Written by Heather Krasna, PhD
The governmental public health workforce in the United States plays a crucial role in the health of every person. COVID-19 made it incredibly clear how important it is to have a well-staffed system of local, state, Tribal, territorial, and federal public health departments, and laid bare the consequences of decades of underfunding of this workforce. The Biden Administration announced on Jan. 21, 2021, and again in May, 2021, a $7.4 billion investment in the public health workforce, and around $3.2 billion was made available for governmental health departments to apply for in summer 2022. The recipients were announced in November.
This new funding creates a special opportunity for health departments to replenish their workforce, at least temporarily. If used strategically, health departments could deliberately transform to be as inclusive as possible and transition these grant-funded hires to permanent ones–if they have the right resources to identify their needs, attract the right candidates, onboard them, and convert them to permanent hires. This page is meant to be a one-stop shopping resource for full-cycle recruitment for local, state, Tribal and territorial government health departments.
Disclaimer: This resource will be continually updated. This resource in its draft form reflects some of my own views and opinions. Some of the resources were created as part of my role at Columbia University, and some I created as a consultant or volunteer, and of course I’m also referring to the the excellent work of many others in this small but mighty field of public health workforce development and research.
Here are some key resources to get you started:
- Generation Public Health: Top 8 Tips for Government Health Departments to Hire New Grads (listed on CDC website)
- New Resources and Creative Strategies for Recruiting Candidates for Health Departments (training)
- Publichealthcareers.org recruitment & career website
- Tell them Why It’s Awesome: Public Health Recruitment Practices (blog article)
- ASPPH Presents: Hot Jobs in Public Health (candidate-facing workshop)
- Public Health Graduates in the United States: Employment Outcomes and Employer Demand
The Recruiting Cycle: Six Keys Steps (plus a Seventh)
The recruitment process has six key steps, and this toolkit is organized into these six areas. Many health departments, especially accredited ones, have spent time on workforce planning (covered in step 1), but haven’t had resources (or regulatory ability) to devote to updating job descriptions (step 2), and haven’t had budget or staff to build recruitment pipelines, conduct recruitment marketing or outreach, or develop an employer brand (step 3). When it comes to selection (step 4), some health departments are restricted by civil service hiring rules, making the hiring process far slower than the private sector (which can result in good candidates giving up on the process). Onboarding–step 5, and crucial for retention–may be challenging in a situation where staff are overburdened or burned out. Evaluation (step 6) helps keep recruitment efforts on track. A seventh step–advocacy–is specific to public health, since we must fiercely advocate for resources to replenish the workforce. I focus mostly on Steps 2 and 3, since they are my area of expertise, but hope to provide resources for every step as this toolkit is updated. And, I’ll be building a full online training on this topic for Region II Public Health Training Center soon–so sign up for news and updates.
- Identify hiring needs
- Write job descriptions
- Build recruitment pipelines, advertise jobs
- Select candidates
- Onboarding and retention
- Assess & Evaluate
- …and advocate for more funding & a better recruiting system
1. Identify Hiring Needs
A new tool, the Public Health Workforce Calculator, can be used by certain health departments (specifically local health departments in decentralized public health systems, which serve fewer than 500,000 residents) to estimate how many staff they need in order to deliver the Foundational Public Health Services. This calculator can be a great first step in determining how many staff you really need, but translating the numbers into job descriptions takes some additional steps.
One step is to take the raw numbers and compare with information you already have from a workforce development plan, if you have one. This plan may include the following elements:
- Workforce analysis
- Environmental scan and gap analysis (what is the gap between current staffing and the staff needed to achieve your mission/mandate)
- Review of rules and regulations (What rules govern the hiring process? What is the labor structure? What are the pay grades? What is the process to reform regulations if needed?)
- Identify competencies needed for the staff required to achieve your mandate (see “job descriptions” section below for details on both cross-cutting and occupation-specific competencies)
- Training needs assessment
- Writing, implementing, monitoring & evaluating the plan
- This can also include:
- Assessing current staff—who they are, what their skills are, what motivates them; demographics of current staff with regards to diversity & inclusion)
- Planning for possible attrition or retirement plans of existing staff, with a plan to replace them or create succession plans
- Estimate of hiring needs based on gap analysis–which specific staff are you missing? What budget is needed to hire them? What budget is available permanently, vs. via grants?
- Assessment of organizational culture–what causes people to stay at the organization? What is driving them to leave?
- A third step after comparing the raw numbers to your workforce development plan, is to also consider your Community Health Assessment, strategic plan, or other data, and also discussing the priorities and needs within your own team.
