J Public Health Manag Pract. 2026 Jan-Feb 01;32(1S Suppl 1):S49-S55. doi: 10.1097/PHH.0000000000002276. Epub 2025 Nov 18.
ABSTRACT
CONTEXT: Large local health departments (LHDs) serve diverse, high-need communities and are uniquely positioned to influence public health policy and practice locally, regionally, and nationally.
OBJECTIVE: The purpose of this study is to investigate policy engagement as a reported training need in the 2024 Public Health Workforce Interests and Needs Survey within large LHDs, highlighting gaps and opportunities to strengthen policy capacity.
DESIGN: Cross-sectional analysis of 2024 Public Health Workforce Interests and Needs Survey data using descriptive statistics and weighted logistic regression.
SETTING: Large LHDs, serving populations of 250 000 or more, across the US.
PARTICIPANTS: Study sample included 24 121 responses from individuals working in large LHDs.
MAIN OUTCOME MEASURES: Descriptive and regression-based statistics for training needs, self-identified skill-building interests, and predictors of reporting a policy engagement training need.
RESULTS: Nearly 40% of staff at large LHDs reported a training need in policy engagement, the only domain to show an increase in need since 2021. Women had significantly higher odds of reporting a policy training need (odds ratios [OR] = 1.67; P < .001), as did supervisors (OR = 2.09; P < .001) and managers (OR = 1.78; P < .001) compared to nonsupervisors, while those with master’s (OR = 0.64; P < .001) or doctoral degrees (OR = 0.40; P < .001) had lower odds compared to bachelor’s-level staff.
CONCLUSIONS: Large LHDs are well positioned to advance public health policy given their scale and connection to local communities. Targeting policy engagement training to workforce segments with the highest reported need offers a strategic opportunity to strengthen policy capacity across the US public health workforce.
PMID:41248529 | DOI:10.1097/PHH.0000000000002276
