On the Road to a Stronger Public Health Workforce

The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public’s health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements—goals and strategies—to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other’s work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC’s commitment to working with partners on the highest priorities for strengthening the workforce to improve the public’s health. The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public’s health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements—goals and strategies—to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other’s work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC’s commitment to working with partners on the highest priorities for strengthening the workforce to improve the public’s health. BackgroundThe public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges that threaten the public’s health.1Gebbie K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 2Perlino C. The public health workforce shortage: left unchecked, will we be protected? American Public Health Association (APHA) issue brief, September 2006. APHA, Washington DC2006Google Scholar, 3Association of State and Territorial Health Officials. 2007 State Public Health Workforce Survey results. astho.org/Programs/Workforce-and-Leadership-Development/2007-State-Public-Health-Workforce-Survey-Results/.Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 5Association of Schools of Public Health (ASPH)More than 250,000 additional public health workers needed by 2020 to avert public health crisis: shortage will leave nation vulnerable to disease, bioterror and health threats according to a new assessment from the Association of Schools of Public Health. ASPH, Washington DC2008Google Scholar Surveys published in 2013 by the Association of State and Territorial Health Officials (ASTHO)6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar and National Association of County and City Health Officials (NACCHO)7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar reiterate the workforce losses and impact on public health services. ASTHO’s 2013 survey data of state health agencies,6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar combined with the latest numbers from NACCHO’s survey of local health department job losses and program cuts,7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar reveal that more than 50,600 state and local jobs have been lost since 2008. This represents approximately 22% of the total state and local health department workforce.6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google ScholarFactors underlying the public health workforce challenges include the following1Gebbie K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 2Perlino C. The public health workforce shortage: left unchecked, will we be protected? American Public Health Association (APHA) issue brief, September 2006. APHA, Washington DC2006Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar, 7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar, 8Gebbie K.M. Turnock B.J. The public health workforce, 2006: new challenges.Health Aff (Millwood). 2006; 25: 923-933Crossref PubMed Scopus (97) Google Scholar: (1) a diminishing number of workers because of an exodus of retiring public health workers; (2) job losses associated with budget cuts; (3) difficulty recruiting new workers because of noncompetitive and the gap workforce and by to public health related to and of in public health for the of public health workers; and for the of challenges affecting the workforce, in the proposed solutions often are fragmented or on selected more comprehensive of the situation be as a for to in the This paper describes two visual tools that help the workforce challenges and a to solutions. The fishbone, or K. to and Scholar, J. a for Scholar diagram depicts multiple factors affecting the public health The roadmap displays key elements—goals and strategies—to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward collective public health workforce strategic public health workforce strategic Public Health Workforce and in in and with partners about strengthening the public health workforce, the with the the workforce the of public health and associated workforce challenges are and complex, be and with a the to that often a of J. in in Scholar, J. causal for the health of Public Health. 2006; PubMed Scopus Google Scholar The on a visual tool that help the of the and help collective and comprehensive the health and strengthening and in on an on strengthening and in health work. paper No. Scholar and other key K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 5Association of Schools of Public Health (ASPH)More than 250,000 additional public health workers needed by 2020 to avert public health crisis: shortage will leave nation vulnerable to disease, bioterror and health threats according to a new assessment from the Association of Schools of Public Health. ASPH, Washington DC2008Google Scholar, 8Gebbie K.M. Turnock B.J. The public health workforce, 2006: new challenges.Health Aff (Millwood). 2006; 25: 923-933Crossref PubMed Scopus (97) Google Scholar the a fishbone diagram the factors related to the workforce for public health for a Public health workforce of the for public health in the Google Scholar the and the fishbone diagram to the factors for the public health workforce the Public Health Workforce additional This fishbone diagram and selected factors to an on the public health and help to and help to for or K. to and Scholar, J. in in Scholar, of Public Health Scholar, The public health American for Scholar The of the of the number of with the in the the the that to the and multiple factors are in each The include and numbers of of and the fishbone diagram as a tool to the problems affecting the public health workforce in a of in needed and about CDC’s in the factors by in in the is in partners reported that the diagram a tool that the workforce The partners from the Health and public health the American Public Health Association of Public Health of State and Territorial and public health and partners that a to the to serve as a and to