Workforce Crisis in MCH Leadership
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COMMENTARY
Workforce Crisis in MCH Leadership Nan Streeter
Published online: 28 October 2014 Ó Springer Science+Business Media New York 2014
Why Do We Need Maternal and Child Health (MCH) Leadership Now? We have a crisis facing us! The aging workforce, the impending challenges of implementing the Affordable Care Act (ACA), and the need to redefine the role of Title V (of the Social Security Act) in light of ACA implementation require uniquely skilled and knowledgeable leaders. Since its inception in 1935, Title V has served a critical need for healthy mothers and children in the nation. From then to the present time, the workforce needs, especially in leadership, have changed dramatically due to the shift of focus from the individual health to the health of the entire population. Early in its history, Title V faced problems of poorly immunized children, infectious diseases, and high infant mortality rates. These issues have shifted at present to the current challenges of rapidly rising rates of obesity among all populations, unmet treatment needs for mental health disorders, and addressing the underlying social determinants which contribute to health status, to list just a few contemporary issues. The numbers of the public health workforce eligible for retirement are overwhelming, estimated at almost 25 % for 2014 [1]. The loss of experienced and skilled staff to retirements is further complicated by the fact that approximately 12 % of state public health agency positions are vacant. More troublesome, agencies are recruiting for only 24 % of vacancies, presumably due to budget cuts and hiring freezes [1, 2]. Agencies report shrinking numbers of qualified candidates for vacancies due to lack of N. Streeter (&) Utah Department of Health, PO Box 142001, Salt Lake City, UT 84114-2001, USA e-mail: [email protected]
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experience, training, and knowledge of public health in general. Decreased funding, lower public sector salaries and shrinking benefits contribute to difficulty in hiring and retaining health professionals who are able to secure much higher salaries in the private sector. Filling public health positions requiring a physician, nurse or psychologist is exceptionally difficult. The pending retirement of many public health professionals will create significant gaps in the workforce, especially in leadership roles. Historically, there has been a concern that public health workers in the United States lack formal public health training. [3] Indeed, even today few Schools of Public Health in the United States offer a focus, concentration, certificate, or degree in MCH Public Health. Of the 47 accredited Schools of Public Health, 19 schools offer an MPH in MCH, 5 offer a DrPH in MCH, 3 offer PhD programs in MCH, and 4 offer MSPH or MHS. The federal Maternal and Child Health Bureau currently supports 13 MCH programs in schools of public health. [4]. The lack of MCH-specific public health programs and educational opportunities presents a challenge to developing the current MCH workforce and future leaders in
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