Quantifying the Public Health Workforce for Hawai‘i: Current Data, Measurement Complexities, and Conceptual Frameworks for Next Steps

The public health workforce is critical to community well-being and too often overlooked. The goal of public health is to prevent disease, promote health, and protect the public from current and emerging health threats. This work is vital to the health, safety, security, and prosperity of all communities and requires an adequate workforce. Despite the well-articulated gaps in the clinical health care workforce, Hawai'i's public health workforce needs and capacities are not as well understood. Public health workforce enumeration is complex. The field lacks a consistent definition of its full workforce and agreed-upon mechanisms for measuring it. Resolving these issues is an active area of scholarship and action, particularly given the COVID-19 pandemic-induced workforce capacity strain. This article reviews existing literature on public health workforce enumeration as a step toward filling this knowledge gap for practical use in the state of Hawai'i. Specifically, using a critical literature review method, this article (1) consolidates existing data about Hawai'i's public health workforce, (2) summarizes public health workforce measurement challenges, (3) shares existing frameworks and models for quantifying the public health workforce, and (4) discusses next steps to provide actionable information for ensuring Hawai'i's public health workforce can fulfill its mission. The article confirms that core public health functions as articulated in the (a) updated 10 Essential Public Health Services framework and (b) Foundational Public Health Services framework provide useful guidance for public health workforce enumeration in Hawai'i. The article also concludes that the US Department of Health and Human Services (HHS) definition of public health workers provides comprehensive framing for this enumeration. Based on this literature synthesis, a descriptive figure of the public health workforce in Hawai'i was developed to guide future work and prioritization.