Public health in Washington State has lost nearly a quarter of its workforce since 2008—with some local agencies losing 50% or more. Since January 2020, our state has lost over 60% of its local leadership. Workforce depletion is a consistent trend across the country. A recent study by the DeBeaumont Foundation found that nearly one-third of our current workforce is considering leaving public health within the next year. This intensifies local instability and the inability to respond to threats and emergencies.
Complex threats and recession budget cuts make it hard for the public health system to protect and serve Washington’s families and communities. Program cuts and service reductions have become the norm for local agencies—creating a diminished workforce just when it’s needed in order to focus on the pandemic’s impact on families, childhood development, and community resiliency. It’s time to rebuild our system to better protect against threats and improve our communities’ health.
Congress recognized this need and passed bipartisan legislation last year to authorize the Public Health Workforce Loan Repayment Program at the Health Resources and Services Administration. The program will offer loan repayment for public health professionals who agree to serve three years in a local, state, or tribal health department; however, no funding was appropriated.
An annual appropriation of $100 million could allow as many as 2,000 public health professionals to receive up to $50,000 in student loan repayment benefits, helping health departments to recruit and retain top talent.
Additionally, Federal public health funding is critical to the work of local health departments. In Washington State, federal funds account for over 35% of local health budgets (2020 Local Health Jurisdiction Funding Report, www.doh.wa.gov). This funding provides local public health capacity to promote health equity, community partnerships, policy systems, and environmental programs. Much of the funding received by local health departments is tied to specific diseases (e.g., COVID-19 and diabetes) or programs (e.g., breastfeeding support and opioid overdose prevention). Often, funding also follows a boom-then-bust cycle, where massive funding influx occurs in an emergency and then quickly stops once the urgency of response abates. Local public health departments need disease and emergency-agnostic funding that can be used to support core public health infrastructure activities like communication, outreach, data analysis, and digitalization.
Investing in our local workforce and core public health capabilities will strengthen and support all the important work done by local health departments and ensure more efficient use of resources.
Recently, WSALPHO and local health participated in two large events that focused on building up the local health workforce and infrastructure. Last week, WSALPHO and local health jurisdictions (LHJs) met in Olympia for the Washington State Public Health Association (WSPHA) Public Health Education Day. Local health staff met with over 100 Legislators to discuss the importance of Foundational Public Health Services funding for their communities and how building a strong workforce is critical to impacting health outcomes. WSALPHO was joined by public health students, community-based groups, and healthcare on this education day. A huge thank you to WSPHA for organizing this event and to our Legislators who took time away from intense fiscal hearings to meet with their district LHJs.
This past week, WSALPHO staff and local health leaders from Whatcom and Clark counties took to the “other” Washington to further promote public health policy and funding at the federal level. Meetings with Congressman Larsen, Congresswomen Strickland and Gluesenkamp-Perez, and Senators Murray and Cantwell highlighted federal support for workforce development and infrastructure stability. We thank our federal policymakers for their continued support of local public health!
WSALPHO, Policy Director