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There Is a Shortage of Public Health Workers. How Can That Be Fixed?

Every public health system is unique, and the reasons for shortages vary. To respond, leaders can analyze their particular needs and then take action to develop and re-stock the talent pool. Here are four actions that can help.

Labor shortages are a global problem, but they matter more in some sectors than in others. In retail, for example, not having enough staff is annoying and stressful; for public health and health care, it can mean lives lost or diminished.

Even before the pandemic, the British medical journal, Lancet, estimated that global health systems were 43 million people short. Now, burnt out by Covid-19, labor gaps threaten to grow to alarming proportions. In 2021, for example, 44 percent of US public-health workers said that they were considering leaving in the next five years. Given that demand for public health services is growing, the labor problem is unlikely to resolve itself.

Every public health system is unique, and the reasons for shortages vary. To respond, leaders can analyze their particular needs and then take action to develop and re-stock the talent pool. But how? Here are four actions that can help.

Support current workers
Public health embodies a noble mission: keeping people alive and well. But to do that, it’s important to promote the wellness and development of those who actually make that mission real. For a start, public-health organizations are known for being hierarchical and bureaucratic—to a fault. A flatter org chart could deliver greater responsiveness and fewer frustrated workers. In addition, employees in all sectors value a statement of expectations. That helps to explain why organizations that clearly set out post-pandemic work arrangements have seen a threefold increase in feelings of inclusionand an almost fivefold increase in feelings of individual productivity. Finally, individuals want to develop their careers—and many are not satisfied with existing options. Think about how to restructure career pathways to make them both clearer and more flexible. Offer ways for people to move laterally, so that they can explore different roles. Identify the needs of different subsegments—laboratory specialists, say, or nurses—and tailor retention initiatives to each type.

Hire and train for future capability needs
Present needs are urgent, but new competencies will be required. Agencies therefore may want to keep in mind how to hire and upskill employees in targeted capability areas to meet evolving public health priorities. For example, the global prevalence of anxiety and depression rose 25 percent in the first year of the pandemic. Public health systems could help fill this need by hiring professionals, creating training programs, and building partnerships with community organizations, academic institutions, and others.

There is also growing demand for data collection and analysis. The pandemic revealed that too many public-health systems didn’t have the information technology (IT) systems needed to capture the data they needed. From a more aspirational perspective, advanced analytics can reveal important insights, such as using syndromic surveillance techniques to spot outbreaks or analyzing environmental and social data to predict risks of lead poisoning or other dangers. This is not just a matter of hiring IT specialists, although that is essential. Public health decision makers—from policy makers to local partners—can also benefit from becoming data literate.

Plan for crises
Covid-19 is a reminder that the unexpected happens — that is why innovation, flexibility, and resilience are critical. One possible approach is to offer training to build up local reserves in less specialized roles who are on “warm standby,” meaning that they can be marshaled at a moment’s notice—as Japan did after the 2011 Tohoku earthquake. For highly specialized roles, national and international organizations could train staff centrally and then deploy them as needed. In terms of existing workers, the goal is to reassess policies to optimize productivity. In an emergency, for example, that could mean establishing emergency thresholds that trigger specific actions, such as temporarily suspending licensing restrictions to allow providers to practice across borders; authorizing pharmacists to prescribe critical medications; or simplifying license renewal processes to bring potential workers out of retirement.

Develop robust talent pipelines
Providers could think of it this way: If they were starting from scratch, how would they go about recruiting candidates? The answer will almost always be, not the way we do it now. The goal, then, is to build streamlined, user-friendly systems that maximize application completion and yield, including leveraging analytically backed digital labor platforms.

Partnerships can be used to great effect. For example, one ministry of immigration in a G-20 country established more than 15 partnerships to attract tech talent, which helped get approximately 100 candidates through its pipeline. Other promising approaches include simplifying job qualifications to emphasize capabilities rather than experience, centralizing public health job listings, ensuring reasonable application turnaround times, providing competitive compensation packages, and offering remote or hybrid work models.

Covid-19 was a terrible human tragedy, costing more than 6.5 million lives. The economic costs are incalculable, but start at $12.5 trillion. Many public-health professionals were little short of heroic, and the case for effective public-health systems was proved. If the lessons of the pandemic are not learned and acted on, however, that would be an additional—and avoidable—tragedy.

By taking these actions, local, national, and global systems could improve their societies for generations to come. That would be a worthy legacy of a terrible time.


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Pooja Kumar

Pooja Kumar is a senior partner in the Social Sector, Healthcare, & Public Sector Entities (SHaPE) practice at McKinsey & Company’s office in Philadelphia. A physician by training, Pooja serves health systems on large-scale performance transformations as well as on growth and partnership strategies. She has worked for public- and private-sector institutions and for not-for-profit and for-profit health systems. Pooja leads McKinsey’s work in academic health systems and leads the firm’s knowledge development on patient access and ambulatory operations.

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