public health workers

This study hears from public health practitioners across Iowa about their experiences responding to COVID-19 and uses their stories to identify existing strengths and areas for improvement.

Team members:

  • UIowa: Rima Afifi (lead), Heidi Haines (lead), Natoshia Askelson, Rylee Beltran, Edith Parker,  Daniel Sewell, Laurie Walkner   
  • PRC-RH Students: Hahn Pham (PhD, graduated), Amanda Sursely (PhD, graduated)
  • Partners: Lina Tucker-Reinders (co-lead, Iowa Public Health Association), Sarah Dixon (Iowa Primary Care Association), Kaitlin Emrich (Black Hawk Public Health), Michelle Lewis (Siouxland Health Department), Jimmy Reyes (University of Northern Iowa), Kelly Wells Sittig (Iowa Cancer Association), Christine Estle (Jefferson County Public Health)

Project dates: 2021-present

Funding sources: UI PRC-RH

Project tags: COVID-19, mental health, public health workforce

Details

 

Description  

This description is partially taken verbatim from Haines et al., 2025. The COVID-19 pandemic had a major impact on the mental health of public health staff, especially those working directly with the public to implement safety measures. The public health workforce (PHW) assumed responsibility for testing, contact tracing, isolation and quarantine, community communication, and overall coordination, all while engaging in an unprecedented vaccination campaign. Their role was crucial in reducing poor health outcomes, deaths, and disease burden in the US. Yet, despite these efforts, the public health workforce did not receive the same level of recognition as essential or frontline workers.

Rural communities faced even greater challenges due to pre-existing conditions such as poverty, limited access to healthcare, provider shortages, and high rates of chronic illness—all of which strained both the healthcare system and public health workforce even before the pandemic. 

The objective of this project, in partnership with the Iowa Public Health Association, was to deconstruct the COVID-19 response in the state of Iowa, to identify what worked well and where improvements are needed.  We used an innovative mixed methods data collection tool, SenseMaker, which helps visualize patterns across stories from a wide range of people. Public health professionals were invited to share short stories of their experiences during the pandemic—what helped, what was hard, and how they grew or struggled—based on the prompt: “Imagine you are trying to explain to someone who does not work in public health how our public health system responded to the COVID-19 pandemic in Iowa. What would you tell them?”

We followed up with questions about their perception of their own stories. These narratives powerfully illustrate what it was like to work in public health during the pandemic in Iowa. They also highlight the severe mental health strain many public health professionals felt and continue to feel, along with feelings of frustration and lack of appreciation. 

Through the analysis of these stories, we’re able to better understand individual experiences and draw insights that can guide future planning and action for communities in the continued response to COVID-19 and other public health crises. Strong partnerships and collaborations emerged from our respondents' stories as a critical facilitator of effective responses. Respondents emphasized the importance of using science and evidence-based practices—not politics—and communicating clearly with the public. Burnout and mental health challenges were major barriers to success. Understanding the environments conducive to the PHW’s sense of control, and ability to carry out their role is critical to supporting the health and wellbeing of this workforce. 

These findings can help public health organizations plan more effectively and support communities and public health professionals in ongoing COVID-19 efforts and future public health crises . It’s important to note that nearly half (about 46%) of the public health workforce in the US left their jobs between 2017 and 2021, a trend worsened by the COVID-19 pandemic. Because of this, we will be expanding and re-fielding this survey to learn more about how the public health workforce and system are doing now. We’re committed to sharing these stories to provide information around decisions and policy making locally and at the State level. 

Resources, Media, & Publications 

 

Resources:

Publications:

Media:

Presentations:

  • Haines H, Sursely A, Tucker Reinders L, Askelson N, Walkner L, Afifi R. Harnessing knowledge elevated learnings: Learning from the COVID-19 pandemic through the eyes of the public health workforce. Presentation at the Annual meeting of the American Public Health Association. Nov. 12-15, 2023; Atlanta, GA, USA.
  • Haines H, Sursely A, Tucker Reinders L, Askelson N, Walkner L, Afifi R, HKEL Planning Committee. Dedication, persistence and resiliency in spite of turmoil. Presentation at Public Health Conference of Iowa; March 28, 2023; Ames, IA.
  • Afifi R, Haines H, Tucker-Reinders L, HKEL planning committee. Harnessing 21: Iowa’s Experience Mitigating COVID -19. Iowa Public Health Association annual conference; May 2022, Ames, IA.
  • Afifi, R. & Haines, H. Harnessing Knowledge/Elevating Learnings: Iowa's Experience Mitigating COVID-19: Using the SenseMaker® Software Platform. Public Health Conference of Iowa; April 2021; Virtual.