The National Association of County and City Health Officials (NACCHO) yesterday released its 2024 Forces of Change Survey report that found that more and more local health departments are losing staff through layoffs or attrition, raising concerns about a shrinking public health safety net.
The study spotlights experiences of health departments at the county, city, and district level, including staffing and budget changes, health department governance, use of public health fellowship and training programs, the roles of public health nurses, program evaluation capacity, and activities that address the infectious disease consequences of substance use. Of 1,200 local health departments invited to complete the survey from March to June 2024, a total of 667 (56%) responded.
“The latest findings highlight critical trends and challenges faced by local health departments during a time of uncertainty in the local public health landscape,” NACCHO said in a news release.
1 in 5 local health departments note job losses
The survey found that, in 2023, 19% of local health departments reported job losses—an increase from 14% in 2021 and 17% in 2022. The rate rose to nearly 40% among large local health departments. Also, 17% of local health departments reported budget cuts during fiscal year (FY) 2024, with 23% anticipating cuts in FY2025.
The latest findings highlight critical trends and challenges faced by local health departments during a time of uncertainty in the local public health landscape.
In addition, 90% of local health departments reported that nurses are involved in health promotion and protection; 72% said they are involved in emergency preparedness, disaster recovery, and cross-sector collaboration; and 41% reported that nurses contribute to policy and advocacy work.
NACCHO also reported, “In 2024, 84% of local health departments reported having programs with an evaluation component. While most incorporated evaluation into their work, nearly 60% reported challenges due to insufficient staff time or capacity.”
NACCHO added, “Overall, few local health departments had individuals from training and fellowship programs assigned to their agency, which puts future workforce development at risk.” NACCHO represents more than 3,300 local health departments.
