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Workforce estimates show that while state and local public health staffing rebounded to around 239,000 employees in 2022, this growth hasn't kept pace with population increases, and many hires were temporary. Regional disparities, underrepresentation of public health nurses, and looming workforce departures highlight the urgent need for sustained investment, strategic planning, and stronger data collection across all levels of government, including Tribal and territorial agencies.

A 2023–2024 enumeration found 239,000 staff employed in state and local health departments, revealing a 2% increase since 2012 but significant workforce losses in several states, especially in the Southeast. The findings highlight chronic underinvestment in public health and call for stronger, sustained federal funding and improved enumeration methods across all government levels.

Enumerating the US governmental public health workforce is crucial for strengthening infrastructure, guiding workforce planning, and addressing staffing needs at federal, state, and local levels. Enumeration 2024 builds on this effort by using a multi-pronged approach to assess the size, key occupations, and changes in the public health workforce since 2012.

The Standard Occupational Classification (SOC) system is the federal standard for categorizing occupation data, used by the Bureau of Labor Statistics (BLS) to collect and analyze workforce information. However, the current SOC and North American Industry Classification System (NAICS) codes lack the granularity needed to accurately enumerate the governmental public health workforce in state, local, Tribal, and territorial health departments.

This research examines the demographics, training, and job functions of nurse officers in the U.S. Public Health Service (USPHS) to improve measurement of the public health nursing (PHN) workforce. The findings underscore the value of job function questions in workforce assessments and suggest USPHS nurses could provide insights for strengthening diversity in the nursing profession.

Using 2022 data from the National Council of State Boards of Nursing, researchers found that PHNs make up 3.7% of registered nurses (RNs) in government settings under a broad definition and 1.8% under a more restrictive definition. The study highlights that PHNs often identify as generalists and work in diverse settings like public health, school health, and correctional health.

This research brief summarizes the evidence regarding employment choices of recent public health graduates. More students are receiving public health degrees than ever before. 

Rural-serving LHDs had a greater staffing proportion of women, less formal public health training, and a smaller proportion of staff with 6 or more years of public health practice experience.

The US public health workforce has markedly declined, falling from 500,000 individuals in 1980 to 239,000 by 2022, a trend exacerbated by economic instability and an aging demographic.

Public health workforce numbers are unsustainable at best and dire at worst: based on 2017 and 2019 data, 80,000 FTEs needed to be hired by health departments to provide basic public health foundational services before COVID-19 hit, suggesting that the situation is worse after the mass exodus of public health officials due to the pandemic.

To describe racial and ethnic representativeness of the local health department (LHD)workforce compared with the populations served.

The public health workforce continues to atrophy due to mass and early retirement, under-funding, slow hiring processes, lack of advancement opportunities, and shifting policies.