Measuring inequalities in the public health workforce at county-level Centers for Disease Control and Prevention in China

Cai, Weiqin; Li, Chengyue; Sun, Mei; Hao, Mo

In this study, the Gini index was used to reflect the overall inequality, while the Theil index was mainly used to decompose the sources of inequality. The overall inequality results show that the inequality of health professionals and field epidemiological investigators was worse than that of staff, with the two being a subset of staff. Among them, field epidemiological investigators had the worst inequality, with a Gini coefficient of close to 0.4 (warning limit for high inequality), which is consistent with the real-life conditions in China [25] . According to a qualitative survey conducted by the Chinese Center for Disease Control and Prevention, field epidemiology training programs (FETP) started in China in 2001, and although such programs have been successful in many areas, the effectiveness and quality of these training programs vary by region. The primary reasons for the lack of success in this regard are limited financial support; inadequate attention from those in leadership roles; absence of good instructors; and only partial involvement of students in field practice training due to excessive routine work [26] . Therefore, local governments in underdeveloped areas should increase financial input, emphasize and support the development of training projects, and enhance trainers' enthusiasm and motivation through various incentives, thereby ultimately increasing the number of field epidemiological investigators in their jurisdictions.