This study demonstrates that how PH workers are
categorized and labeled may not match employees’ skill
sets or how health departments allocate resources. We
found higher agreement in tasks compared to knowledge
and resources, which suggests that job class labels may
differentiate what is done, but not how PH accomplishes
its mission. The discrepancy appears to be less about
differences in LHD governance, location, or size, and
more about how specific job titles are defined. Such
discrepancies may contribute to unexplained fluctuations
in the performance of the nation’s public health
systems.