Need to Know: Details on Biden's New Public Health Workforce Plan

Yesterday, the Biden Administration announced a $7.4 billion investment in a public health workforce, to be drawn from the American Rescue Plan Act recently passed by the United States Congress. This follows an earlier announcement of $250 million for community-based organizations, also drawn from the American Rescue Plan Act. 

Partners In Health (PIH) applauds the decision to invest in our critical public health and community health workforces while we continue to battle the COVID-19 pandemic and the underlying inequities in the U.S. health system through our U.S. Public Health Accompaniment Unit. PIH has been working and will continue to work with key partners to advance policies that will enable investment in new public health and community health jobs across the country.

This announcement couldn’t have come soon enough. Over the last decade, the nation has lost at least 38,000 public health jobs, while state and local public health budgets have dropped by 16% and 18% per capita, respectively.

Systemic under-funding since 1980 has slashed the state and local public health workforce from nearly 500,000 jobs to under 200,000 today. Especially hard hit are poor communities and communities of color, which have been continually passed over and neglected due to entrenched inequities. This undermines health in all communities. As a result, hospitalization rates of Black people in the U.S. due to COVID-19 are almost three times those of white people, while COVID-19 related death rates are twice that of white people.

The new public health jobs announced by the Biden administration make clear that there is a concerted priority to advance equity in the response to COVID-19 and beyond, reflected in the following key aspects of the plan:

Investing in Local and State Public Health

The administration is setting aside $3.4 billion to hire staff in state and local public health departments to further respond to COVID-19, and $500 million for the hiring of school nurses—critical members of a community-based health care response—who can offer vaccine information to parents and students as availability increases for younger people. These priorities fill critical gaps in public health and build toward a stronger infrastructure for years to come.

Investing in the Future and Greater Health Equity

The administration allocates $3 billion for modernizing the public health workforce and building toward better health equity beyond the pandemic. Funds will be distributed through a new grant program—designed by various federal, state, local, and territorial public health experts—aimed to support health departments in lower-income and under-resourced communities. This grant program will increase hiring of community health workers and provide an opportunity to continue in their role beyond COVID-19.

Elevating Community Health

The Biden administration is investing $250 million for community-based organizations to work with those hardest hit by COVID-19. Half of these funds are expected to reach programs by mid-June, with the other half in a future funding opportunity for smaller community based organizations. This funding is crucial for building a larger cadre of community-based workers and social support specialists, who help connect the most vulnerable individuals and families to basic resources like food, medicine, and housing assistance. These programs will help to address inequities by building capacity in communities with need and trust in vaccines; however, we hope to see these investments grow.

These community-based responses are essential to delivering on vaccine equity, the COVID-19 response, and stronger public health systems. PIH estimates that the U.S. needs to create more than 500,000 community health worker jobs alone to address underlying inequities. Community-based organizations have been pivotal in the work to combat COVID-19, and have developed  strategies to work side by side with officials to tackle COVID-19 and more. 

Diversity, Equity, and Jobs 

To best serve the communities that face the greatest inequities, PIH and partners have encouraged the federal government to recruit and hire from those same communities. This is critical because the workforce plays two distinct roles: a means of delivering services to communities, and a jobs program for communities grappling with the intersecting crises of unemployment and a disproportionate impact of COVID-19 illness and death.

Diversity and equity are a clear focus in the Biden administration’s workforce plans. These efforts include launching the Public Health AmeriCorps, which has the stated purpose of building a diverse pipeline for the public health workforce and providing direct service to communities across the country. The administration’s efforts also include recruiting and training public health professionals with backgrounds from minority serving institutions and universities, encouraging all grant awardees to hire from communities served, and a focus on recruiting from backgrounds that are underrepresented in public health professions.

Long-Term Goals

Too often, U.S. policies have undervalued and devalued the vital work of community health and public health workers, leaving them to earn below living wages. In a March 2021 letter to Department of Health and Human Services Secretary Xavier Becerra and Centers for Disease Control and Prevention Director Rochelle Walensky, U.S. senators call for workforce members to be well-compensated and hired from those communities hardest hit by COVID-19. We believe all public and community health jobs should be good jobs, backed by strong labor standards.

We recognize these funds from the American Rescue Plan are a down payment on what must be a broader, sustainable investment in our public health infrastructure and community-based workforce. Efforts in the American Jobs Plan, American Families Plan, and future priorities of the administration must build on these investments so we can create a more equitable system and prepare for the next pandemic. PIH and our partners look forward to the long-term project of making that aspiration a reality.