- Finally, you may want to prioritize your hiring needs. A tool to consider for this is here.
- Public Health Workforce Calculator
- Workforce Development Plan: What is it and how to get ready? (Region V PHTC)
- Evaluating your Workforce: Assessing your Organizational Environment, Selecting your Competencies, and Assessing your Training Needs (Region V PHTC)
- Enhancing the Diversity of the Public Health Workforce (Region V PHTC)
- Diversity and Succession Planning (Midwest Center for Lifelong Learning in Public Health (MCLPH))
- Succession Planning and Workforce Development for Public Health Agencies (Region 2 Public Health Training Center)
- Diversity, Equity, And Inclusion: Where Does Public Health Workforce Development Fit Into This Growing Movement? (Rhode Island (RI) Department of Health)
- Succession Planning and Change: Growing and Developing Talent in Public Health
- ASTHO Workforce Development Plan Toolkit
- Staffing Up study
- Public Health Workforce Interests & Needs Survey (PH-WINS)
- Prioritizing resource (thank you to Dr. Leslie Beitsch for this reference)
- Workforce analysis
2. Create Job Descriptions
Visit https://www.rvphtc.org/public-health-model-job-descriptions-project/ to access model job descriptions through the Public Health Model Job Descriptions Project.
I’ve been the key contributor to a new job descriptions & job postings project via Region V Public Health Training Center and University of Minnesota Center for Public Health Systems, and in order to create evidence-based and attractive job descriptions, we followed the steps below:
- Reviewed job description writing best practices
- Gathered existing job task analyses for key public health occupations from professional associations, certifications, and “body of knowledge” documents
- Synthesized at least 3-5 current job postings per position
- Analysis of large-scale job postings data from Burning Glass technologies
- Incorporated data from US Department of Labor Occupational Outlook Handbook where possible, using evidence-based labor market taxonomy for public health occupations
- Assessment of National Board of Public Health Examiners job task analysis survey (2014) & PH-WINS responses regarding key skills/competencies by occupation
- Gathered feedback on the job descriptions from individuals working in each occupation as well as professional society leaders
- Transformed job descriptions (for internal use) into postings (for advertising). A job description is used primarily for internal purposes, while a posting is used to attract candidates to apply for positions. This required edits to ensure:
- Search engine optimization
- Inclusive wording: using a SAAS job writer tool: https://jobwriter.io/ to avoid bias & improve marketing. (It’s crucial to ensure the job posting wording does not include implicit bias or dissuade diverse candidates from applying.)
- Incorporation of the motivation of the “persona” of each occupation (for instance, what motivates a nurse to work in public health is potentially different from what motivates a sanitarian)
- Competition & benchmarking with other industries (note: a salary benchmarking analysis will be conducted in future)
- Additional resources (including existing job task analyses and competencies lists for public health occupations below):
- Public Health Job Descriptions Project
- Determining Essential Core Competencies for Job Positions
- Guiding Workforce Development: The Core Competencies for Public Health Professionals
- Columbus Public Health. User Guide & Resource Manual Guidance Document for Columbus Public Health Employees to Complete the PCQ Form and Create Functional Public Health Competency Based Job Descriptions.; 2017.
- Public health nurses:
- Quad Council Coalition Competency Review Task Force. Community/Public Health Nursing Competencies. Published online April 13, 2018.
- Public Health Nursing: Scope & Standards of Practice, 2nd Edition. ANA. Accessed April 20, 2022.
- Epidemiologists: Council of State and Territorial Epidemiologists CDC/CSTE Applied Epidemiology Competencies (AECs).
- Disease Intervention Specialists:
- National Coalition of STD Directors. DIS Job Task Analysis.
- Public Health Accreditation Board. Disease Intervention Specialist Certification Project Final Report to the Centers for Disease Control and Prevention.; 2017.
- Community Health Workers:
- Roles of Community Health Workers – RHIhub Toolkit.
- Connecticut Health Foundation. Community Health Worker Certification Requirements by State.
- Public health informatics: Informatics Workforce Position Classifications and Descriptions. PHII.
- APHL Laboratory Competency Implementation Toolbox. APHL.
- Centers for Disease Control and Prevention. Competency Guidelines for Public Health Laboratory Professionals, MMWR.; 2015.
- Sanitarians: Credentials | National Environmental Health Association: NEHA.
- Environmental Engineers: AAEES Publications-Environmental Engineering Body of Knowledge.
- Human Resources staff: SHRM Competency Model.
- Health educators: Health Education Job Analysis Projects | NCHEC.
