Assessment Finds Critical Public Health Disease Surveillance Capacity Lacking

The CDC’s Morbidity and Mortality Weekly Report (MMWR) has released a report showing that the number of state-level epidemiologists has decreased steadily since 2004, with a marked decline of more than 10 percent since 2006.

There was also a substantial decrease in core epidemiology capacity over this same period, including epidemiology capacity for bioterrorism and emergency response. For some important subject areas such as occupational health, substance abuse, and oral health, basic epidemiology capacity in most states is described as minimal to non-existent, and many states still lack the 21st century technology capacity needed for state-of-the-art surveillance.

Dr. James Hadler, the lead author of this article, concluded that, "The current condition of national epidemiology is a preparedness and public health vulnerability." States indicated a substantial need for more epidemiologists in all program areas. The deterioration of state epidemiology capacity is a consequence of declines in funding for bioterrorism preparedness and emergency response as well as an effect of the economic downturn on state budgets.

CSTE's 2009 Epidemiology Capacity Assessment (ECA) is the most recent in a series of epidemiology capacity assessments that enumerate and characterize epidemiologists, measure core epidemiology capacity, and assess competency-specific training. The 2009 ECA also conducted initial assessments of surveillance system technologic capacity and substance abuse program capacity. The 2009 ECA builds on the previous ECAs of 2004 and 2006. This year's assessment indicates a substantial decline in overall epidemiology capacity across the nation.

Epidemiologists are best known for their "disease detective" work with infectious diseases that are naturally occurring or intentionally released, but they are mainly involved in everyday surveillance/monitoring and study of many diseases and conditions that affect the health of the their state's population. These activities can range from food and waterborne disease investigations to disease monitoring for environmental health conditions, chronic diseases, maternal and child health, injury, occupational and oral health and substance abuse.

"State, federal and local agencies need to work together to address the understaffed epidemiology workforce, the downward trends in capacity and the looming epidemiology workforce shortage. Public health needs to achieve a full, well-trained and competent workforce prepared with the appropriate tools and skills for the 21st century," says co-author Matthew Boulton from the University of Michigan School of Public Health, Center of Excellence in Public Health Workforce Studies.