the multiple with a in strengthening the that on the public health workforce include other that to the public’s health the a of the by to the visual the National Public Health Workforce the fishbone diagram depicts problems the workforce, the National Public Health Workforce key for roadmap the and Public Health of State and Territorial Health Officials. and public health strategic Scholar through the and Public Health strategic by public health and in to the of and Public to and public to improve health. Scholar The is intended to the of and in the of public health and of the National Public Health Workforce a and partners from the in and the The roadmap to be and and to the multiple that and to the health. with the on public health and the roadmap that be for the that are needed to the of workforce from a focus on workers to that and the of the roadmap a of for strengthening the public health and workforce to improve the public’s as the focus of the collective the the multiple of the workforce; improve for public health and strengthen and to support the each the and to the the reflect the roadmap as the for the Public Health Workforce the Workforce for the the the workforce for the public’s the Scholar The partners as a to to and the needed for strengthening the workforce and to of a public health workforce strategic that from multiple roadmap been by partners in other workforce The Association of Public Health and to for a public health workforce strategic in a with and other to on for the public health on the of the the roadmap and a of to the of the and are an of the roadmap that will partners to about public health workforce the of the roadmap in will serve as an and will partners to about workforce as or or other will of to and will be to have thus and to with and on as as the of are in a of to strengthen the public health workforce; collective solutions will to leverage resources and build on each other’s work. The public health workforce fishbone diagram and roadmap are visual tools that help state and local public health and leverage related to The strategic roadmap and associated are intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC’s commitment to with partners the highest priorities for strengthening the workforce to improve the public’s health. BackgroundThe public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges that threaten the public’s health.1Gebbie K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 2Perlino C. The public health workforce shortage: left unchecked, will we be protected? American Public Health Association (APHA) issue brief, September 2006. APHA, Washington DC2006Google Scholar, 3Association of State and Territorial Health Officials. 2007 State Public Health Workforce Survey results. astho.org/Programs/Workforce-and-Leadership-Development/2007-State-Public-Health-Workforce-Survey-Results/.Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 5Association of Schools of Public Health (ASPH)More than 250,000 additional public health workers needed by 2020 to avert public health crisis: shortage will leave nation vulnerable to disease, bioterror and health threats according to a new assessment from the Association of Schools of Public Health. ASPH, Washington DC2008Google Scholar Surveys published in 2013 by the Association of State and Territorial Health Officials (ASTHO)6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar and National Association of County and City Health Officials (NACCHO)7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar reiterate the workforce losses and impact on public health services. ASTHO’s 2013 survey data of state health agencies,6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar combined with the latest numbers from NACCHO’s survey of local health department job losses and program cuts,7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar reveal that more than 50,600 state and local jobs have been lost since 2008. This represents approximately 22% of the total state and local health department workforce.6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google ScholarFactors underlying the public health workforce challenges include the following1Gebbie K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 2Perlino C. The public health workforce shortage: left unchecked, will we be protected? American Public Health Association (APHA) issue brief, September 2006. APHA, Washington DC2006Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar, 7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar, 8Gebbie K.M. Turnock B.J. The public health workforce, 2006: new challenges.Health Aff (Millwood). 2006; 25: 923-933Crossref PubMed Scopus (97) Google Scholar: (1) a diminishing number of workers because of an exodus of retiring public health workers; (2) job losses associated with budget cuts; (3) difficulty recruiting new workers because of noncompetitive and the gap workforce and by to public health related to and of in public health for the of public health workers; and for the of challenges affecting the workforce, in the proposed solutions often are fragmented or on selected more comprehensive of the situation be as a for to in the This paper describes two visual tools that help the workforce challenges and a to solutions. The fishbone, or K. to and Scholar, J. a for Scholar diagram depicts multiple factors affecting the public health The roadmap displays key elements—goals and strategies—to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward collective public health workforce strategic The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges that threaten the public’s health.1Gebbie K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 2Perlino C. The public health workforce shortage: left unchecked, will we be protected? American Public Health Association (APHA) issue brief, September 2006. APHA, Washington DC2006Google Scholar, 3Association of State and Territorial Health Officials. 2007 State Public Health Workforce Survey results. astho.org/Programs/Workforce-and-Leadership-Development/2007-State-Public-Health-Workforce-Survey-Results/.Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 5Association of Schools of Public Health (ASPH)More than 250,000 additional public health workers needed by 2020 to avert public health crisis: shortage will leave nation vulnerable to disease, bioterror and health threats according to a new assessment from the Association of Schools of Public Health. ASPH, Washington DC2008Google Scholar Surveys published in 2013 by the Association of State and Territorial Health Officials (ASTHO)6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar and National Association of County and City Health Officials (NACCHO)7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar reiterate the workforce losses and impact on public health services. ASTHO’s 2013 survey data of state health agencies,6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar combined with the latest numbers from NACCHO’s survey of local health department job losses and program cuts,7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar reveal that more than 50,600 state and local jobs have been lost since 2008. This represents approximately 22% of the total state and local health department workforce.6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar underlying the public health workforce challenges include the following1Gebbie K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 2Perlino C. The public health workforce shortage: left unchecked, will we be protected? American Public Health Association (APHA) issue brief, September 2006. APHA, Washington DC2006Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 6Association of State and Territorial Health Officials. Budget cuts continue to affect the health of Americans; update October 2013. astho.org/budget-cuts-Nov-2013/.Google Scholar, 7National Association of County and City Health Officials (NACCHO)Local health department job losses and program cuts: findings from the 2013.Profile Study. NACCHO, Washington DC2013www.naccho.org/topics/infrastructure/lhdbudget/upload/Survey-Findings-Brief-8-13-13-3.pdfGoogle Scholar, 8Gebbie K.M. Turnock B.J. The public health workforce, 2006: new challenges.Health Aff (Millwood). 2006; 25: 923-933Crossref PubMed Scopus (97) Google Scholar: (1) a diminishing number of workers because of an exodus of retiring public health workers; (2) job losses associated with budget cuts; (3) difficulty recruiting new workers because of noncompetitive and the gap workforce and by to public health related to and of in public health for the of public health workers; and for the of challenges affecting the workforce, in the proposed solutions often are fragmented or on selected more comprehensive of the situation be as a for to in the This paper describes two visual tools that help the workforce challenges and a to solutions. The fishbone, or K. to and Scholar, J. a for Scholar diagram depicts multiple factors affecting the public health The roadmap displays key elements—goals and strategies—to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward collective solutions. Public Health Workforce and in in and with partners about strengthening the public health workforce, the with the the workforce the of public health and associated workforce challenges are and complex, be and with a the to that often a of J. in in Scholar, J. causal for the health of Public Health. 2006; PubMed Scopus Google Scholar The on a visual tool that help the of the and help collective and comprehensive the health and strengthening and in on an on strengthening and in health work. paper No. Scholar and other key K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 5Association of Schools of Public Health (ASPH)More than 250,000 additional public health workers needed by 2020 to avert public health crisis: shortage will leave nation vulnerable to disease, bioterror and health threats according to a new assessment from the Association of Schools of Public Health. ASPH, Washington DC2008Google Scholar, 8Gebbie K.M. Turnock B.J. The public health workforce, 2006: new challenges.Health Aff (Millwood). 2006; 25: 923-933Crossref PubMed Scopus (97) Google Scholar the a fishbone diagram the factors related to the workforce for public health for a Public health workforce of the for public health in the Google Scholar the and the fishbone diagram to the factors for the public health workforce the Public Health Workforce additional This fishbone diagram and selected factors to an on the public health and help to and help to for or K. to and Scholar, J. in in Scholar, of Public Health Scholar, The public health American for Scholar The of the of the number of with the in the the the that to the and multiple factors are in each The include and numbers of of and the fishbone diagram as a tool to the problems affecting the public health workforce in a of in needed and about CDC’s in the factors by in in the is in partners reported that the diagram a tool that the workforce The partners from the Health and public health the American Public Health Association of Public Health of State and Territorial and public health and partners that a to the to serve as a and to the multiple with a in strengthening the that on the public health workforce include other that to the public’s health the a of the by to the visual the National Public Health Workforce the fishbone diagram depicts problems the workforce, the National Public Health Workforce key for roadmap the and Public Health of State and Territorial Health Officials. and public health strategic Scholar through the and Public Health strategic by public health and in to the of and Public to and public to improve health. Scholar The is intended to the of and in the of public health and of the National Public Health Workforce a and partners from the in and the The roadmap to be and and to the multiple that and to the health. with the on public health and the roadmap that be for the that are needed to the of workforce from a focus on workers to that and the of the roadmap a of for strengthening the public health and workforce to improve the public’s as the focus of the collective the the multiple of the workforce; improve for public health and strengthen and to support the each the and to the the reflect the roadmap as the for the Public Health Workforce the Workforce for the the the workforce for the public’s the