title: The epidemiology and surveillance workforce among local health departments in California: mutual aid and surge capacity for routine and emergency infectious disease situations.
abstract: OBJECTIVE
  Public health surveillance and epidemiologic investigations are critical public health functions for identifying threats to the health of a community. We conducted a survey of local health departments (LHDs) in California to describe the workforce that supports public health surveillance and epidemiologic functions during routine and emergency infectious disease situations.
  
  
  METHODS
  The target population consisted of the 61 LHDs in California. The online survey instrument was designed to collect information about the workforce involved in key epidemiologic functions. We also examined how the public health workforce increases its epidemiologic capacity during infectious disease emergencies.
  
  
  RESULTS
  Of 61 LHDs in California, 31 (51%) completed the survey. A wide range of job classifications contribute to epidemiologic functions routinely, and LHDs rely on both internal and external sources of epidemiologic surge capacity during infectious disease emergencies. This study found that while 17 (55%) LHDs reported having a mutual aid agreement with at least one other organization for emergency response, only nine (29%) LHDs have a mutual aid agreement specifically for epidemiology and surveillance functions.
  
  
  CONCLUSIONS
  LHDs rely on a diverse workforce to conduct epidemiology and public health surveillance functions, emphasizing the need to identify and describe the types of staff positions that could benefit from public health surveillance and epidemiology training. While some organizations collaborate with external partners to support these functions during an emergency, many LHDs do not rely on mutual aid agreements for epidemiology and surveillance activities.
authors.affiliation: University of California at Berkeley, School of Public Health, Cal PREPARE Research Center and Division of Epidemiology, Berkeley, CA ; University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA.
authors.forename: Wayne T A
authors.initials: WT
authors.lastname: Enanoria
authors.affiliation: University of California at Berkeley, School of Public Health, Cal PREPARE Research Center and Division of Epidemiology, Berkeley, CA.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Crawley
authors.affiliation: University of California at Berkeley, School of Public Health, Cal PREPARE Research Center and Division of Epidemiology, Berkeley, CA.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Hunter
authors.affiliation: University of California at Berkeley, School of Public Health, Cal PREPARE Research Center and Division of Epidemiology, Berkeley, CA.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Balido
authors.affiliation: University of California at Berkeley, School of Public Health, Cal PREPARE Research Center and Division of Epidemiology, Berkeley, CA ; San Francisco Department of Public Health, San Francisco, CA.
authors.forename: Tomas J
authors.initials: TJ
authors.lastname: Aragon
mesh_terms: D002140:California / Q000453:epidemiology; D003140:Communicable Disease Control / Q000458:organization & administration*; D004812:Epidemiologic Methods; D006285:Health Planning / Q000458:organization & administration*; D006801:Humans; D011159:Population Surveillance; D011634:Public Health; D055872:Surge Capacity; D011795:Surveys and Questionnaires; D000078329:Workforce