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Item Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey(Wolters Kluwer, 2019-03) McFarlane, Timothy D.; Dixon, Brian E.; Grannis, Shaun J.; Gibson, P. Joseph; Epidemiology, Richard M. Fairbanks School of Public HealthOBJECTIVE: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. DESIGN: Cross-sectional study. SETTING: US local and state health agencies. PARTICIPANTS: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, "information technology specialist or information system manager" (IT/IS), "public health science" (PHS), and "clinical and laboratory" workers. MAIN OUTCOME MEASURE: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. RESULTS: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. CONCLUSIONS: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce.