Developing the Environmental Public Health Workforce

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Developing theEnvironmental Public Health
Workforce

• CAPT Michael E. Herring, REHS, MPH
• Senior Environmental Health Scientist
• Centers for Disease Control and Prevention
• National Center for Environmental Health
• Environmental Health Services Branch

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National Center for Environmental
HealthDivision of Emergency and Environmental
Health Services

• Environmental Health Services Branch

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Environmental Health Services Branch

• Improve the practice of environmental health and
  ensure the quality and accessibility of
  environmental health services in the U.S.
• Develop and enhance the knowledge and skills of
  environmental health professionals who deliver
  these services.

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The extent which we are able to address the
complex challenges of the 21st century and make
additional improvements in the health of the
public depends, in large part, upon the quality
and preparedness of our public health
workforce. - Who Will Keep The Public Healthy?
Educating Public Health Professionals for the
21st Century Institute of Medicine, November,
2002
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What is the problem?

• Between 40 and 50 percent of the EH workforce in
  state and local agencies may be eligible to
  retire in the next 5 years.
• Over 90 percent of the current EH workforce has
  no formal education in public health or
  environmental health.
• Loss of environmental health leaders
• Potential loss of over 10 percent of the EH
  workforce by the end of 2009 due to ongoing
  economic crisis.

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ASTHO 2007 State Public Health Workforce Survey

• The average age of a state public health worker
  is 47.
• The average age of new hires in state health
  agencies is 40.
• By 2012, over 50 of the workforce in some state
  health agencies will be eligible to retire.
• Most states continue to be affected by
  shortages in public health classifications
  including epidemiologists, laboratorians and
  environmental health workers.

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Vacancy Rates
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The Aging Workforce
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Workforce Education and Credentials(NEHA Survey)

• 91 of environmental health professionals hold
  bachelors degrees
• Most of the bachelors degrees are in science
  fields, but not specifically environmental health
• 51 percent of all respondents to the NEHA survey
  hold a credential
• 93 hold the Registered Environmental Health
  Specialist (REHS) or Registered Sanitarian (RS)

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Environmental Public Health Salaries(2002
Dollars)

• Average salary ranges from 31,235 for entry
  level EH specialists to 52,101 for directors
  (assuming a 3 annual salary increase, this would
  translate to 39,110 and 64,077 respectively
  today.)
• Annual compensation increases with the population
  of ones service area
• Salary is also affected by educational degrees,
  years of experience, credentials and location

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How do we meet the challenge?
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CDCs EHS Revitalization Strategy

• Build Capacity
• Support Research
• Foster Leadership
• Communicate and Market
• Develop the Workforce
• Create Strategic Partnerships

• For each goal
• 1-4 objectives
• Concrete and measurable activities

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Goal 5. Develop the Workforce

• Provide support to develop the EHS workforce via
  enumeration, performance standards, training,
  recruitment and retention activities
• Enumerate the EHS workforce
• Define a set of EHS performance standards
• Define the training and continuing education
  needs of the EHS workforce
• Expand efforts to improve the recruitment and
  retention of competent and effective EHS
  practitioners

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Association ofEnvironmental HealthAcademic
Programs
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Why are accredited environmental health academic
programs so important?
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Environmental health challenges are increasing in
complexity and frequency
E-Coli H7O157
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New, Emerging, and Re-EmergingEnvironmental
Health Challenges
West Nile Virus
Land Use Planning/ Built Environment
Aging Infrastructure
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while the traditional EH functions only continue
to grow in demand
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Association of Environmental Health Academic
Programs (AEHAP) Member Programs
39 member programs 32 accredited members 7
federally recognized minority serving
institutions 3 high Hispanic enrollment
universities (greater than 25 of student body).
Accredited Members
Non- Accredited
(Associate Members)
Accredited Minority Serving
Institutions Minority Serving Institutions
seeking accreditation
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Increase in EH Academic Programs
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Enrollment Over Time
58 decline over 10 years
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What should the EPH Workforce look like?
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Diversity Progress

• 2009 data indicate that over 50 of students
  enrolled in EHAC programs are minorities.