Scholar The partners as a to to and the needed for strengthening the workforce and to of a public health workforce strategic that from multiple roadmap been by partners in other workforce The Association of Public Health and to for a public health workforce strategic in a with and other to on for the public health on the of the the roadmap and a of to the of the and are an of the roadmap that will partners to about public health workforce the of the roadmap in will serve as an and will partners to about workforce as or or other will of to and will be to have thus and to with and on as as the of are in a of to strengthen the public health workforce; collective solutions will to leverage resources and build on each other’s work. The public health workforce fishbone diagram and roadmap are visual tools that help state and local public health and leverage related to The strategic roadmap and associated are intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC’s commitment to with partners the highest priorities for strengthening the workforce to improve the public’s health. in in and with partners about strengthening the public health workforce, the with the the workforce the of public health and associated workforce challenges are and complex, be and with a the to that often a of J. in in Scholar, J. causal for the health of Public Health. 2006; PubMed Scopus Google Scholar The on a visual tool that help the of the and help collective and comprehensive solutions. the health and strengthening and in on an on strengthening and in health work. paper No. Scholar and other key K. Merrill J. Tilson H.H. The public health workforce.Health Aff. 2002; 21: 57-67Crossref Scopus (71) Google Scholar, 4Draper DA, Hurley RE, Lauer J, Center for Studying Health System Change (HSC). Public health workforce shortages imperil nation’s health. HSC research brief No. 4. hschange.org/CONTENT/979/.Google Scholar, 5Association of Schools of Public Health (ASPH)More than 250,000 additional public health workers needed by 2020 to avert public health crisis: shortage will leave nation vulnerable to disease, bioterror and health threats according to a new assessment from the Association of Schools of Public Health. ASPH, Washington DC2008Google Scholar, 8Gebbie K.M. Turnock B.J. The public health workforce, 2006: new challenges.Health Aff (Millwood). 2006; 25: 923-933Crossref PubMed Scopus (97) Google Scholar the a fishbone diagram the factors related to the workforce for public health for a Public health workforce of the for public health in the Google Scholar the and the fishbone diagram to the factors for the public health workforce the Public Health Workforce additional This fishbone diagram and selected factors to an on the public health and help to and help to for or K. to and Scholar, J. in in Scholar, of Public Health Scholar, The public health American for Scholar The of the of the number of with the in the the the that to the and multiple factors are in each The include and numbers of of and The the fishbone diagram as a tool to the problems affecting the public health workforce in a of in needed and about CDC’s in the factors by in in the is in These partners reported that the diagram a tool that the workforce The partners from the Health and public health the American Public Health Association of Public Health of State and Territorial and public health and partners that a to the to serve as a and to the multiple with a in strengthening the that on the public health workforce include other that to the public’s health the a of the by to the visual the National Public Health Workforce the fishbone diagram depicts problems the workforce, the National Public Health Workforce key for solutions. The roadmap the and Public Health of State and Territorial Health Officials. and public health strategic Scholar through the and Public Health strategic by public health and in to the of and Public to and public to improve health. Scholar The is intended to the of and in the of public health and of the National Public Health Workforce a and partners from the in and the The roadmap to be and and to the multiple that and to the health. with the on public health and the roadmap that be for the that are needed to the of workforce from a focus on workers to that and The the of the roadmap a of for strengthening the public health and workforce to improve the public’s as the focus of the collective the the multiple of the workforce; improve for public health and strengthen and to support the each the and to the the reflect the The roadmap as the for the Public Health Workforce the Workforce for the the the workforce for the public’s the Scholar The partners as a to to and the needed for strengthening the workforce and to of a public health workforce strategic that from multiple The roadmap been by partners in other workforce The Association of Public Health and to for a public health workforce strategic in a with and other to on for the public health on the of the the roadmap and a of to the of the and The are an of the roadmap that will partners to about public health workforce the of the roadmap in will serve as an and will partners to about workforce as or or other will of to and will be to have thus and to with and on as as the of are in a of to strengthen the public health workforce; collective solutions will to leverage resources and build on each other’s work. The public health workforce fishbone diagram and roadmap are visual tools that help state and local public health and leverage related to The strategic roadmap and associated are intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC’s commitment to with partners the highest priorities for strengthening the workforce to improve the public’s health. are in a of to strengthen the public health workforce; collective solutions will to leverage resources and build on each other’s work. The public health workforce fishbone diagram and roadmap are visual tools that help state and local public health and leverage related to The strategic roadmap and associated are intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC’s commitment to with partners the highest priorities for strengthening the workforce to improve the public’s health.