The Centers for Disease Control and Prevention's Public Health Infrastructure Grant: Early Evidence of How It Bolsters Health Departments' Efforts to Recruit, Hire, and Retain Our Nation's Public Health Workforce.

Abstract

Context: The Centers for Disease Control and Prevention's (CDC's) Public Health Infrastructure Grant (PHIG) is a recent, large investment aimed at strengthening the nation's public health infrastructure and addressing workforce gaps.

Objective: To assess how PHIG supports health departments in recruiting, hiring, and retaining their workforce during early implementation.

Design, setting and participants: We conducted thematic coding and descriptive analyses of data submitted to CDC from 107 recipients, representing state, territorial, local, and freely associated state health departments. Work plan and progress report data were coded to generate themes, and descriptive analyses of the themes were conducted to aggregate recipient level results. We also conducted a descriptive analysis of the grant's hiring data. Purposive sampling was used to generate a sample of evaluation results from health departments.

Main outcome measures: Recruitment, hiring, and retention of the public health workforce.

Results: All recipients (n = 107, 100%) reported plans to recruit and hire staff by developing and publicizing job descriptions (n = 73, 68%) and establishing external partnerships (n = 52, 49%). Most (n = 94, 88%) reported plans to use PHIG funds to retain staff. By 18 months, 6255 positions were filled; 57% were in indirectly funded local health departments, mainly clinical roles. Recipients showed early signs of progress toward implementing system-level improvements, such as streamlined hiring processes, standardized recruitment systems, revised job classifications, and updated pay scales.

Conclusions: PHIG is addressing immediate staffing needs, particularly in rural and smaller local communities where direct clinical services may be most needed. The grant is enabling health departments to pursue system-level improvements to recruit, hire, and retain staff. PHIG's flexibility is key to supporting a workforce that meets local communities' needs, and strengthening the infrastructure to build workforce capacity, enhancing the ability of health departments to respond to future public health threats.