This Thursday, ASPH, in cooperation with the Association of American Medical Colleges (AAMC), the American Public Health Association (APHA), the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO), hosted a briefing for Congressional members and staff on the public health workforce and its response to the H1N1 influenza. The briefing was attended by more than 60 attendees representing Congressional offices, public health associations, the ASPH Public Health Policy Fellows and students from The George Washington University School of Public Health and Health Services.

During the briefing, speakers Dean Linda Rosenstock (UCLA), Dr. Georges Benjamin (APHA), Mr. Robert Pestronk (NACCHO), Dr. John Prescott (AAMC) and Dr. Dan Sosin (Coordinating Office for Terrorism Preparedness and Emergency Response, Centers for Disease Control and Prevention) discussed what needs to be done to support this critical component of the nation’s ability to stay ahead of the new and potentially dangerous flu virus and other public health emergencies.

In her introductory comments, Dean Rosenstock noted that speakers would address the response to the current H1N1 influenza outbreak in the context of the public health workforce and the looming worker shortage crisis. The public health workforce, Dean Rosenstock noted, is a vital infrastructure to effectively respond to any health emergency, yet it currently faces a shortage of workers which will only increase in the years to come.

Dr. Georges Benjamin, executive director of APHA, discussed the characteristics of the H1N1 virus—its genetic structure and how it replicates—and the implications for the public health workforce response. He discussed the many resources needed to mitigate, control and extinguish an outbreak of a novel virus for which there is no current vaccine.

"That requires a great deal of work," Dr. Benjamin stated. "It’s not just the disease detective work. It’s not just the research and development work. There’s also a fair amount of work with the communities to control the disease. We have to rely, at least initially, on our classic public health measures of good hygiene, educating the public and doing good epidemiology work to try to break the cycle."

Mr. Robert Pestronk, executive director of NACCHO, echoed this sentiment and added that much of the work in culling an outbreak is performed by workers at the community level and through local health departments. While the current outbreak of H1N1 has been considered mild, he cautioned that the there are not enough people in the local health departments to ensure an adequate response to a larger, more virulent outbreak, which many expect could occur if the H1N1 virus resurges later in the year. Local health departments have the potential to create conditions in which people and the nation can be healthy; however, this would require sustained funding to the entire public health workforce to main and update skills, and train new workers. Mr. Pestronk stated that the current conditions "paint a woeful picture…which Congressional action can change."

Dr. John Prescott, chief academic officer of AAMC, also emphasized how funding should be focused on the entire public health workforce, and stressed that the workforce needs to be equipped to "handle any situation and not just one particular virus." He further stressed that physicians need to be trained in public health, and that "we need to make sure there is stable funding to encourage physicians to enter the public health workforce."

Lastly, Dr. Dan Sosin, acting director of COTPER/CDC, stated that the number one priority of the CDC is to supply the local public health workforce with the capacity needed to address public health emergencies. The CDC offers many fellowships, workforce trainings and volunteers for response readiness in order to assist health departments in case of public health emergencies.

The H1N1 outbreak provided a "stress test" of the ability for public health to respond and there have been successes in dissemination of both clear, consistent messages and efforts to cull the outbreak. However, should a more virulent resurgence occur, the shortages in the workforce will severely strain abilities to adequately control and extinguish the outbreak. Additionally, resources will have to be pulled from other projects and activities—such as sanitation, health services delivery and responding to other infectious diseases—which could fall by the wayside.

ASPH is grateful to Senator Durbin (D-IL) and Representative Matsui (D-CA) for sponsoring the briefing. Their support of public health issues, including workforce issues, is to be commended. This was illustrated by the introduction of the Public Health Workforce Development Act of 2009 in the afternoon following the briefing. A Friday Letter article on the act is available here.

A video of the briefing will be available soon on the ASPH web site, www.asph.org. Please check the site for more updates.