title: Assessment of epidemiology capacity in state health departments, 2004-2009.
abstract: OBJECTIVE
  To assess the number of epidemiologists and epidemiology capacity nationally, the Council of State and Territorial Epidemiologists surveyed state health departments in 2004, 2006, and 2009. This article summarizes findings of the 2009 assessment and analyzes five-year (2004-2009) trends in the epidemiology workforce.
  
  
  METHODS
  Online surveys collected information from all 50 states and the District of Columbia about the number of epidemiologists employed, their training and education, program and technologic capacity, organizational structure, and funding sources. State epidemiologists were the key informants; 1,544 epidemiologists provided individual-level information.
  
  
  RESULTS
  The number of epidemiologists in state health departments decreased approximately 12% from 2004 to 2009. Two-thirds or more states reported less than substantial (< 50% of optimum) surveillance and epidemiology capacity in five of nine program areas. Capacity has diminished since 2006 for three of four epidemiology-related Essential Services of Public Health (ESPHs). Fewer than half of all states reported using surveillance technologies such as Web-based provider reporting systems. State health departments need 68% more epidemiologists to reach optimal capacity in all program areas; smaller states (< 5 million population) have higher epidemiologist-to-population ratios than more populous states.
  
  
  CONCLUSIONS
  Epidemiology capacity in state health departments is suboptimal and has decreased, as assessed by states' ability to carry out the ESPHs, by their ability to use newer surveillance technologies, and by the number of epidemiologists employed. Federal emergency preparedness funding, which supported more than 20% of state-based epidemiologists in 2006, has decreased. The 2009 Epidemiology Capacity Assessment demonstrates the negative impact of this decrease on states' epidemiology capacity.
authors.affiliation: Center of Excellence for Public Health Workforce Studies, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA. mboulton@umich.edu
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Boulton
authors.forename: James
authors.initials: J
authors.lastname: Hadler
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Beck
authors.forename: Lisa
authors.initials: L
authors.lastname: Ferland
authors.forename: Maureen
authors.initials: M
authors.lastname: Lichtveld
mesh_terms: D000704:Analysis of Variance; D057191:Capacity Building; D002908:Chronic Disease / Q000453:epidemiology; D002959:Civil Defense; D004189:Disaster Planning; D018563:Disease Notification; D004813:Epidemiology / Q000193:education / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D020380:Needs Assessment / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011159:Population Surveillance; D015397:Program Evaluation; D015980:Public Health Practice / Q000706:statistics & numerical data; D012958:Societies, Scientific; D013219:State Government; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology