Relationship between public health workforce competency, provision of services, and health outcomes in Tennessee

Information on the composition of the public health workforce in the United States remains relatively sparse. Recent efforts for enumeration have identified secondary data sources such as NACCHO and ASTHO to be the best sources of overall data on the governmental public health workforce at the local and state level. However, none of the data sources contain information on the competency level of public health workers.Public Health Training Centers needs assessment data provide a potential mechanism for capturing the competency level of public health workers. In 2012 the Tennessee Public Health Training Center (LIFEPATH) conducted a needs assessment of the Tennessee Department of Health (TDH) workforce including both state and local governmental public health workers. As part of this needs assessment, competency of each worker was assessed using a three tier and eight competency level tool based on the Council on Linkages Core Public Health Competencies. Simultaneously, the IOM has made recommendations for a “minimum package” of public health services that no health department should be without including both foundational capacities and basic programs.In order to fulfill this “minimum package” of services a key competent may constitute a competent workforce. A key assumption of this framework is that a competent workforce will lead to better health outcomes. The competency level of public health workers was obtained from the needs assessment data. Public health services were obtained from NACCHO 2010 profile and health outcomes from County Health Rankings for Tennessee. This research will examine if there is a relationship between the competency of public health workers, provision of public health services, and county level health outcomes in Tennessee. This study may provide preliminary evidence of the value of needs assessment data in decision making for resource allocation, educational training of public health workers, and to improving health of the states.