- Emergency Preparedness: Public Health Preparedness and Response Core Competencies.
- Accreditation specialists: PHAB. Public Health Accreditation Board (PHAB) Accreditation Coordinator Handbook for Public Health Department Initial Accreditation.
- Communications: Park SY, Harrington NG, Crosswell LH, Parvanta C. Competencies for Health Communication Specialists: Survey of Health Communication Educators and Practitioners. Journal of Health Communication. 2021;26(6):413-433.
3. Recruitment pipelines, candidate sourcing, advertising
KEY RESOURCE: publichealthcareers.org
KEY RESOURCE: New Resources and Creative Strategies for Recruiting Candidates for Health Departments
Once your job postings are ready, you have to disseminate them to attract candidates to apply for jobs. To help with this, I’m proud to have contributed to publichealthcareers.org, an ASTHO-led website specifically designed to educate the public about careers in governmental public health departments. This site includes a job board, overview of careers in the field, high-quality videos of people in public health jobs, and a linked map bringing people to the job board for each state and territorial health department (hopefully local ones will be added too). If there’s one key resource to use in this toolkit, it’s this one.
Besides having updated job descriptions, health departments need the most help in establishing recruitment pipelines and attracting candidates to apply (and to stick with it through the often long hiring process). To build a recruitment pipeline, it’s critical to identify talent sources that match your job requirements (which is why steps 1 and 2 must be completed first), and will generate candidates who reflect the communities you serve. To have successful recruitment partnerships, you must build long-term partnerships. You may also have to be proactive, and think about your employer brand. Here are a few ideas about how to build talent pipelines:
Partnerships with Academia
- Identify your target schools (majors, demographics)
- National Association of Colleges & Employers (NACE) is the nation’s largest association for college recruiters and career services staff. If you plan to hire college graduates, join and get involved.
- Association of Schools & Programs of Public Health https://publichealthjobs.org/
- Find the contact person at each school: career services, field practice, faculty, student group leaders
- Post your jobs, and develop Internships, Practica, Service learning opportunities for students
- Attend Career fairs, Employer presentations, Alumni panels
- Offer a guest presentation in a class or student groups; offer a Field trip
- Envisioning and Building the Public Health Workforce of the Future: The Critical Role of Partnerships
- Public Health: Opportunities for Every Major (an article I wrote for NACE which can be used in college recruiting outreach)
Other Talent Sources
Public health departments need candidates from a diverse range of sources; and for many roles, college recruitment is not the right source. Here are other talent sources:
- Public Health AmeriCorps –a great new program designed to introduce new talent into public health. Contact them to find out how to apply to host your own AmeriCorps members; and to see how you can hire “alumni” of the program.
- State Departments of Labor employment agencies and workforce career centers; workforce development agencies; local workforce boards
- US Dept of Labor’s Career OneStop program https://www.careeronestop.org/
- Community-based organizations; churches/faith-based organizations; health fairs etc.
- Job boards (publichealthcareers.org is great one to start with)
- Outreach at conferences and events
- Professional associations (nurses’ associations, APHA etc.)
- Youth employment programs (state departments of education may have career and technical education programs) https://youth.gov/youth-topics/financial-capability-literacy/employment
- Reentry programs: “School to Prison” to “School Again:” Preparing a New Workforce to Address Health Disparities https://www.train.org/main/course/1061769/ and National Reentry Resource Center https://nationalreentryresourcecenter.org/
- Disability recruiting programs: https://www.dol.gov/general/topic/disability/hiring and https://abilityjobs.com/
- “Encore Careers”/retirees https://jobs.encoreglobal.com/
- iRelaunch/”returnships” https://irelaunch.com/
- Staffing firms
- Executive search firms (for very senior positions)
- Social media outreach (LinkedIn, Twitter, Instagram, TikTok)
- Proactive Sourcing: Direct sourcing includes using social media like LinkedIn to find candidates with the profile you need and cold-contacting them to ask them to apply. Knowing solid Boolean searching is key for this type of sourcing. Additional sources include referrals from existing staff (but be sure this does not perpetuate a non-inclusive candidate pool). If you really want to learn this, I suggest AIRS Certification: https://airsdirectory.com/ and ERE: https://www.ere.net/
- Additional Resources:
- Washington State Department of Health employee recruitment and retention plan
- Boston Public Health Commission Emerging Leaders Program
4. Screening, Selection, Hiring
This is the step in the process where, from my view, things can become very tough for a health department. Many candidates cannot wait for a 4-6 month long hiring process. Anything you can do to speed up the hiring process, or at minimum maintain good communication with candidates, is key. This step is also another one where you must be intentional to ensure the process is anti-racist and inclusive! Some government agencies have been able to alter their processes, work with their central HR team or civil service department, or even change regulations to allow flexibility in hiring in some cases. I’m actively seeking examples of success stories like this–contact me if you have ideas. I’ll be adding more here soon. This process includes:
- Screening resumes/applications
- References & Background checks
- Resources (including examples of health departments and other government agencies that have improved their hiring processes successfully):
- More public health grads being drawn to private sector jobs: this article includes examples of health departments that have improved their hiring process
- Innovation in Recruiting and Hiring: Attracting the Best and Brightest to Wisconsin State Government
- State Chamber of Oklahoma Research Foundation: A Comparative Analysis of States’ Civil Service Reforms gives some examples of streamlining the hiring process to improve efficiency.
