Public Health in the 21st Century

American Journal of Preventive Medicine supplement addresses critical challenges to public health

Ann Arbor, MI, October 16, 2014

Although disease outbreaks and epidemics drawing worldwide attention emphasize the importance and acute need for public health professionals, the world faces a longer-term challenge—a public health workforce that is truly effective in the 21st century. In a new supplement to the American Journal of Preventive Medicine, experts address critical challenges to public health, from workforce development, capacity building, partnership and collaborations, and changes and needs in workforce composition.

As the U.S. healthcare system evolves and communities gain more access to care, diverse forces are driving change, and the practice of public health is adapting. Given the challenges to the public health system and those faced as a nation—including urgent health threats (e.g., antibiotic resistance, prescription drug use and overdose, global health security) and decreased funding for addressing public health concerns—having trust in public health practitioners, their scientific knowledge, and particularly the public health system, has never been more important.

"The public health workforce is now not only required to take a lead in protecting citizens' health, but it also must provide the evidence base needed for linking public health information with clinical services and activities; offer targeted, scalable public health interventions; and support clinical services in a way that affects populations at large," notes Guest Editor Fátima Coronado, MD, MPH, Deputy Associate Director for Science, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA. "This supplement is both timely and important because it reviews some of the critical challenges faced by the public health workforce, discusses selected changes under way, and highlights data-driven research to advance the field of public health services and systems research."

This groundbreaking supplement, The Public Health Workforce,includes 22 articles from more than 30 institutions, agencies, foundations and public companies and covers two major areas: public health workforce capacity building and public health workforce size and composition.

Key topics in the Supplement include:

  • How to clearly define the public health workforce challenges using cause-and-effect diagrams and a concise roadmap.
  • Use of Massive Open Online Courses (MOOCs) by the School of Public Health at Harvard and concerns about retention of the knowledge gained using that method of instruction.
  • How the CDC conducts workforce development within its own organization.
  • Do students who receive adequate training in Public Health and Community Medicine tend to practice in areas with physician shortages?
  • How do we count public health workers? In the first study since 2000, 50% of all public health workers are employed at the local level, with 30% and 20% at the state and federal levels, respectively.
  • How can we define public health workers properly? A taxonomy has been developed which is a necessary step to continuously monitor the size and composition of the workforce to ensure sufficient capacity to deliver essential public health services.
  • Data show that part-time public health workers are a low percentage of the total workforce and the percentage has decreased over the last 5 years.
  • Despite relatively uncompetitive pay, local health departments experience lower rates of employee turnover than state health agencies and lower rates than state and local government in general.
  • How can we align public health workforce competencies with population health improvement goals?
  • How the Public Health Accreditation Board (PHAB) developed the standards and measures to encourage health departments to strengthen the current public health workforce and strategically develop the workforce of tomorrow.
  • Do Internal Medicine Residency Programs develop public health competencies?
  • How a training program for racial and ethnic minorities for careers in public health sciences has resulted in 60% of the students entering public health careers.
  • Will epidemiology education change rapidly enough to keep up with trends in communications and computing?
  • How the growth of cities, "Big Data," and cognitive computing will change the public health workforce.
  • Building a Culture of Health – How the public health workforce will not only provide medical care but will help to establish a Culture of Health.
  • Nursing as a critical driver of the Culture of Health.

Guest Editors Dr. Coronado and Denise Koo, MD, MPH, Office of Public Health Scientific Services, CDC, Atlanta, GA, and Kristine Gebbie, DrPH, RN, Faculty of Health Sciences, Flinders University, Adelaide, South Australia, write that "we are buoyed by the increased efforts to meet workforce challenges and the valuable contribution of researchers and practitioners to strengthen the public health workforce. Efforts to strengthen the public health workforce should be a continuing priority involving well-planned, evidence based, and coordinated actions from decision makers undaunted by the mission of transforming public health and improving the population's health while facing the complex landscape of the 21st century."


Notes for editors
The Public Health Workforce
Guest Editors:
Fátima Coronado, MD, MPH, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, GA
Denise Koo, MD, MPH, Office of Public Health Scientific Services, CDC, Atlanta, GA
Kristine Gebbie, DrPH, RN, Faculty of Health Sciences, Flinders University, Adelaide, South Australia
American Journal of Preventive Medicine, Volume 47/Issue 5, Supplement 3 (November 2014), published by Elsevier.

This supplement edition of the American Journal of Preventive Medicine has been sponsored by the U.S. Centers for Disease Control and Prevention (CDC), an Agency of the Department of Health and Human Services, under the Cooperative Agreement with the Public Health Foundation and University of Michigan Center of Excellence in Public Health Workforce Studies (CDC RFA-OT13-1302). The ideas expressed in the articles are those of the authors and do not necessarily reflect the official position of CDC.

The full table of contents and full text of the contributions are available to credentialed journalists upon request; contact Angela J. Beck at +1 734 764 8775 or Journalists wishing to interview the Guest Editors or authors should contact Fátima Coronado, MD, MPH, at +1 404 498 6551 or

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine ( is the official journal of The American College of Preventive Medicine ( and the Association for Prevention Teaching and Research ( It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine, with an Impact Factor of 4.281, is ranked 10th in Public, Environmental, and Occupational Health titles and 17th in General & Internal Medicine titles according to the 2013 Journal Citation Reports® published by Thomson Reuters, 2014.

About Elsevier
Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Research Intelligence and ClinicalKey— and publishes over 2,500 journals, including The Lancet and Cell, and more than 35,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group, a world-leading provider of information and analytics for professional and business customers across industries.

Media contact
Angela J. Beck
Managing Editor
+1 734 764 8775