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Reporter Finds CDC Old, Getting Older

July 1, 2008

Alison Young, of the Atlanta Journal-Constitution, has penned an article on the state of the CDC workforce based on a GAO report about the CDC workforce. Project Disaster picked it up.

The article reads like every other article I’ve read on the state of the public health workforce and government contracting in the last year and a half. Long story short, public health is peopled by folks who are mostly 50+, and they’re not being replaced as they retire. Those few who are being replaced are being done so by contracted employees. A significant part of Ms. Young’s, and the GAO’s, report focuses on the use of contractors, though I (showing my naivete) fail to see the problem with that.

The fact of the matter is that it’s becoming more and more difficult to fill all types of public health jobs, even really cool ones that have to do with preparedness issues. The reasons for this are myriad, ranging from exceptionally poor pay across the field, to disinvestment at all levels of the public health infrastructure, to schools of public health leading students to take up global public health (it’s not a knock, I know that the greatest good can be done in third world countries, but public health professionals are still needed here, too) and a dozen other things.

When you’re in that situation of either not hiring a person to fill a role that needs to be filled and you can’t fill it, then a contractor is the next best thing. Would I rather public health be filled with full-time regular, represented employees? Absolutely! And until we get there, the work still needs to be done, so contractors it is.

It’s a sad state of affairs; one that’s been lamented in every publication having to do with the state of the field for years. Precious little has been done about it to date. Every year I hope that some sort of public health workforce development legislation makes it to the floor, and every year (for the last three that I know of) it’s been sent to die in committee. ASTHO pulled together a pdf fact sheet on the situation here.

Photo credit: University of Washington School of Public Health blog

4 Comments leave one →
  1. Anon permalink
    July 3, 2008 8:37 am

    The reason why CDC hires contractors is that they are cheaper over the long run (no pension, no or few maternal benefits, fewer holidays, sick days, and vacation days, etc.), the CDC can hire them and get rid of them quickly (days vs. the 6 month lead time going through AHRC), specific programs are in greater control over the qualifications of the person being hired, and positions have less EEOC oversight. I am a contractor to the CDC and am making more than a similar FTE position. In my experience, contractors do better work than FTEs because they face greater incentives (positive and negative). Frankly, all work at the CDC should be done by contractors. As Ms. Young correctly points out, this is an HR problem. If it were easier to hire, fire, and reassign FTEs, we wouldn’t see this problem (if it really is a problem).

    Some of the content of this “story” is related to preparedness in the rationale provided relative to the public health workforce. I think schools of public health are continuing to churn out MPHs & PhDs. You hit the target when you state that the pay is deplorable. For example, the Comm. of Massachussetts was recently advertising for a Director of Emergency Management and was willing to pay something like $48,000 per year (to live in Boston, no less)! This is a leadership problem not a public health problem. I assume that the entire public health department could be funded (well) many times over just by the cost overruns from the “big dig” – cushy no bid contracts given to “goombahs” with no oversight or teeth.

  2. July 4, 2008 9:36 am


    Thanks for stopping by. I mostly agree with your comment. I’ve had experience working as a contractor in an organization dominated by full-time employees, and agree that the contractors can seem more productive, though I’ve also been in an opposite situation where the FTE’s are the more productive. As for all employees should be contractors, I disagree. As a government agency, there really are conflict of interest issues that should be avoided by many management positions.

    As for your second paragraph, I couldn’t agree more. It’s really a question of priorities not only in MA, but in the country as a whole. For so long, we’ve concentrated funding on other things, to the detriment of our infrastructure, both physical (think the Minneapolis bridge and New Orleans levys) and in human capital (your example is just classic). It’s a huge problem I have, and continue to harp on.

    Thanks again for stopping by, I really appreciate your point of view.



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