From competencies to capacity: assessing the national epidemiology workforce.

OBJECTIVES We determined the competency of the public health epidemiolOgy workforce within state health agencies based on the Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs). METHODS The competence level of current state health agency staff and the need for additional training was assessed against 30 mid-level AECs. Respondents used a five-point Likert scale-ranging from "strongly agree" to "strongly disagree"-to designate whether staff was competent in certain areas or whether additional training was needed for each of the competencies. RESULTS Most states indicated their epidemiology workforce was competent in most of the AECs subject areas. Subject areas with the greatest number of states reporting competency (82%) are creating and managing databases and applying privacy laws. However, at least one-third of the states reported a need for additional training in all competencies assessed. The greatest reported needs were for additional training in surveillance system evaluation and use of knowledge of environmental and behavioral science in epidemiology practice. CONCLUSIONS The results indicate that most epidemiologists mastered the traditional discipline-specific competencies. However, it is unclear how this level of competency was achieved and what strategies are in place to sustain and strengthen it. The results indicate that epidemiologists have lower levels of competence in the nontraditional epidemiologic fields of knowledge. Future steps to ensure a well-qualified epidemiology workforce include assessing the full AECs in a subgroup of Tier 2 epidemiologists and implementing competencies in academic curricula to sustain reported competency achievements.