Local health department workforce cuts: The impact on health disparities and workforce diversity

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. Washington (WA) is one of only 11 states in the nation in which more than 75 percent of Local Health Departments (LHDs) cut programs and workforce in 2010, compared to the previous year. The impact of cuts on communities of color may disproportionately impact racial/ethnic health disparities. LHD cuts that reduce workforce diversity may influence capacity to address health disparities among vulnerable populations. It is unclear, however, what impact workforce cuts in WA's LHDs have had on service and system changes. It is also unclear whether workforce cuts have adversely impacted public health services that address health disparities or workforce diversity in WA LHDs. To explore the impact of workforce cuts, the WA Public Health Practice-based Research Network (WA PH PBRN) is conducting a mixed methods study analyzing local secondary datasets and collecting qualitative data from interviews with WA LHD leaders. This study expands upon the work of the WA PH PBRN investigating decision-making in LHDs during times of financial crisis. Preliminary findings from quantitative data indicate that LHDs in WA lost 9% of their workforce between 2007 and 2010. Interviews that follow with LHD leaders will examine the impact of workforce cuts on LHD's capacity to address health disparities, and the impact of workforce cuts on LHDs' workforce diversity. Understanding how budget-related LHD workforce reductions impact efforts to address health disparities and workforce diversity can be used to inform decision-making and resource allocation in LHDs during times of economic hardship. The information presented will have applications for policy, practice, and competencies for reducing health disparities locally and nationally; and, it is of particular salience given the current economic climate-->