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Workforce: Capacity Assessments

Epidemiology Capacity Assessment (ECAs)

Since 2001 CSTE has conducted six periodic Epidemiology Capacity Assessments (ECAs) to monitor the numerical strength and functional applied epidemiology capacity in state and territorial health departments.

The 2017 ECA was completed by the State and Territorial Epidemiologists from all 50 states, the District of Columbia, and three territories. This report represents the most complete and comprehensive national data on epidemiology workforce needs.

The ECA serves many purposes:
  • Monitor changes in the quantity and quality of the applied epidemiology workforce
  • Identify policy, system and environmental influences affecting epidemiology services and staffing
  • Provide data to health departments for evidence-based decision making
  • Describe the needed skills and expertise among the applied epidemiology workforce
Key findings include:
  • The number of epidemiologists increased 22% between 2013 and 2017 to 3370, the highest number yet observed since the ECAs began in 2001.
  • Three-quarters of epidemiologists work in infectious disease, chronic disease and maternal-child health (MCH), while less than 5% work in emerging areas such as substance abuse, informatics, and mental health.
  • An additional 1200 epidemiologists are needed to reach full capacity, a 36% increase
  • Capacity to conduct monitoring and investigate health problems remains high, but evaluation and research capacity lag behind. Overall capacity is low in emerging program areas such as informatics, substance, abuse, and mental health.
  • Training, hiring, and retaining a qualified workforce represent serious challenges to health departments, as does the continued reliance on federal funding.
  • The greatest training priority was in analytics, defined as informatics and the application and translation of public health data.
  • Restrictions on offering competitive pay (80%), salary scale (76%), opportunity for promotion (73%), and hiring quickly enough (62%) were important problems.
For more details view the full 2017 ECA report or the one page summary.

Click HERE to view the April 3, 2019 erratum.

CSTE partnered with the National Association of County and City Health Officials (NACCHO)'s Big Cities Health Coalition (BCHC) to conduct a local version of the ECA. The results are summarized in the 2017 BCHC ECA Report.
In 1995, CSTE spearheaded a national epidemiology workforce assessment effort and compiled a guide to aid states in assessment their epidemiologic capacity. CSTE followed up this effort in 1997 with an assessment piloted in 10 states and in 2001 with the first Epidemiology Capacity Assessment (ECA). The ECA was the first national assessment of core epidemiology capacity in state and territorial health departments. CSTE administered additional ECAs in 2004, 2006, 2009, and 2013. CSTE also conducted an epidemiology enumeration assessment in 2010 to determine the epidemiology workforce in both state and local health departments. Data from ECAs been shared as Congressional hearing testimony in support of greater targeted funding for capacity development. ECA results help illuminate the status of state epidemiology efforts and assist our member states with targeting improvements in epidemiology capacity within their health departments. Future ECAs will attempt to continue capturing information about workforce capacity.

Additional Related Resources
Previous ECA’s
 Click the image below to see the data in full
For more information about the Epidemiology Capacity Assessments, please contact Jessica Arrazola. Click here to view other workforce activities.
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