departments nationwide; Richard Hamburg, Executive Director of the Safe States Alliance, outlines...

Chrissie Juliano, Executive Director of the Big Cities Health Coalition, explains the critical need to hire hundreds of epidemiologists in public health departments nationwide; Richard Hamburg, Executive Director of the Safe States Alliance, outlines the vision for a national injury and violence prevention program; Dr. Kimberlee Wyche Etheridge, ASTHO’s Senior Vice President of Health Equity and Diversity Initiatives, discusses equity as part of a panel hosted by the Centers for Medicare and Medicaid Services; and ASTHO prepares to recognize women and nutrition in March.

Big Cities Health Coalition: Report – Cities Need to Increase Number of Epidemiologists

Safe States Alliance: Blueprint for a National Injury and Violence Prevention Program

CMS YouTube: Black Health and Wellness – Building a More Equitable Health Care System


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This is Public Health Review Morning Edition for Tuesday, March 1st, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


A new report highlights the need for hundreds of epidemiologists to fill positions in public health departments across the United States. The Big Cities Health Coalition and the Council of State and Territorial Epidemiologists worked together on the study. Big Cities Health Coalition executive director Chrissie Juliano offers more in today's morning conversation.

How did we get to this point of not having enough epidemiologists around the nation?


Unfortunately as a country, we've really failed to resource our public health system at all levels of government. You know, so many of us have known that and have said that over the years; but this report—and I would say also, you know, the COVID-19 pandemic—has really illustrated that.

We've not invested enough in the governmental public health workforce, particularly in a way that makes sure that dollars get to local communities—the city and county health departments that really, you know, respond on the ground. We also haven't invested in building a modern data system that helps effectively and efficiently monitor the health of communities.

And, you know, I think as a field we've just gotten too good at doing more with less, and we need to do a better job of raising the alarm about the workforce needs and capabilities, and really thinking about how we can make sure that we have sound data that can contribute to good policy-making and decision-making. And that starts with making sure that we have the right staff in health departments to be able to collect and analyze and share those data with policy makers and the public.


I wanted to ask you about that. How do we fix the problem? What's the answer?


So, you know, we need to invest in public health and we need to invest in the workforce. The other piece of this is thinking about investing upfront and investing in prevention so that we're prepared—whether it's a pandemic or a flood or hurricane—but also to always be able to do the routine work that public health does. So, you know, those big events get headlines, but we also have way too many people who are overweight and obese in this country, you know, who still use tobacco products, who are still drinking, you know, three sugary sodas a day, and all of those things affect the health of communities.

So, you know, to bring it back to the report, epidemiologists—epis—are on the front lines of identifying and analyzing what's going on in communities, right. They track the data that tells us where the next problem may arrive. They track what's causing those problems so that we can inform policy decisions that health leaders and elected officials are making.

You know, we make some recommendations about the workforce in the report. Those include cross training epis to make sure that we can, in a flexible way, shift staff across needs and health departments. But we also need to make sure that we have enough expertise in specific areas. So, in the big cities, that means substance use disorder or injury and violence prevention, and folks who are really digging into the data on those specific challenges.

We also need to make hiring easier. You know, we know hiring in government is hard, but we need to streamline processes where possible and make sure that we're paying salaries so that people will stay in government service and public service, and also come into public service.


Now that you have the report, how do you plan to use it?


Yeah, so we're doing—we're having a lot of conversations like these, right, with partners in the public health field, we held a media briefing—we're going to continue to do things like that. But also then, looking at pulling pieces out of it; we'll be putting together a one-pager that we'll be sharing with members of Congress on the Hill to really show them the need and what that looks like and, you know, compare differences across the state version of this research with the big cities piece.

Our members, you know, may use it locally. They'll be able to say to their local policymakers, "You know, we have some of these epis. Other big cities have, you know, twice as much," right, just as an example. So, they can also use it to illustrate why they need additional help. And really, I think with all the other conversations that are happening across the field with other survey data and sort of anecdotal stories about where we are and where we need to go, this is going to be another input to that type of work.


You can read the report by clicking the link in the show notes.


The Safe States Alliance has a vision for a nationwide focus on injury and violence prevention. Executive director Richard Hamburg explains the purpose of the Blueprint for a National Injury and Violence Prevention Program.


The report also provides a vision: a vision of a nation free from injury and violence, meaning that no people—no matter who they are, where they reside—are safe where they live, work, travel, and play; it means a nation that fully embodies the value of health equity, where all people have safe and nurturing relationships; are resilient, connected, and have access to the resources necessary for them to thrive.

Injuries and violence will be greatly reduced with long-term and sustained investments, they give public health professionals the tools that they all need.


There's a link to the blueprint in the show notes.


Also, ASTHO's Dr. Kimberlee Wyche-Etheridge joined a panel hosted by the Centers for Medicare and Medicaid Services last week to discuss ways to advance health equity. She made the case for helping black women better advocate for themselves and pressed for improving access to healthcare and addressing environmental factors that can impact public health.


If we're able to create an instance where health equity is the default and not the exception, then the women—all women—will experience an improvement in their healthcare. And I think that CMS is on the right path to starting that by encouraging health equity at all levels.


You can watch a recording of the panel discussion using the link in the show notes.


Finally today, it's March 1st, and that means the start of two important commemorations this month—it's Women's History Month and National Nutrition Month. We'll have more on these in the coming weeks.


That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

Kimberlee Wyche-Etheridge MD MPH

Senior Vice President, Health Equity and Diversity Initiatives, ASTHO

Richard Hamburg MPA

Executive Director, Safe States Alliance

Chrissie Juliano MPP

Executive Director, Big Cities Health Coalition