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Recruitment & Retention in the Public Health Workforce

Recruitment and retention are two problem areas that need to be addressed to build a strong public health workforce. According to a new analysis, state and local health departments need to hire a minimum of 80,000 more full-time equivalent positions (FTEs) — an increase of nearly 80% — to provide adequate infrastructure and minimal public health services (de Beaumont, 2021). Nearly half of state and local public health employees left their jobs between 2017 and 2021, exacerbating an existing workforce shortage and causing a critical lack of skills and experience that puts communities at risk (de Beaumont, 2023).

Public health analysts and other experts offer different perspectives on why these challenges exist. However, there is one key element that has remained constant and is at the forefront of recruitment and retention: funding.

Recruitment Assessment
Recognizing that funding drives recruitment, the federal government awarded $3.14 billion to state, local, and territorial public health departments to strengthen the public health infrastructure and workforce. Heather Krasna, Ph.D., MS, EdM, internationally recognized expert on public health careers, co-author of the book 101+ Careers in Public Health (3rd Ed), and Associate Dean, Career and Professional Development at Columbia University Mailman School of Public Health, believes the new funding creates a special opportunity for health departments to replenish their workforce.

With over 24 years of experience, Krasna offers a unique perspective on how health departments can use this funding to recruit and retain workers. She says prioritizing who needs to be hired is the first step. According to Krasna, health departments should first review workforce development plans and community health assessments; if there are specific issues that are happening within the community that need to be addressed, prioritize those and the need for additional support.

Next, health departments should explore resources like the Public Health Workforce Calculator, if applicable. This tool supports local health departments’ workforce planning efforts by estimating the number of full-time equivalents (FTEs) needed to ensure the provision of the Foundational Public Health Services, the minimum public health capabilities and programs no jurisdiction can be without.

Krasna also suggests finding out how and where to reach the people that need to be hired. For instance, looking into community-based organizations, faith-based groups, local colleges, and attendees at health fairs to target outreach and build relationships. She encourages using job boards and social media sites such as LinkedIn, Indeed.com, or Idealist.org for both potential candidates and job advertisements. If funding and accessibility permits, health departments may find value in applicant tracking software, which supports a quick and seamless hiring experience and creates a deep talent pool. Health departments can give a second look to what Krasna describes as the “silver medalist candidates”— people who may not have been hired, but were “runners-up” for a particular position, but might be a good fit for future roles.

Building a Strong Employer Brand
Employer branding is also important aspect of recruiting. Paying attention to what past and present employees are saying about the work environment is key, as both may influence recruitment and retention. Diversity and inclusion efforts also affect employer branding and are crucial in the recruitment process. Krasna believes employers should go the extra mile to have a diverse pool of candidates and that no one is left out.

Building multiple candidate sources is critical as funding and accessibility may be an issue for both the candidate and the public health agency posting the job. For instance, candidates who may have been incarcerated or have gaps in their employment may not use the same job search tools as other candidates. While large universities may have access to platforms like Handshake, many colleges, graduate schools, and community colleges do not.

Transportation, internet accessibility, and other socio-economic factors play a crucial role in recruitment. Krasna stresses the importance of diverse candidates representing your community and how the hiring process should be equitable and transparent. “Think about people who may been overlooked in the hiring process and may need special accommodation, such as those who have disabilities,” emphasizes Krasna. Providing encouragement and a sense of belonging can help health departments find phenomenal candidates who have the potential to make a difference in their community.

Recruitment: A Collaborative Effort
Krasna has worked with the Region II and Region V public health training centers, providing strategies for workforce recruitment and retention and employer branding. For Region 2, these strategies are provided in a four-part workshop series, including How to Identify Hiring Needs, Employer Marketing & Branding, How to Keep Top Candidates Engaged in Your Hiring Process, and Onboarding & Retention. During one of the sessions, attendees got a chance to hear from Washington State Health Department’s Talent Acquisition & Candidate Experience Manager and CDC’s Foundation COVID-19 surge staffing team as they offered tips on how to engage with possible candidates in non-conventional ways and how to utilize metrics for the candidate experience.

These sessions are currently offered to organizations in Region 2 Public Health Training Center but the first three session recordings are now available on Train.org. The complete training series will be available in Summer 2023 on Train.org, a national learning network that provides quality training opportunities for professionals who protect and improve the public’s health.

Although recruitment can be a tedious process for both the employer and the candidate, with the right resources and tools, this process can be a positive experience for all. For more information about recruitment, use the Recruitment Toolkit found on the Region 2 Public Health Training Center website. For more in-depth information about public health careers, visit PublicHealthCareers.org.

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