The Importance of Local Epidemiology—Results From the 2024 Big Cities Health Coalition Epidemiology Capacity Assessment

CONTEXT: Epidemiologists in local health departments are central to ensuring healthy, thriving communities and responding to public health threats, particularly in big cities where diseases often emerge and spread quickly due to their landscape. PROGRAM: In Spring 2024, the Council of State and Territorial Epidemiologists and the Big Cities Health Coalition (BCHC) collaborated to field the third Epidemiology Capacity Assessment in 35 large, urban health departments, who were BCHC members at the time. The assessment aimed to track workforce capacity by understanding the number of epidemiologists currently in departments, the number of epidemiologists needed, current funding status and other key metrics of capacity. IMPLEMENTATION: The 30-question assessment was distributed electronically to the 35 BCHC member jurisdictions, and data collection took place from March to June 2024. EVALUATION: Quantitative results were analyzed in R Studio software and Excel 2008 through a combination of descriptive statistics, cross-tabulations, and tests of significance. Qualitative results were coded and grouped thematically. DISCUSSION: There is a need for additional epidemiologists at the local level, even in the nation's largest cities, to effectively deliver the Essential Public Health Services, and many existing staff will be lost with the end of pandemic funding. Flexible, sustained funding would allow epidemiologists to prioritize the unique needs of their communities, retain current staff and institutional knowledge, and proactively build a workforce prepared to respond to future public health emergencies.