- Renewing America’s Civil Service: Volcker Alliance
- Innovative Strategies to Attract and Retain the Next Generation (PA Times article)
5. Onboarding and Retention
Recruitment is useless if your candidates quit after a week on the job. An exciting program, New to Public Health, builds in evidence-based interventions to keep people engaged, like building a community of practice and matching with mentors. Additionally, considering the culture of the organization, and ensuring it is a healthy and inclusive work environment, is crucial for retention. In our current environment, some health departments face an uphill battle to maintain a safe and positive environment for staff so this is an advocacy issue (see step 7).
Also, health departments might need to hire new staff who are funded by the ARPA CDC workforce grant via third-party entities; or might like to hire their Public Health AmeriCorps members as staff. The potential to convert these new hires to permanent staff, especially if more sustained funding is achieved or even if current staff retire or leave and new hires can fill their vacant roles, is an important aspect of being intentional in the use of the ARPA funding. Training new staff on how to navigate the civil service process in your jurisdiction may be an important part of onboarding.
- KEY RESOURCE: New To Public Health
- Mentoring and community-building:
- Mentoring Matters training
- Public Health Nurse Residency Program (PHNRP) (one example is here)
- Introduction to public health trainings for new staff:
- Introduction to Public Health Practice: new training by CDC TRAIN
- NYS Citizen Public Health Program: a good overview of public health, to onboard new staff
- Public Health 101 Series – Introduction to Public Health another intro for new hires
- 101+ Careers in Public Health, 3rd Edition
- Navigation of civil service hiring process:
- I have taught a workshop on “Secrets of the Government Job Search” for several years and will be updating it to add here. A few past blog posts cover some tips (NYS Civil Service, City of Seattle, King County, Washoe County, NV, State of MD, Eden Prarie, MN, Virginia Beach, VA)
- Prevention of burnout:
- Stress Burnout and Dedication: The State of the Governmental Public Health Workforce (training)
- Building Psychological Resilience for the Public Health Workforce during the COVID19 Pandemic (training)
- Stand with Public Health (advocacy efforts to prevent harassment of public health workers)
- Workplace Perceptions and Experiences Related to COVID-19 Response Efforts Among Public Health Workers – Public Health Workforce Interests and Needs Survey, United States, September 2021-January 2022
Evaluating your recruitment effort will help you improve in future, and is important for reporting to funders. Just like with any program where you use a logic model, you can track outputs, short-term outcomes, and long-term outcomes.
- Just a few recruitment metrics: https://www.aihr.com/blog/recruiting-metrics/
- Contact Consortium for WOrkforce Research in Public Health (CWORPH), the workforce research consortium I’m proud to be part of, to help with your evaluation needs: https://www.sph.umn.edu/research/centers/cphs/cworph/or reach out to others such as a public health institute, your Regional Public Health Training Center, or academic partner organizations.
Advocacy for sustainable, permanent funding for the public health workforce can be tiring and even discouraging. But every person whose life depends on the work of their public health department should be your allies. In Summer of 2023, I’ll be launching a Massive Open Online Course via Columbia University to train public health students and graduates on advocacy. Just a small handful of topics to advocate for include:
- $7.4 billion over 5 years is a game-changing level of investment in public health workforce… but it’s really only a small percentage of the funding needed to replenish the workforce, and it’s temporary. A permanent, $10-15 billion increase each year, to hire the 80,000 new staff to provide basic staffing to health departments, is needed to meet Foundational Public Health Services.
- Equitable pay for governmental public health workers. It’s very difficult to recruit candidates when salaries are markedly lower than the competition. Advocating to improve salaries has been successful in a range of states
- Review of civil service exams & processes to ensure equity, avoid bias and create shorter time to hire
- Modernized applicant tracking systems and processes
- Revision of job descriptions
- Culture change: ensuring an inclusive work environment
- Funding for job advertising, marketing, etc.
