Assessment of Workforce Capacity for Local Health Departments in Nebraska: A Perspective from Public Health Topical Areas

To assess the workforce capacity of local health departments (LHDs) in Nebraska, we conducted a survey of all 21 LHDs in 2010. Unlike most existing surveys, our instrument collected workforce information by public health topical area, rather by occupational type. Although the median FTEs per LHD increased from 8 in 2008 to 9.6 in 2010, the survey results suggested that there was a significant deficiency of workforce capacity in some public health areas for Nebraska LHDs. Among the responding LHDs (n=18), 67%, 44%, and 39% reported not having any staff dedicated to cover issues related to mental health, sexually transmitted diseases, and occupational safety/injury, respectively. More than 60% of the responding LHDs reported a need for additional staff to address issues related to chronic diseases, food safety, indoor air quality, environmental health, and health disparities. In addition, we created a shortage index by dividing “additional FTEs needed” by the sum of “current FTEs” and “additional FTEs needed”. The results suggested that Nebraska LHDs experienced the greatest workforce shortage in mental health (median shortage index=0.80), followed by environmental health (0.79) and oral health (0.79). The survey results also suggested that almost 40% of the responding LHDs did not develop agency or individual plan for staff development. The majority of the responding LHDs (72%) reported that the instability of funding was a major barrier for LHDs to build a competent workforce. Policy makers should consider implementing appropriate financing mechanisms to help Nebraska LHDs fill the workforce gaps identified by this research.