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www.cdc.gov/nceh/ehs/ephli
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Five Cohorts of EPHLI and Counting
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Environmental Public HealthLeadership
Instituteest. 2004

• Enhance leadership skills of EPH professionals
• To increase abilities of programs to better
  provide essential services
• To provide better response to emerging
  environmental health threats
• To better coordinate the delivery of effective
  services to areas impacted by unintentional,
  intentional, and natural disasters
• Improve ability to identify existing and
  potential problems and develop appropriate,
  sustainable interventions systems thinking.

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EPHLI

• Application Process
• Curriculum Vitae
• Application Form
• Participant and Program Commitment Form
• Letters of support
• Application Deadline is October 31, 2009
• http//www.cdc.gov/nceh/ehs/EPHLI/application.htm

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How can the armed services help?
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Military EH Practitioners

• 6800 EH practitioners on active duty
• Many retire or leave active duty each year
• Have extensive, high quality training in the
  environmental health sciences
• Could bring much needed diversity to EPH
• Experience with PCS may result in military EH
  practitioner willingness to take jobs in states
  and regions with the greatest need

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Environmental Health Preparedness Training

• Lack of defined roles in emergency response
• Multiple skills needed
• Understanding the broader scope of EH response
• No national training program

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Environmental Health Trainingin Emergency
Response (EHTER)
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EHTER Courses

• Over 750 trained from all 50 states, two
  territories, DC and Canada
• 10 Introductory Level courses
• 2 Train-the-Trainer courses
• Partnership with DHS (Center for Domestic
  Preparedness)

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EHTER Training

• Nine modules
• Disaster Management
• Responder Safety
• Potable Water
• Food Safety
• Wastewater

• Shelters
• Vector Control Pest Management
• Solid Waste HAZMAT
• Building Assessment

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Biology and Controlof Insects and Rodents
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Biology and Controlof Insects and Rodents

• Created due to
• Significant loss of vector control capacity at
  the local health agency level
• NEHA training needs survey
• Lack of available broad spectrum vector training
• Obvious threats to public health (e.g. WNV,
  continued deterioration of inner cities,
  hantavirus, etc.)

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Biology and Control of Insects and Rodents

• Training focal areas
• Integrated Pest Management (IPM)
• Vectorborne Diseases
• Rodent Control
• Mosquito Control
• Tick Control
• Bio-terror Agents
• Pesticides/Green Pest Control
• Housing and Lodging Pests
• Food Service Pests
• Global Climate Change

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• Biology and Control of Insects and Rodents
• Environmental Health Training in Emergency
  Response (EHTER)
• Environmental Health Performance Standards
• www.nehacert.org
• CDC Sponsored Programs

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Environmental Public Health Performance Standards

• Strong role for EH across 10 essential health
  services (? regulation)
• Aligns with movement towards national voluntary
  accreditation for health departments
• Improved accountability and performance of EH

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Environmental Public Health Performance Standards

• Identify service gaps in environmental health
  programs
• Continual performance improvement to build
  capacity, consistency, and accountability
• Causes us to find, generate, and use data
  necessary to measure performance and provide
  evidence of success

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Training/Reference Material

• www.cdc.gov/nceh/ehs/default.htm

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• Environmental Health Primer
• Community Food Safety
• On-Site Wastewater Treatment
• Land Use Planning
• All-Hazards Emergency Planning
• Environmental Health Policy
• Recreational Water
• Vector Control
• Coming Soon
• Workforce Development Guide
• CAFO Guide
• Healthy Homes Guide

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Environmental Health Service Corps(Concept)

• A number of outstanding EH practitioners selected
  annually.
• Trained in latest technologies and concepts in
  the environmental health sciences
• 2-year field practicum
• Establish a cadre of highly trained and motivated
  EH professionals serving in various capacities
  throughout the U.S.

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How can CDC ensure the success of these
projects?Contact InformationCAPT Mike
Herring770-488-7351mherring_at_cdc.gov
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Questions?