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May 15, 2025 – As public health challenges in the United States grow increasingly complex, a new paper published by Columbia University’s Mailman School of Public Health urges policymakers and researchers to radically rethink how the nation defines its public health workforce.
The study, authored by Dr. Heather Krasna, Associate Dean of Career and Professional Development at Columbia Mailman, appears in the latest issue of the American Journal of Public Health (AJPH). Krasna argues that the traditional approach-defining the public health workforce solely by job titles or government employment-no longer reflects the reality of who is delivering essential health services across the country.
Beyond Government: A Two-Tiered Workforce
Krasna proposes an intersectional framework that divides the public health workforce into two key tiers:
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Core Workforce: Employees of federal, state, local, tribal, and territorial health departments.
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Wider Public Health Workforce: Individuals in various sectors and industries who spend at least 50% of their work time delivering services aligned with the Centers for Disease Control and Prevention’s (CDC) 10 Essential Public Health Services or the Foundational Public Health Services.
This expanded definition recognizes that many professionals outside traditional government roles-such as those in non-profits, academia, and private industry-play vital roles in promoting and protecting public health.
Shifting Focus: From Job Titles to Job Impact
Krasna’s approach moves away from simply counting occupations (e.g., all nurses) and instead emphasizes the actual impact of their work. By “reverse engineering” the workforce-starting with the services delivered and identifying who delivers them-researchers can better understand the full ecosystem of professionals supporting community health.
This model, Krasna argues, will help identify whether critical public health functions are being outsourced in ways that may not be cost-effective, or if there are significant gaps in workforce coverage. It also enables more accurate workforce assessments, informs targeted training programs, and strengthens the resilience of public health systems.
Preparing for the Future
“In fact, without more accurate assessments, we lack a clear understanding of who comprises the public health workforce and whether essential public services can be effectively delivered during a crisis or in the face of a future pandemic,” Krasna notes.
The paper calls on policymakers and public health leaders to adopt this broader, impact-focused definition to ensure the nation is better prepared for emerging health threats.
Disclaimer:
This article is based on information from a news release published by News-Medical.net on May 15, 2025, summarizing a peer-reviewed paper by Dr. Heather Krasna. The content is intended for informational purposes only and should not be interpreted as official policy or medical advice. For more details, please refer to the original publication and consult public health professionals for guidance on workforce planning.
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