Assessment of epidemiology capacity in State Health Departments - United States, 2009.

Since 2001, the Council of State and Territorial Epidemiologists (CSTE) periodically has conducted a standardized national assessment of state health departments' core epidemiology capacity. During April-June 2009, CSTE sent a web-based questionnaire to the state epidemiologist in each of the 50 states and the District of Columbia. The assessment inquired into workforce capacity and technological advancements to support surveillance. Measures of capacity included total number of epidemiologists and self-assessment of the state's ability to carry out four essential services of public health (ESPH). This report summarizes the results of the assessment, which determined that in 2009, 10% fewer epidemiologists were working in state health departments than in 2006. Compared with 2006, the percentage of state health departments with substantial-to-full (>50%) epidemiology capacity decreased in three ESPH, including 1) capacities to monitor and detect health problems, 2) investigate them, and 3) evaluate the effectiveness of population-based services. The percentage of departments with substantial-to-full epidemiology capacity for bioterrorism/emergency response decreased slightly, from 76% in 2006 to 73% in 2009. More than 30% of states reported minimal-to-no (<25%) capacity to evaluate and conduct research and for five of nine epidemiology program areas, including environmental health, injury, occupational health, oral health, and substance abuse. Working together, federal, state, and local agencies should develop a strategy to address downward trends and major gaps in epidemiology capacity.