How Valuing the Public Health Workforce Impacts COVID-19 Vaccine Hesitancy

This opinion piece was authored by Dr. Michelle Fiscus, a subject matter expert that consults for AIM. Note: this opinion piece is not an official AIM statement.

As highlighted in Supporting immunization programs to address COVID-19 vaccine hesitancy: Recommendations for national and community-based stakeholders (Wells et. al., 2022), now is the time for state and federal government agencies and other stakeholders to invest in the public health workforce.

Public health professionals have been historically undervalued, despite the critical nature of their work. At no time has this been more apparent than during the COVID-19 pandemic, when public health professionals were often asked to work for weeks or months without a day off, often with days lasting 12-16 hours. They were asked to shift from the duties they were hired to perform to serve the public health pandemic response, and often did so with a sense of pride and dedication to serving their communities.

But months of long days and abuse by a public that felt put upon and inconvenienced has taken its toll, with 53% of public health workers responding to a survey reporting at least one adverse mental health condition in the two weeks preceding the survey (CDC, 2021).

Over the course of the pandemic, countless public health workers have retired, resigned, or been removed from their positions, many citing burnout, abuse, demoralization, and inadequate compensation. Recent modeling from the de Beaumont Foundation and the Public Health National Center for Innovations estimates 80,000 full-time equivalent public health workers would need to be hired just to provide a minimal set of basic public services to all Americans (2021). As a result, the United States may find itself less prepared for the next major infectious disease event than it was for the COVID-19 pandemic.

As the Delta and Omicron SARS-CoV-2 virus variants surged across the U.S. in 2021 and early 2022, health departments were often stymied by the bureaucracy of state and local governments. Government hiring processes can take weeks to navigate, often putting health departments in a place of needing to play “catch up” to the current state of the pandemic.
Despite ample emergency funding from the federal government, many health departments were unable to hire permanent staff due to the inability to gain the approval of their legislature or Governor to create more staff positions, leaving departments no choice but to work with temporary contractors. Pay rates were often inequitable despite individuals frequently floating between job duties, and temporary workers were not provided the benefits that accompany permanent positions, resulting in high staff turnover.

As outlined by Wells, et. al., there is an urgent need to build the public health workforce and capacity needed to respond to future crises in this country. Federal and state governments should foster the development of the pipeline of public health professionals needed to provide foundational public health services and implement evidence-based strategies to promote health and prevent disease. These professionals should be valued and supported—financially, professionally, and emotionally—so that the workforce can be rebuilt and retained. Additionally, public health professionals should be defended from community influencers who oppose sound, evidence-based public health policy, and stakeholders should collaborate to educate misinformed policymakers.

Given the impact of the COVID-19 pandemic across all aspects of society, the investment in public health infrastructure and workforce is justified and should be given the prioritization that has been lacking for decades.

Read the complete article, Supporting immunization programs to address COVID-19 vaccine hesitancy: Recommendations for national and community-based stakeholders, here.

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