- Student loan repayment for public health students who work in governmental public health departments… for which I’ve helped lead the nation’s first National Public Health Students & Graduates Hill Week
- How to Advocate for Good Jobs to End the Covid-19 Crisis and Address Health Inequity with Federal Funding (by Global Health Justice Partnership at Yale Law School)
- Public Health Needs More Lobbying Health Affairs article
- Stand with Public Health (advocacy efforts to prevent harrassment of public health workers):
- Public Health Advocacy (training)
- Krasna H, Fried LP. Generation Public Health: Fixing the Broken Bridge Between Public Health Education and the Governmental Workforce. American Journal Of Public Health. Published July 2021.
Additional trainings and toolkits:
- How to Recruit, Hire, Monitor and Train Community Health Workers: Guide for Local Health Departments https://www.train.org/main/course/1104796/
- Association of Public Health Labs STEM Recruitment Toolkit https://www.aphl.org/toolkits/Pages/STEM-Recruitment-Toolkit.aspx
- Public Health Foundation recruitment resources: http://www.phf.org/programs/recruitmentandretention/Pages/RecruitmentandRetention_of_public_healthworkers.aspx
- Advocates for Human Potential: behavioral health toolkit http://toolkit.ahpnet.com/
- Maine hiring toolkit https://www.maine.gov/dhhs/recruitment-and-retention-toolkit
- NACHC hiring toolkit http://www.nachc.org/wp-content/uploads/2015/06/NACHC-Recruitment-Onboarding-and-Retention-Toolkit-04092015.pdf
- NYS Citizen Public Health Program: https://www.ny.gov/programs/citizen-public-health-training-program
- Partnership for Public Service https://ourpublicservice.org/our-solutions/workforce/
- IHS recruitment toolkit https://www.ihs.gov/dhps/recruitmentandretention/
- Careers of Substance career page–an example of recruitment website targeting those interested in working in substance use disorder
- McKinsey “Hire the best” government recruiting report
Articles and Research
1. Yeager VA, Wisniewski JM. Factors That Influence the Recruitment and Retention of Nurses in Public Health Agencies. Public Health Rep. 2017;132(5):556-562. doi:10.1177/0033354917719704
2. Krasna H, Fried LP. Generation Public Health: Fixing the Broken Bridge Between Public Health Education and the Governmental Workforce. American Journal Of Public Health. Published July 2021.
3. Krasna H, Czabanowska K, Beck A, Cushman LF, Leider JP. Labour market competition for public health graduates in the United States: A comparison of workforce taxonomies with job postings before and during the COVID-19 pandemic. The International Journal of Health Planning and Management. n/a(n/a). doi:https://doi.org/10.1002/hpm.3128
4. Locke R, McGinty M, Guerrero Ramirez G, Sellers K. Attracting New Talent to the Governmental Public Health Workforce: Strategies for Improved Recruitment of Public Health Graduates. J Public Health Manag Pract. Published online February 2, 2021. doi:10.1097/PHH.0000000000001336
5. Yeager V, Leider J. The Role of Salary in Recruiting Employees in State and Local Governmental Public Health: PH WINS 2017. ajph.aphapublications.org; 2019. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2019.305008
6. Yeager VA, Wisniewski JM, Amos K, Bialek R. What Matters in Recruiting Public Health Employees: Considerations for Filling Workforce Gaps. Am J Public Health. 2015;105(12):e33-36. doi:10.2105/AJPH.2015.302805
7. Yeager VA, Wisniewski JM, Amos K, Bialek R. Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers. J Public Health Manag Pract. 2016;22(6):559-566. doi:10.1097/PHH.0000000000000380
8. Horney JA, Davis MK, Ricchetti-Masterson KL, MacDonald PDM. Fueling the public health workforce pipeline through student surge capacity response teams. J Community Health. 2014;39(1):35-39. doi:10.1007/s10900-013-9750-5
9. Manske J, Hayes H, Zahner S. The New to Public Health Residency Program Supports Transition to Public Health Practice. J Public Health Manag Pract. 2022;28(5):E728-E733. doi:10.1097/PHH.0000000000001569
10. Hare Bork R, Robins M, Schaffer K, Leider JP, Brian C Castrucci, Workplace Perceptions and Experiences Related to COVID-19 Response Efforts Among Public Health Workers – Public Health Workforce Interests and Needs Survey, United States, September 2021-January 2022