A Systematic Review on Professional Regulation and Credentialing of Public Health Workforce.

The public health workforce (PHW) counts a great variety of professionals, and how services are delivered differs in every country. The complexity and the diversity of PHW professions also reflect structural problems of supply and demand of PHW in various organizations and health care systems. Therefore, credentialing, regulation, and formal recognition are essential for a competent and responsive PHW to address public health challenges. To ensure comparability of the credentialing and regulation systems for the PHW and to enable its collective action at the macro level in the event of a health crisis, we systematically analyzed documented evidence on the PHW. A systematic review was selected to answer the research questions: (1) what are the most effective aspects and characteristics in identified programs (standards or activities) in professional credentialing and regulation of the PHW and (2) what are common evidence-based aspects and characteristics for the performance standards to support a qualified and competent PHW? The identification of professional credentialing systems and available practices of the PHW was performed systematically using a systematic review of international resources in the specialized literature published in English. The PRISMA framework was used to verify the reporting of combined findings from three databases: Google Scholar (GS), PubMed (PM), and Web of Science (WoS). The original search covered the period from 2000 until 2022. Out of 4839 citations based on the initial search, 71 publications were included in our review. Most of the studies were conducted in the US, UK, New Zealand, Canada, and Australia; one study was conducted in an international context for professional credentialing and regulation of the PHW. The review presents specific professional regulation and credentialing approaches without favoring one of the proposed methods. Our review was limited to articles focused on professional credentialing and regulation of the PHW in the specialized literature published in English and did not include a review of primary PHW development sources from international organizations. The process and requirements are unique processes displaying knowledge, competencies, and expertise, regardless of the field of practice. Continuous education, self-regulatory, and evidence-based approach can be seen as common characteristics for the performance standards on both community and national levels. Certification and regulation standards should be based on competencies that are currently used in practice. Therefore, answering questions about what criteria would be used, what is the process operation, what educational background the candidate should have, re-examination, and training are essential for a competent and responsive PHW and could stimulate the motivation of the PHW.

COVID-19 Revealed Shortcomings Of The US Public Health System And The Need To Strengthen Funding And Accountability.

The US governmental public health system, which includes federal, state, and local agencies, is seen by many observers as having a money problem, stemming from a lack of resources. During the COVID-19 pandemic, this lack of resources has had unfortunate consequences for the communities that public health practice leaders are expected to protect. Yet the money problem is complex and involves understanding the nature of chronic public health underinvestment, identifying what money is spent in public health and what the country gets for it, and determining how much money is needed to do the work of public health in the future. This Commentary elucidates each of these issues and provides recommendations for making public health services more financially sustainable and accountable. Well-functioning public health systems require adequate funding, but a modernized public health financial data system is also key to the systems' success. There is a great need for standardization and accountability in public health finance, along with incentives and the generation of research evidence demonstrating the value of and most effective delivery for a baseline of public health services that every community should expect.

Voluntary Separations and COVID-19: A Snapshot of Turnover Intention in the Federal Workforce in the First Year of the Pandemic.

Voluntary separations can exact heavy tolls on organizations that affect their efficiency or effectiveness. This historical retrospective investigates how the COVID-19 pandemic may have influenced federal employees' intention to leave for reasons other than retirement. We examined the 2020 Federal Employee Viewpoint Survey (FEVS) with a particular focus on agencies likely heavily impacted by the pandemic, including the Departments of Agriculture (USDA), Health and Human Services (HHS), Homeland Security (DHS) and the US Environmental Protection Agency (EPA). We used inferential statistics and a logistic model to identify correlations for intent to leave, considering changes related to the pandemic. Intentions to leave notably increased after the pandemic for most respondents, and overall intentions to leave were lower for USDA, HHS, and EPA staff than for all federal employees. Reasons included perceived unavailability of protections from COVID-19 exposure, disruptions to work by the pandemic, and increased work demands due to the pandemic.

Public Health Workforce Gaps, Impacts, and Improvement Strategies from COVID-19.

The public health workforce has been instrumental in protecting residents against population health threats. The COVID-19 pandemic has highlighted the importance of the public health workforce and exposed gaps in the workforce. Public health practitioners nationwide are still coming to understand these gaps, impacts, and lessons learned from the pandemic. This study aimed to explore Minnesota's local public health practitioners' perceptions of public health workforce gaps, the impacts of these workforce gaps, and the lessons learned in light of the COVID-19 pandemic. We conducted seven concurrent focus groups with members of the Local Public Health Association of Minnesota (LPHA; n = 55) using a semi-structured focus group guide and a survey of the local agencies (n = 70/72 respondents, 97% response rate). Focus group recordings were transcribed verbatim and analyzed using deductive and inductive coding (in vivo coding, descriptive coding), followed by thematic analysis. The quantitative data were analyzed using descriptive analyses and were integrated with the qualitative data. Participants indicated experiencing many workforce gaps, workforce gaps impacts, and described improvement strategies. Overall, many of the workforce gaps and impacts resulting from COVID-19 discussed by practitioners in Minnesota are observed in other areas across the nation, making the findings relevant to public health workforce nationally.

Funding Public Health: Achievements and Challenges in Public Health Financing Since the Institute of Medicine's 2012 Report.

OBJECTIVE: The purpose of this study was to review changes in public health finance since the 2012 Institute of Medicine (IOM) report "For the Public's Health: Investing in a Healthier Future." DESIGN: Qualitative study involving key informant interviews. SETTING AND PARTICIPANTS: Purposive sample of US public health practitioners, leaders, and academics expected to be knowledgeable about the report recommendations, public health practice, and changes in public health finance since the report. MAIN OUTCOME MEASURES: Qualitative feedback about changes to public health finance since the report. RESULTS: Thirty-two interviews were conducted between April and May 2019. The greatest momentum toward the report recommendations has occurred predominantly at the state and local levels, with recommendations requiring federal action making less progress. In addition, much of the progress identified is consensus building and preparation for change rather than clear changes. Overall, progress toward the recommendations has been slow. CONCLUSIONS: Many of the achievements reported by respondents were characterized as increased dialogue and individual state or local progress rather than widespread, identifiable policy or practice changes. Participants suggested that public health as a field needs to achieve further consensus and a uniform voice in order to advocate for changes at a federal level. IMPLICATIONS FOR POLICY AND PRACTICE: Slow progress in achieving 2012 IOM Finance Report recommendations and lack of a cohesive voice pose threats to the public's health, as can be seen in the context of COVID-19 emergency response activities. The pandemic and the nation's inadequate response have highlighted deficiencies in our current system and emphasize the need for coordinated and sustained core public health infrastructure funding at the federal level.