Funding: Jr Investigator Award
The nation’s financial crisis has forced local, state and federal public health agencies to make dramatic service and system cuts, while simultaneously attempting to respond to significant health disparities. Since 2008, local health departments (LHDs) in the United States (US) have cut 34,400 workers (NACCHO, 2011). Between January 2011 and June 2011, in nineteen states more than half of the LHDs surveyed lost positions (NACCHO, 2011). Nationwide, forty-four percent of all LHDs lost at least one staff to layoffs or attrition over this same six month period, and 69 percent of the US population lives in a jurisdiction impacted by these reductions (NACCHO, 2011). It is unclear, however, how changes in the size of the LHD workforce due to cuts may have impacted the distribution of workers in geographic areas with the most vulnerable populations. Exploring the relationship between LHD workforce cuts and sociodemographic characteristics (e.g. poverty and racial composition) across geographic areas is of particular relevance to Public Health Practice-based Research Network (PUBLIC HEALTH PBRN) goals and the National Agenda for Public Health Systems and Services Research (PHSSR) regarding LHD workforce, social determinants of health, and health disparities. In the state of Washington (WA) the WA Public Health Practice-based Research Network (Public Health PBRN) has made “addressing health inequities among underserved populations” one of its highest priority areas of PBRN-related research (WA PBRN, 2009, unpublished).
Dr. Betty Bekemeier
University of Washington School of Nursing