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Race and Ethnicity of Local Health Department Staff and Leaders Carolyn J. Leep

Race and Ethnicity of Local Health Department Staff and Leaders Carolyn J. Leep Academy Health PHSR Interest Group Meeting June 7, 2008. Background. NACCHO Strategic Plan: Address the under-representation of racial and ethnic communities in the public health workforce and leadership

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Race and Ethnicity of Local Health Department Staff and Leaders Carolyn J. Leep

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  1. Race and Ethnicity of Local Health Department Staff and Leaders Carolyn J. Leep Academy Health PHSR Interest Group Meeting June 7, 2008

  2. Background • NACCHO Strategic Plan: Address the under-representation of racial and ethnic communities in the public health workforce and leadership • 2005 Profile of LHDs Study included questions about employee race and ethnicity for the first time

  3. Methodology 2005 Profile questionnaire sent to every LHD in the U.S. (N=2,864) • LHD top executive race/ethnicity to all LHDs Response rate = 80% • LHD staff race/ethnicity to sample of 520 LHDs Response rate = 82% 1993 Profile questionnaire sent to every LHD in the U.S. (N=2,888) Response rate = 72%

  4. Race and Ethnicity of LHD Top Executives: 1993 and 2005 Source: 2005 National Profile of LHDs

  5. Percentage of LHDs and U.S. Population Served by Top Executive in Selected Racial and Ethnic Groups Source: 2005 National Profile of LHDs

  6. LHD Workforce Three analyses: • Overall percentages by race and ethnicity • Comparing percentages in LHDs staff and jurisdiction population • Actual and expected numbers of employees

  7. Race and Ethnicity Estimates for the LHD Workforce *Based on U.S. Census Bureau estimates for 2005. Source: 2005 National Profile of LHDs

  8. Comparison of Racial Diversity of LHD Staff and Jurisdiction Population Staff more diverse (>2% difference) 15% Staff much less diverse (>10% difference) 26% Staff and population served similar (within 2%) 16% Staff less diverse (2 to 10% difference) 42% n=398 Source: 2005 National Profile of LHDs

  9. Comparison of Ethnicity of LHD Staff and Jurisdiction Population LHD staff much less Hispanic (>10% difference) 8% LHD staff more Hispanic 13% LHD staff less Hispanic (2 to 10% difference) 30% LHD staff and community similar (within +/- 2%) 49% Source: 2005 National Profile of LHDs

  10. Differences Between Actual and Expected Number of Employees in Selected Racial and Ethnic Groups Source: 2005 National Profile of LHDs

  11. Study Limitations • Relatively small number of observations • Large uncertainties • Does not permit analysis for specific races • Does not provide information about specific professions or positions at LHDs • Service population may be very different from jurisdiction population

  12. Findings (1) • Almost all LHDs could provide information on race & ethnicity of staff • 7% missing for race • 11% missing for ethnicity • “Promoted” to the core questionnaire for 2008 Profile study

  13. Findings (2) • Number of Black LHD leaders is increasing • 5% of all LHDs (more than double % than in 1993) • Cover 15% of the U.S. population • Number of Hispanic LHD directors is very small and not growing

  14. Findings (3) • Overall racial and ethnic make-up of LHD employees is similar to that of the U.S. as a whole • Most LHDs show small excesses of White employees and small deficits of Black and Hispanic employees (compared to their jurisdiction populations) • Larger jurisdiction LHDs are more likely to reflect the racial diversity of their jurisdiction • LHDs in areas with substantial Hispanic populations are less likely to reflect the ethnicity of their jurisdictions

  15. Implications—Size of Problem • Overall discrepancy is actually smaller than some of NACCHO’s leaders believed • Discrepancies in professional or managerial positions are likely larger & recruitment of minorities is challenging: • LHDs experience major challenges in hiring professional employees, regardless of race & ethnicity • Pool of qualified Black & Hispanic candidates is smaller

  16. Implications—Potential Solutions • Long-term: eliminate inequities that result in racial and ethnic differences in educational attainment and employment • Short-term: identify ways to attract and retain minority PH workers

  17. NACCHO Workforce Development Programs • Survive and Thrive – year-long orientation program to prepare new local health officials with the necessary knowledge and skills to succeed within the multi-faceted environment of local public health practice • Community Colleges as pathways to PH careers • Compilation of stories about minority PH leaders

  18. Further Research • Collecting individual-level data to further explore the issue • Exploring strategies of LHDs that have met with success in recruiting & retaining a diverse workforce • Understanding whether it matters — Can a more diverse LHD workforce deliver public health services more effectively?

  19. For more information Carolyn Leep NACCHO Director, Research and Evaluation cleep@naccho.org www.naccho.org/profile

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