When Michelle Taylor, MD, DrPH, MPA, joined the Shelby County Health Department (SCHD) in Memphis, Tennessee, as director and health officer in 2021, the future of the county’s public health workforce weighed heavily on her mind. Between planning for retirements and finding ways to recruit and retain early- and mid-career workers, Taylor knew bold action was needed to strengthen Shelby County’s workforce and build capacity for the future.

Her goal was a comprehensive approach to training and development that would meet public health workers at every point in the pipeline — during recruitment and once they’re employed by SCHD. The approach had to include those who intentionally chose public health, as well as those who weren’t sure they wanted to stay in the field.

“What a lot of people don’t realize is that most people who work at local health departments are not traditionally public health trained,” Taylor said. “Many people stumble into public health.”

An intentional training and development program would help employees build their skills and visualize a path forward in their careers. But Taylor knew building such a program would require significant funding and strong support.

Fortunately, that’s when serendipity entered the picture.

A committed partner

During her first year as SCHD director, Taylor served on a community panel that interviewed Ashish Joshi, PhD, MBBS, MPH, for the role of dean of the University of Memphis School of Public Health. During his interview, Joshi talked about coming from New York City, where there was a strong partnership between the City University of New York and the local health department, according to Taylor.

“He was speaking my language,” she said. “I didn’t know he was going to be hired, but when I heard him say that, I thought, ‘This is somebody who might want to work with the local public health department in new ways.’ That hadn’t happened before in Memphis and Shelby County.”

When Joshi was hired, he approached Taylor and said, “We have to work together.”

It wasn’t long after that Taylor learned of the public health infrastructure grant (PHIG) funding opportunity. “I knew we could use this money in a way that would strengthen the public health workforce,” she said. She and Joshi talked about a partnership to create community-based pipeline programs that would benefit both SCHD and the university by developing Shelby County’s public health workers.

The two wrote the PHIG application together with that intention, Taylor said.

Training for every stage

When SCHD was awarded PHIG funds, Taylor and Joshi partnered on a strategic approach to building public health workforce capacity in Shelby County that included:

Experiential learning for high school students

Building on Tennessee’s existing dual enrollment program, SCHD and the University of Memphis offer a 240-hour hybrid program for high school students to encourage careers in public health after post-secondary graduation. Students who complete the 240 hours receive a stipend of nearly $5,000 (minus taxes).

Four students recently graduated from the program, each with 18 credit hours in public health courses. These transferrable credits allow students to enter college with their public health electives completed. This “head start” helps reduce required per-semester courseload, allowing students to focus on challenging courses like epidemiology and biostatistics, according to Nichole Saulsberry-Scarboro, PhD, PH-IDEAS director of workforce and strategic partnerships at the University of Memphis School of Public Health.

Population health data analytics program for undergraduate students

Some undergraduate students participate in a program focused on collecting, analyzing, and disseminating public health data. These students participate in the program for one semester during their junior year and one semester during their senior year. They also spend 16 hours per week during the summer working on these skills through a partnership with CodeCrew, a Memphis-based nonprofit that teaches tech skills to youth and adults from underrepresented communities. Participating students receive both a tuition stipend and a monthly stipend during their junior and senior years.

Shelby County Health Department Employee Scholars program

Up to 18 current SCHD employees can obtain graduate certificates and degrees in public health through the SCHD Employee Scholars Program. Accepted students receive paid tuition at the University of Memphis School of Public Health, along with a $12,000 annual stipend to mitigate costs associated with returning to school. SCHD Employee Scholars have flexible work schedules to accommodate classes and dedicated workspace at the university.

Employee Scholars must be accepted into the university’s program. While there are no service strings attached, employees who leave SCHD while enrolled must pay their own tuition and expenses if they want to continue their education.

Capacity-building workshops for the community and for employees

SCHD and the university offer a two-hour workshop designed to equip community members with skills in emotional literacy, trauma-informed care, and collective well-being. The goal of these workshops is to build trust between the community and SCHD.

SCHD has also designed capacity-building workshops specifically for SCHD employees. These workshops are held during the workday and provide analytical tools and skills necessary for staff to engage more deeply with communities they serve.

Employees are ‘flourishing’

Early indications point to success for these programs, which are about to begin their third year. “About 250 employees expressed interest in the SCHD Employee Scholars Program,” Taylor said. “Eighteen were able to go back to school to get advanced degrees. It has been wonderful seeing the experiences of these students who are also full-time Shelby County Health Department employees. They have just flourished in this program. They bring the things they’re learning in the classroom back to their work.”

Several students have already graduated with certificates and gone on to their next degree, she said. Only three employees who have graduated have left SCHD, but all have moved on to public health roles elsewhere.

Taylor also noted the benefits of having SCHD employees as classmates for the university’s traditional students. “Our employees help them take theories they’re talking about in class and understand how they’re applied in real life,” she said. “The instructor may introduce a public health concept. Our employees, some of whom have worked in public health for 10 to 15 years, may say, ‘In theory this is how it’s supposed to work. But in practice, let me tell you all the things we must do to get this across the finish line.’ Imagine being a traditional student and having that experience.”

Making the case for partnership

Taylor said that having a contract in place between SCHD and the University of Memphis School of Public Health was critical to making this partnership a success. “We could have kept most of the money in house, but we recognized it would be harder to run this program due to county processes and how long it takes to pay and who you can pay and how you can pay,” she said. “We said, ‘Forget that. We’ll keep some of the key positions such as accounting roles in the health department. But everything else we’re going to contract with the University of Memphis School of Public Health to do.’”

Still, it took some convincing to cross the finish line, she said. Taylor had to go before the county commission and make the case for this partnership.

“It’s a huge multimillion dollar contract,” she said. “I had to justify why we were giving the University of Memphis $12 million. I said, ‘Let me tell you what we’re planning. Let me tell you how we wrote our application and let me tell you why this contract is so important.’

She won the commission’s support.

“I have director colleagues from across the country who have used big dollars in more traditional ways,” she said. “They’ve plugged holes and kept staff over from COVID. We chose to write our application in a different way, and it has really paid off for the community.”

It’s also paid off for SCHD, encouraging employees to see public health as a long-term career. “Our Employee Scholars Program has helped plant a seed in people’s heads,” Taylor said. “They see that they can expand and grow. A good majority have no traditional public health training. This program encourages people to think more broadly about their own professional development, to consider how they can progress in their career, and to have stretch goals. All of that strengthens public health as a whole.”

Actions for intentional training and development

  • Consider partnership. Academic institutions are often well equipped to build programs that offer foundational public health skills and the specific advanced capabilities that workers want.
  • Seek stakeholder buy-in. Support from department and governing leadership is critical to proposing new funding methodologies and partnerships. Arm yourself with data to make the case for how workforce training benefits the community.
  • Row in the same direction. An effective training and development program requires all parties to work toward a common goal — a stronger public health workforce.
  • Remove barriers. Professional development, especially pursuing academic training, can be a heavy lift for employees. Smooth the path and provide support to set training program participants up for success.

Dr. Michelle Taylor was recently named commissioner of the Baltimore City Health Department. Dr. Bruce W. Randolph now serves as the interim Shelby County Health Department director and health officer.