de Beaumont Foundation and Public Health National Center for Innovations Release First-of-its-Kind Estimate of Public Health Workers Required to Meet Nation's Basic Needs

New research shows that state and local public health departments need nearly 80% more full-time-equivalent positions to provide core services

Bethesda, Maryland, Oct. 07, 2021 (GLOBE NEWSWIRE) -- Public health departments need approximately 80% more full-time equivalent positions (FTEs) just to meet basic health requirements, according to a first-of-its-kind report released today that provides a research-based estimate of staffing needs. The report was produced by the de Beaumont Foundation, the nation’s largest philanthropy focused on state and local public health, and the Public Health National Center for Innovations (PHNCI), a division of the Public Health Accreditation Board. See details at

The research brief documents the staffing gap that’s been created by budget cuts to state and local health departments over the past few decades. It emphasizes that the additional 80,000 employees would only provide adequate infrastructure and a minimum package of public health services. Because it’s based on data from 2017-2019, it also doesn’t account for new ongoing needs the COVID-19 pandemic may have created. 

In the last decade alone, state and local health departments have lost 15% of their essential staff, hindering their ability to address community health challenges and be prepared for emergencies.

“This estimate is an important starting point for the national discussion we need to have about the value of public health, prevention, and preparedness,” said Brian C. Castrucci, DrPH, president and CEO of the de Beaumont Foundation. “Increasing the workforce by approximately 80% is a relatively small investment to ensure that every community has basic public health services.”

Paul Kuehnert, DNP, RN, FAAN, president and CEO of the Public Health Accreditation Board, added, “For years, a disinvestment in public health departments has led to a crumbling public health infrastructure, lack of modern data systems, and an inability for health departments to equitably provide necessary services to their communities. We now have the data we need to build support and fund health departments to perform their critical roles in protecting the health of all communities.” 

Steering Committee Organizations:


  • American Public Health Association
  • Association of Public Health Laboratories
  • Association of Schools and Programs of Public Health
  • Association of State and Territorial Health Officials
  • Big Cities Health Coalition
  • Black Hawk County Public Health
  • City of Longview Environmental Health Department
  • Colorado School of Public Health, Anschutz Medical Campus
  • Columbus Public Health
  • Council of State and Territorial Epidemiologists
  • de Beaumont Foundation
  • Eastern Band of Cherokee Indians
  • Los Angeles County Department of Public Health
  • Louisiana Department of Health
  • Minnesota Department of Health
  • National Association of Community Health Workers
  • National Association of County and City Health Officials
  • National Board of Public Health Examiners
  • National Indian Health Board
  • Public Health Accreditation Board
  • Richard M. Fairbanks School of Public Health
  • Society for Public Health Education
  • Trust for America’s Health
  • University of Washington, School of Medicine
  • Washington State Department of Health

Ex-Officio Members

  • Center for State, Tribal, Local, and Territorial Support Centers for Disease Control and Prevention
  • Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention 

Liaison Member

  • Office of Strategy, Programs, and Partnerships, Bureau of Health Workforce Health Resources and Services Administration 

Research Advisory Committee Members

  • Angela Beck, University of Michigan School of Public Health
  • Betty Bekemeier, University of Washington School of Nursing
  • Paul Erwin, University of Alabama at Birmingham School of Public Health
  • Bianca Frogner, University of Washington, School of Medicine
  • Glen Mays, Colorado School of Public Health, Anschutz Medical Campus 
  • Mike Meit, NORC at the University of Chicago
  • Jean Moore, State University of New York at Albany School of Public Health
  • Jessica Owens-Young, American University
  • Beth Resnick, Johns Hopkins Bloomberg School of Public Health
  • Gulzar Shah, Georgia Southern University

About the de Beaumont Foundation

The de Beaumont Foundation creates and invests in bold solutions that improve the health of communities across the country. Its mission is to advance policy, build partnerships, and strengthen public health to create communities where everyone can achieve their best possible health. For more information, visit

About the Public Health National Center for Innovations

The Public Health National Center for Innovations (PHNCI), a division of the Public Health Accreditation Board (PHAB), was established in 2015 to identify, foster, and share health department innovations in public health practice. Our mission is to advance and transform public health practice by championing performance improvement, strong infrastructure, and innovation. For more information, visit


The national estimates were generated from data collected from nearly 170 local health departments in four states (Colorado, Ohio, Oregon, and Washington) and three state health departments. These states underwent extensive exercises to cost out their current implementation of baseline services, understand what full implementation would cost, and identify the gap (i.e., the dollars and staff needed to move from current to full implementation). As a result, these states provided the best available data about what infrastructure health departments need to serve communities.

Researchers then extrapolated findings from these 173 health departments to the nation’s 2,450 local health departments by creating models for the key activities that all health departments should be able to implement, based primarily on population size. They are calculated based on data from state and local health departments (prior to COVID-19) and, as such, are not representative of workforce needs for U.S. territories and freely associated states or Tribal Nations.



Infographic: Public Health Staffing Needs

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