People assume states ready, but public health net 'fragile'
Unaware or unconcerned that many state and local government workers will be retiring in the next few years and there may not be enough replacements waiting to take their place, most Americans are confident that governments at all levels are prepared to deal with a public health emergency such as a nationwide outbreak of pandemic flu. That's one of the major findings from a public opinion survey sponsored by the Center for State and Local Government Excellence to draw attention to what it sees as a need to cultivate talent to fill the many state and local government positions that will open up in the next few years.
"We count on public health professionals to prevent the spread of disease, protect us from bioterrorist threats, make sure our food is safe to eat, and our air is safe to breathe," says Center for State and Local Government Excellence executive director Elizabeth Kellar. "Those closest to the public health infrastructure know that the safety net is fragile. The public sector work force is older than the private sector's, and state and local governments are facing their greatest turnover ever. Public health is an area that already faces critical shortages, so there is no time to lose."
While as many as 45% of public health workers are expected to retire over the next five years, the poll of 1,200 adults found that only one in three Americans see this as a major problem for state governments, and only one in four see it as a problem for local governments.
Data from the Association of State and Territorial Health Officials (ASTHO) show some states with vacancy rates as high as 20% in key public health positions and turnover rates as high as 14%. The most severe shortages are in epidemiology, public health nursing, and environmental health. As an example, state health departments estimate they need 47% more epidemiologists than they have today, or nearly 1,200 new epidemiologists.
Part of the problem, however, is finding workers to fill the slots. More than half the states say they don't have enough qualified applicants, according to ASTHO, and local governments say they face similar challenges. Local public health departments have said they will have problems finding qualified nursing candidates this year and note that on average nurses account for 24% of their work force.
Nearly 40% of local health departments also say they will face problems hiring qualified environmental health professionals to monitor air and water quality.
Many will work for government
One interesting poll result was the finding that many Americans see working for a state or local government as a real possibility for them in the future. Some 20% of workers are very interested in taking a job at some point with state and local governments and the numbers are even higher in specific public health areas. Thus, two-thirds are interested in working in a hospital or other public health organization, and 30% said they were very interested in such work.
"The perception that jobs in public health would be attractive is an important one for that is an area where a quiet talent crisis is building in state and local governments in the public health area," the report says.
The report finds that more than one-third of both state and local government workers are age 50 or older, compared with a little less than a quarter of private sector workers. And with the first baby boomer having applied for Social Security retirement benefits in 2007, the "leading edge of this tidal wave of retirements is hitting state and local governments. This impact is felt, in some cases, earlier in state and local government since government pension provisions are often keyed to the number of years of service in ways that is not the case in private business."
While Americans see the wave of retirements as a problem for governments, they are divided over how significant a problem it is. Thus, 31% say the retirements will be a major problem for state government and another 31% say it will be a minor problem. And there are 35% who say it will not be a problem at all.
Even fewer see the retirements as a major problem at the local level, with just 24% seeing it that way. Some 34% say it will be a minor problem and 39% say it's not a problem at all.
While only 32% of private sector workers are classified as knowledge workers, almost 70% of public sector employees fall into that category and this will have a significant impact on the ability of state and local governments to meet the public's needs in an increasingly complex world.
Looking at the country's response to public health emergencies, the survey found that Americans are divided about which level of government should take the lead in the event of a public health emergency. A small plurality (36%) says the federal government should take the lead in the event of an emergency such as pandemic flu. But about 25% favor state governments taking the lead and 25% say local governments should be in charge.
Surprising level of confidence
Despite overall low levels of confidence in government, the public is pretty confident that all levels of government are ready for a public health emergency. Those who named a level of government as the most responsible for helping people deal with a public health emergency were then asked how they thought that level of government would do in handling the task. Some 65% of those looking to the federal government said it is very prepared or somewhat prepared for such an emergency. Likewise, 73% said state governments are prepared and 71% said local governments are prepared.
The researchers note that since public health issues cover a broad range of state and local government responsibilities, from school vaccinations to sexually transmitted diseases to public hospitals, it may not be surprising that state and local governments receive negative marks for their handling of such matters. Only 36% of respondents gave excellent or good marks to state governments in the public health area, while 62% gave fair or poor ratings. The pattern was similar for local governments with 37% giving positive marks and 58% poor marks.
In the last 40 years, the researchers said, there has been an erosion of confidence in governments at all levels in the U.S. as well as in many other institutions. And events such as Hurricane Katrina and the collapse of an interstate bridge in Minneapolis have not helped restore citizens' confidence in their government.
Today, only 20% of Americans express a great deal or quite a lot of confidence in the federal government, while 77% say they have only some or very little confidence in it. State and local governments get somewhat higher marks, with 35% expressing a high level of confidence in their local governments and 27% expressing high confidence in their state governments.
About half of all adults say each level of government is now better prepared for an emergency, but in each instance more than 40% maintain there has been no change in the level of government preparedness to deal with emergencies.
Download the report at http://www.slge.org/vertical/Sites/%7BA260E1DF-5AEE-459D-84C4-876EFE1E4032%7D/uploads/%7B51A97981-9310-4E8B-812D-02B2CABFDF14%7D.PDF.
Unaware or unconcerned that many state and local government workers will be retiring in the next few years and there may not be enough replacements waiting to take their place, most Americans are confident that governments at all levels are prepared to deal with a public health emergency such as a nationwide outbreak of pandemic flu.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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