the public health workforce has broader responsibilities and must be much more diverse. For example, as part of the performance of essential services, members of the public health workforce must be prepared to engage the community in effective actions to promote mental, physical, environmental, and social health. Advances in biomedical and genomics research and technologies have the potential to change the way public health practitioners think about population-level disease risk and how disease prevention and health promotion activities might be practiced. Moreover, rapidly evolving computer and information technologies and the use of mass media and social marketing have the potential to revolutionize health departments’ access to up-to-date surveillance information, disease databases, and communications networks as well as to enhance worker productivity.

The need to strengthen the public health workforce was recognized by IOM in 1988 and has been the focus of a variety of efforts since then. Some of these activities will be discussed in the chapter on the role of academia in the public health system (Chapter 8). A few key efforts focusing on the current workforce (rather than training new workers) are also covered here. In particular, the report The Public Health Workforce: An Agenda for the 21st Century (USPHS, 1997) called for greater leadership on workforce issues from national, state, and local public health agencies; use of a standard taxonomy to better assess and monitor workforce composition; competency-based curriculum development; and greater use of new technologies for distance learning. The Taskforce for Public Health Workforce Development, established in 1999 by CDC and ATSDR, recommended six broad strategies for a national public health workforce development agenda (CDC, 2000e):

  1. Monitor current workforce composition and project future needs.

  2. Identify competencies and develop curricula.

  3. Design integrated learning systems.

  4. Use incentives to promote public health practice competencies.

  5. Conduct and support evaluation and research.

  6. Assure financial support for a lifelong learning system in public health.

An almost universal priority for workforce development is ensuring that all public health practitioners have mastery over a basic set of competencies involving generalizable knowledge, skills, and abilities that allow them to effectively and efficiently function as part of their public health organizations or systems (CDC-ATSDR, 2000; DHHS, 2000; CDC, 2001d) (see Appendix E for an extended list of competencies for public health workers). Many experienced public health professionals require a variety of cross-cutting competencies to help them meet the routine and emergent



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