28: Supporting the Public Health Workforce

Dr. Norman Oliver, Virginia’s Health Commissioner, discusses the approach states and territories should take to funding for the public health workforce; ASTHO Chief Medical Officer Dr. Marcus Plescia reacts to a new CDC/Trust for America’s Health...

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Dr. Norman Oliver, Virginia’s Health Commissioner, discusses the approach states and territories should take to funding for the public health workforce; ASTHO Chief Medical Officer Dr. Marcus Plescia reacts to a new CDC/Trust for America’s Health report on obesity in the U.S.; and ASTHO releases the findings of its annual scan of issues important to state and territorial health agencies.

ASTHO Statement: ASTHO encourages immediate action to address the rising obesity rates in the wake of COVID-19

ASTHO: Workforce resources

ASTHO News Release: New report on the mental health impacts of the COVID-19 pandemic on public health workers presents concerning data on workforce well-being

ASTHO Blog Article: Doing business as usual when nothing is usual – managing public health priorities during a pandemic

ASTHO Brief: Performance management essentials

ASTHO logo


This is Public Health Review Morning Edition for Friday, September 17th, 2021. I'm Robert Johnson. 
Here's today's news from the Association of State and Territorial Health Officials. Obesity rates are at an all time high. 
The pandemic blamed for poor eating habits, higher stress levels, less physical activity, and increased food insecurity. 
A new report from the CDC and the trust for America's Health says 16 states now have adult obesity rates at, or above 35%. 

That's up from 12 states in 2019. ASTHO'S chief medical officer, Dr. Marcus Plescia says the pandemic has kept Public Health teams from working on many issues. 

We talk about a new normal for Public Health and that new normal is one where we do a bit of a balancing act. 
I think we'll have to continue to work on controlling COVID, but we've got to start to find a way to open the 
door back up to work on some of these other very pressing issues or once we do finally get through COVID, we're going to be in a real mess with other equally important public health challenges. 

While the pandemic is forced departments to pull staff off other projects to respond to COVID-19, it's also drained the workforce. 
People are burned out tired and anxious. Many have quit their jobs. 
Dr. Norman Oliver is Virginia's health commissioner. He's talking about the public health workforce in today's morning conversation.
Your team like every other public health team in the country has been battling COVID for a long, long time. How are people in the team holding up? 

I think our workforce has shown a great deal of resiliency, but that being said, it's taken its toll on us, like other healthcare workers and the healthcare delivery system and hospitals and clinics. 
Our folks on the front line, they've been exposed to dangers and dealing with people who are infected with COVID-19. They've been out there vaccinating and testing and doing the case investigations 
and contact tracing day in and day out, no breaks. And for some of us, it's really worn us down so there's a much higher incidence of anxiety, depression, burnout among our workforce. 
We've seen a lot of turnover, particularly on those frontline staff, the nursing staff, other clinical staff, who've been out there doing more clinical work on the front lines. 
And this is in a workforce that's already under-resourced and understaffed. 

A lot of money has been allocated to fight COVID, but it's hard to imagine those funding levels will continue forever. 
How are you approaching the funding question given the possibility that one day the money might dry up. 

We have a bunch of money right now. We have more money than I think we've had in Public Health memory, through ARPA and other things. 
So we can make some immediate gains, I believe on both workforce and some of this other public health infrastructure. 
The challenge is going to be convincing our state legislatures that they need to step forward and provide the year in year out sustenance. 
They have to provide a sustainable funding of public health, this big influx of federal money, it's only going to be there for three years, maybe four years, and then it's gone. 
And so once we build up this infrastructure, it's going to be on the states to help maintain it. 
So I think that means for us in public health, that we have to take a very assertive stance right now. We're investing in the future of public health and we should be going to our 
legislatures and our administrations now and letting them know that, okay, this is an investment and you have to provide the sustainable funding to keep it going. 

Do you think some in your position are holding off spending the money because they don't think their lawmakers at home will come up with the dollars to continue 
paying for these programs if the federal dollars run out? 

I think some people may feel a little more conservative and treat this like you treat a grant funding, right? 
You don't invest in something that you want to be a permanent fixture in your agency with money that's only going to last for a few years. 
So instead you get contractors or temporary work restricted employees, and then you can let them go when the project is over. 
I think that's too conservative. I think one of the bright lights, if there are any of this pandemic, is an increased understanding on the part of many, many people of the importance of public health. 

And now's the time to use that increased understanding to also get the support for sustaining public health agencies and doing that now. 

It's no surprise today that workforce development capacity and retention are among the priorities identified in ASTHO's annual scan of issues, 
important to state and territorial health agencies. The complete list assembled by ASTHO's research team is online now.  
You can see it using the link in the show notes. 
Finally, this morning states and territories thinking about how to better measure and manage workforce performance need to check out a new ASHTO brief on performance management approaches and frameworks, 
the report outlines key considerations and provides examples of work others have done in this area. 

Like everything else today, you can find a link to this resource in the show notes. 
Also remember to follow us on apple podcasts or Spotify, or listen on Alexa or Google assistant. 
And if you have a minute, please take time to leave us a rating and a review. Join us Monday morning for more ASTO news and information. I'm Robert Johnson. 
You're listening to Public Health Review Morning Edition. 

Norman Oliver MD MA

Virginia State Health Commissioner

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO