Assessing health human resource structure at Urumqi’s center for disease control and prevention

Abstract

By conducting an in-depth investigation and analysis of the health human resource framework within the Urumqi Center for Disease Control and Prevention (CDC), this study aims to offer valuable insights for the objective assessment and future enhancement of its talent development endeavors. A questionnaire survey was administered, followed by a descriptive analysis, involving the healthcare professionals affiliated with the Urumqi Center for CDC. The Urumqi Center for CDC exhibited a lower compilation number than its on-duty personnel count. When compared to county (district) level, the municipal level CDC displayed a higher educational attainment, a more favorable title distribution, and a younger workforce demographic. The human resource count in both Urumqi’s city and county (district) level CDCs has decreased, but the relative numbers have improved, indicating enhanced quality and a younger workforce. The municipal-level CDC boasts a superior human resource structure compared to the county (district) level, with better fairness in population distribution by area than geography. Allocation equity within the central urban area is higher than in distant urban areas, highlighting regional disparities as a significant factor.

1. Introduction

Amid the pressing need to establish a robust national public health system and bolster our capacity, scholars in the field of public health underscore the pivotal role played by the disease prevention and control system. This system serves as a vital safeguard for preserving the health of the populace, upholding public health security, and ensuring social and economic stability.^[1] It can be stated that the Center for Disease Control and Prevention [CDC] (referred to as CDC hereafter) assume a pivotal role in safeguarding and advancing public health.^[2] In the contemporary world, health productivity, serving as the cornerstone of social productivity, has emerged as a critical factor in addressing issues related to societal imbalances and insufficient development. Advancing health productivity and enhancing the equity and accessibility of healthcare services have emerged as primary objectives in China’s health care system reform.^[3] As China’s economic influence continues to expand and with the ongoing evolution of healthcare reforms, the reform’s focal point has gradually shifted from the development of physical infrastructure within medical institutions to the strategic cultivation of “software,” specifically in the area of health human resources research.^[4] The analysis of healthcare organization’s human resource structure remains somewhat unclear, and achieving a more precise understanding of the composition of human resources within various public health units is crucial for devising tailored solutions to specific challenges. Researchers like Karan in India have offered insights into the scale and composition of local health manpower, emphasizing the need for increased investment in human resources for health. Likewise, in the context of a complex healthcare system like China’s, a comprehensive examination of various units is indispensable.^[5] The examination and analysis of the present state and composition of health human resources structure hold significant importance in ensuring the CDCs sustainable and well-organized development. In an effort to comprehensively grasp the distribution of health human resources within Urumqis CDCs and to further bolster research and development in this domain, this study collected data on health human resources in Urumqis CDCs spanning from 2016 to 2020 and conducted an in-depth investigation.

2. Objectives and methods of the study

2.1. Object of the study

One city-level and 8 county (district) level CDCs in Urumqi District, Xinjiang Uygur Autonomous Region.

2.2. Sources and methods

Questionnaires were distributed to CDCs in 1 city, 7 districts, and 1 county within Urumqi region. The survey covered aspects such as agency personnel, age, education, and titles over the past 5 years, excluding data from the Corps. National data information was obtained from the China Health and Health Statistical Yearbook. Descriptive statistical analysis was conducted using R software, SPSS 26.0 and Excel 2016.

In the equity studies, the health agglomeration method was employed.^[5] The agglomeration degree signifies the concentration level of a production factor within an area compared to a higher-level area. In this research, the Population Agglomeration Degree (PAD) indicates the percentage of the population concentrated in a district or county that occupies 1% of the total land area of Urumqi.

The calculation formula is:

$${\displaystyle \begin{array}{l}{\displaystyle PA{D}_i=\frac{\left(P_i/P_n\right)\ast 100\mathrm{\%}}{\left(A_i/A_n\right)\ast 100\mathrm{\%}}=\frac{P_i/P_n}{A_i/A_n}}\end{array}}$$

Some scholars have introduced this indicator into the field of health economics, and based on the basic idea of agglomeration degree, a new indicator has been derived to evaluate the equity of health resource allocation—Health Resource Agglomeration Degree (HRAD). HRAD refers to the ratio of the number of health resources clustered in a region on 1% of the land area of the region’s parent region.

The calculation formula is:

$${\displaystyle \begin{array}{l}{\displaystyle HRA{D}_i=\frac{\left(H{R}_i/H{R}_n\right)\ast 100\mathrm{\%}}{\left(A_i/A_n\right)\ast 100\mathrm{\%}}=\frac{H{R}_i/Ai}{H{R}_n/A_n}}\end{array}}$$

where P_i is the population of each district and county, and P_n is the population of the whole city of Urumqi; A_i is the land area of each district and county, and A_n is the total land area of Urumqi city; HR_i is the number of CDC health personnel in each district and county, and HR_n is the total number of CDC health personnel in Urumqi city. When HRAD_i > 1, it means that the equity of CDC health personnel in the area is better by geographical area, and vice versa, when HRAD_i < 1, the equity of configuration is poor.

When the ratio HRAD_i/PAD_i equals 1, it indicates better CDC staffing and relatively equitable resource distribution within the region. Conversely, when HRAD_i/PAD_i < 1, it suggests inadequate CDC staffing and relatively insufficient resource allocation in the region. This ratio, which combines population and land area, is particularly well-suited for application in sparsely populated areas like Urumqi.^[6]

3. Results

3.1. Basic information on human resources for health at the Urumqi Regional CDC

From 2016 to 2020, there was a reduction in the workforce at the Urumqi Regional CDC, decreasing from 506 employees to 473, Notably, in 2018, the average number of CDC staff per 10,000 population stood at 2.15, as indicated in Table 1.

Table 1.

CDC health personnel in Urumqi region, 2016 to 2020.

Year	Number of people on board	Number of staff	Number of people on staff	Number of supernumeraries	Number of vacancies
2016	569	549	506	20	43
2017	555	532	491	23	41
2018	548	525	477	23	48
2019	543	522	469	21	53
2020	545	514	473	31	41

CDC = Center for Disease Control and Prevention.

3.2. Gender structure of health human resources in the CDC of Urumqi region

Between 2016 to 2020, the healthcare personnel at the Urumqi Regional CDC experienced a general decline in both male and female staff members. During this period, the gender ratio decreased from 57.3% to 48.7%, primarily due to an overall reduction in the proportion of male personnel, as illustrated in Table 2.

Table 2.

Gender structure of health personnel in Urumqi CDC, 2016 to 2020.

Year	Male		Female
	n	%	n	%
2016	184	36.44	321	63.56
2017	160	32.59	331	67.41
2018	164	34.38	313	65.62
2019	155	33.05	314	66.95
2020	155	32.77	318	67.23

CDC = Center for Disease Control and Prevention.

3.3. Ethnic structure of health human resources in the CDC in Urumqi

Between 2016 to 2020, the representation of ethnic minorities within the health personnel of the Urumqi CDC remained relatively consistent. The most prominent ethnic minority group in the structure is consistently “Uyghurs,” and their representation has been on a gradual increase each year, as indicated in Table 3.

Table 3.

Ethnic structure of health personnel at the Urumqi Regional CDC, 2016 to 2020.

Year	Han Chinese		Uighur		Kazakh people		Other
	n	%	n	%	n	%	n	%
2016	370	73.12	55	10.87	18	3.56	63	12.45
2017	358	72.91	55	11.20	18	3.67	60	12.22
2018	345	72.33	54	11.32	17	3.56	61	12.79
2019	345	73.56	54	11.51	17	3.62	53	11.30
2020	345	72.94	58	12.26	18	3.81	52	10.99

CDC: Center for Disease Control and Prevention.

3.4. Age group structure of health human resources in the Urumqi Regional CDC

From 2016 to 2020, the majority of health personnel in the Urumqi CDC fell within the “35~” age group, with noteworthy increases observed across all age groups except for the age groups of “35~” and “55~,” where a decrease in overall proportions was noted. Notably, the most significant increase was observed in the “25~” age group, as indicated in Table 4.

Table 4.

Age group (years) structure of health personnel at the Urumqi Regional CDC.

Year	<25		25~		35~		45~		55~
	n	%	n	%	n	%	n	%	n	%
2016	20	3.95	103	20.36	203	40.12	121	23.91	59	11.66
2017	24	4.89	127	25.87	184	37.47	112	22.81	44	8.96
2018	28	5.87	122	25.58	179	37.53	109	22.85	39	8.18
2017	22	4.69	122	26.01	163	34.75	128	27.29	34	7.25
2020	26	5.50	131	27.70	160	33.83	127	26.85	29	6.13

CDC = Center for Disease Control and Prevention.

3.5. Educational structure of health human resources in the Urumqi Regional CDC

Between 2016 to 2020, the educational composition of health personnel within the Urumqi CDC was predominantly at the undergraduate level, with college-level education being the second most common. Notably, there was a year-on-year increase in the percentage of personnel holding undergraduate, graduate, and higher-level educational qualifications, as evidenced in Table 5.

Table 5.

Educational structure of health personnel at the Urumqi Regional CDC, 2016 to 2020.

Year	High school and below		Secondary school		College		Undergraduate		Graduate student and above
	n	%	n	%	n	%	n	%	n	%
2016	45	8.89	28	5.53	144	28.46	203	40.12	86	17.00
2017	48	9.78	24	4.89	125	25.46	200	40.73	94	19.14
2018	42	8.81	24	5.03	116	24.32	203	42.56	92	19.29
2019	42	8.96	27	5.76	106	22.60	202	43.07	92	19.62
2020	40	8.46	24	5.07	103	21.78	212	44.82	94	19.87

CDC = Center for Disease Control and Prevention.

Starting from 2017, the primary distribution of health personnel within Urumqi CDC title structure shifted from the “junior” group to the “intermediate” group. Over the period from 2016 to 2020, the senior group consistently had the percentage within the personnel title structure, as shown in Table 6.

Table 6.

Structure of health personnel titles at the Urumqi Regional CDC, 2016 to 2020.

Year	No title		Primary		Intermediate		Deputy high		Positively high
	n	%	n	%	n	%	n	%	n	%
2016	42	8.57	202	41.22	175	35.71	55	11.22	16	3.27
2017	51	10.39	164	33.40	191	38.90	69	14.05	16	3.26
2018	44	13.25	161	33.75	193	58.13	64	19.28	15	4.52
2019	41	8.74	167	35.61	184	39.23	61	13.01	16	3.41
2020	34	7.19	171	36.15	191	40.38	64	13.53	13	2.75

CDC: Center for Disease Control and Prevention.

3.6. Professional structure of health human resources in Urumqi Regional CDC

In 2016 to 2020, “public health” dominates, with the exception of the “clinical medicine” and “other” categories. All other categories exhibit a general decreasing trend during this period, as illustrated in Table 7.

Table 7.

2016 to 2020 Urumqi regional CDC health staff professional structure.

Year	Public health		Health business management		Clinical medicine		Technical inspection		Nursing		Other
	n	%	n	%	n	%	n	%	n	%	n	%
2016	207	40.91	17	3.36	87	17.19	95	18.77	20	3.95	80	15.81
2017	204	41.80	13	2.66	84	17.21	91	18.65	19	3.89	77	15.78
2018	201	42.14	12	2.52	77	16.14	86	18.03	17	3.56	84	17.61
2019	181	38.59	20	4.26	85	18.12	73	15.57	17	3.62	93	19.83
2020	187	39.53	14	2.96	89	18.82	74	15.64	13	2.75	96	20.30

CDC = Center for Disease Control and Prevention.

3.7. Structure of years of experience in CDC work for health human resources in Urumqi CDC

Since 2017, the number of years that health personnel in Urumqi CDC have been engaged in CDC work is mainly “20 years~,” followed by “10 years~”; among them, “20 years~ “ group has the largest growth rate. See Table 8.

Table 8.

Structure of health personnel at Urumqi Regional CDC 2016 to 2020 number of years in CDC (years).

Year	<5		5~		10~		20~		30~
	n	%	n	%	n	%	n	%	n	%
2016	64	12.65	60	11.86	162	32.02	146	28.85	74	14.62
2017	60	12.22	59	12.02	153	31.16	154	31.36	65	13.24
2018	55	11.53	67	14.05	141	29.56	155	32.49	59	12.37
2019	61	13.01	72	15.35	120	25.59	156	33.26	60	12.79
2020	63	15.18	63	15.18	71	17.11	159	38.31	59	14.22

CDC = Center for Disease Control and Prevention.

3.8. Gender structure

The gender distribution among CDC personnel in both the city and county (district) levels in Urumqi, Xinjiang and nationwide is detailed in Table 9. The chi-square statistic (c2) is calculated at 32.728, with a significant P-value of .000, which is less than the threshold of .05. This significant result indicates noteworthy disparities in gender composition across different geographical regions. Notably, the trend of having a higher number of female CDC personnel compared to male personnel is particularly pronounced within the county (district) level CDCs in Urumqi

Table 9.

Gender composition of CDC personnel at different levels (%).

Institution	Male	Female
Municipal	48.7	51.3
County (district) level	27.7	72.3
National	42.9	57.1

CDC = Center for Disease Control and Prevention.

3.9. Age group structure

The age group composition of CDC personnel at Urumqi city and county (district) levels with Xinjiang and national data is shown in Table 10, χ² = 262.920, significant difference P = .000 < .05, indicating that there are significant differences in age group composition across geographic regions.

Table 10.

Age group (years) composition of CDC personnel at different levels (%).

Institution	<25	25~	35~	45~	55~
Municipal	3.9	29.6	38.8	13.2	14.5
County (district) level	6.8	23.7	36.8	27.4	5.2
Xinjiang	2.0	22.1	36.5	32.2	7.2
National	1.6	23.6	31.5	31.7	11.6

CDC = Center for Disease Control and Prevention.

Concerning the age structure of CDC personnel, it is evident that the distribution of individuals under 25 and those over 55 years old is comparatively lower, with the largest proportion falling within the 35 to 46 age range. Notably, the key difference between the Urumqi CDC and district/county-level CDCs is that the city CDC has fewer personnel under 25 years old, whereas the district and county-level CDCs have fewer personnel over 55 years old. In comparison to Xinjiang and the national levels, the age structure of personnel in both city and county-level CDCs in Urumqi leans more towards the middle age groups.

3.10. Years of working in CDC

The composition of years of experience in CDC work among CDC personnel at the city and county (district) levels in Urumqi and Xinjiang and national data are shown in Table 11, χ² = 900.051, significant difference P = .000 < .05, indicating that there are significant differences in the composition of years of experience in CDC work in different regions.

Table 11.

Composition of CDC personnel at different levels in terms of years of experience in CDC work (years) (%).

Institution	<5	5~	10~	20~	30~
Municipal	5.9	17.1	39.5	25.0	12.5
County (district) level	14.2	12.6	24.9	36.0	12.3
Xinjiang	8.8	7.7	31.2	35.7	16.6
National	7.4	12.5	20.8	30.7	28.7

CDC = Center for Disease Control and Prevention.

The number of years of experience in a job typically reflects the familiarity and proficiency in that role, with longer tenures often indicating higher levels of expertise. Notably, personnel in national CDC institutions tend to have more extensive experience, primarily falling within the 20 to 29 years and 30 years and above categories. In contrast, CDC personnel in Xinjiang, including those in Urumqi at both city and county (district) levels, are more concentrated in the 10 to 19 years and 20 to 29 years’ experience brackets. The structure of CDC personnel in Urumqi’s district and county levels closely resembles that of Xinjiang as a whole.

3.11. Educational structure

The educational composition of the CDC personnel in Urumqi city and county (district) levels with Xinjiang and national data is shown in Table 12, χ² = 929.418, significant difference P = .000 < .05, indicating that there are significant differences in the educational composition of the CDC personnel in different geographical areas. The educational structure of health personnel in Urumqi’s district and county CDCs closely aligns with that of Xinjiang and the entire nation, primarily emphasizing college and bachelor’s degrees, with bachelor’s degrees being the most prevalent. In contrast, CDC personnel in Urumqi’s municipal CDCs predominantly hold undergraduate and postgraduate degrees and above, with a significantly higher proportion of individuals possessing postgraduate degrees and higher qualifications than those in the district and county CDCs.

Table 12.

Educational composition of CDC personnel at different levels (%).

Institution	Junior college and below	College	Undergraduate	Graduate student and above
Municipal	4.0	9.2	45.4	41.4
County (district) level	18.4	31.4	46.2	8.4
Xinjiang	13.0	40.9	44.4	1.7
National	20.7	35.1	37.4	6.8

CDC = Center for Disease Control and Prevention.

3.12. Title structure

The composition of CDC personnel at the 2 levels of Urumqi city and county (district) in terms of job titles and Xinjiang and national data are shown in Table 13, χ² = 3642.326, significant difference P = .000 < .05, indicating that there are significant differences in the composition of CDC personnel in different geographical areas.

Table 13.

Composition of personnel titles at different levels of CDC (%).

Institution	No title	Primary	Intermediate	Deputy high	Positively high
Municipal	5.9	30.3	42.1	14.5	7.2
County (district) level	10.8	35.4	39.7	12.9	1.2
Xinjiang	33.7	24.8	26.7	11.9	2.9
National	10.6	46.9	30.0	9.6	2.9

CDC = Center for Disease Control and Prevention

In terms of title structure, the distribution of CDC personnel at both Urumqi’s city and county (district) levels is remarkably similar. However, it is noteworthy that Xinjiang CDC personnel have the highest proportion of individuals without titles in their job titles structure, whereas national CDCs have the highest proportion of junior personnel in their title composition.

3.13. Equity analysis based on agglomeration

From 2016 to 2018, the concentration ratios of health human resources in CDCs located in Tianshan District, Shaibak District, Xincheng District, Shuimangu District, and Tutunhe District were >1. This suggests that the geographical distribution of health staffing in CDCs in these areas was more equitable. In contrast, the concentration ratios of health human resources in CDCs located in Dabancheng District, Middong District, and Urumqi County were <1, indicating that the geographical allocation of health staffing in these regions was less equitable. However, when considering both the clustering ratios of the population served and health resources, a different pattern emerges. In this case, the clustering ratios of health human resources in CDCs located in Tianshan District, Shaibak District, Xincheng District, Shuimangu District, and Tutunhe District were all <1. This indicates that the health staffing in CDCs in these regions was inadequate relative to the population they served. On the other hand, the clustering ratios of health human resources in CDCs located in Dabancheng District, Middong District, and Urumqi County were all >1, suggesting that the allocation of CDC health human resources in these 3 regions was excessive relative to the population they served. This information is summarized in Table 14.

Table 14.

CDC health resource concentration by county (district), 2016 to 2018.

Region	2016			2017			2018
	PADi	HRADi	Ratio	PADi	HRADi	Ratio	PADi	HRADi	Ratio
Tianshan District	13.56	9.09	0.67	13.58	8.71	0.64	13.23	8.57	0.65
Shaibak District	7.68	4.47	0.58	7.71	4.31	0.56	7.67	4.44	0.58
New downtown	12.37	4.78	0.39	11.82	4.60	0.39	11.94	4.51	0.38
Shuimangu District	5.51	3.34	0.61	5.11	3.44	0.67	5.20	3.54	0.68
Toutunhe District	4.18	2.27	0.54	4.15	2.65	0.64	4.42	2.41	0.55
Darshan City	0.04	0.06	1.31	0.04	0.06	1.33	0.04	0.06	1.43
Middletown	0.44	0.54	1.22	0.50	0.53	1.06	0.50	0.51	1.01
Urumqi County	0.08	0.24	3.11	0.09	0.24	2.69	0.08	0.24	3.09

CDC = Center for Disease Control and Prevention, HRAD = Health Resource Agglomeration Degree, PAD = Population Agglomeration Degree.

Health resource allocation policies have historically been primarily based on the population being served.

The calculation of health resource concentration highlights the significant disparities in health human resource allocation within CDCs due to geographical factors. Notably, in Urumqi, Tianshan District, Shaibak District, Xincheng District, and Shuimangu District, which constitute the central urban areas, are home to 83.76% of the city’s population but occupy only 10.22% of the city’s geographic area. When considering both population and geographic area, the equity in health human resource allocation in CDCs located in Dabancheng District, Middong District, and Urumqi County is notably better than in other areas. These 3 regions exhibit distinctive characteristics of having a “wide area and sparse population,” with extensive service areas and dispersed service populations. Consequently, the influence of geographical factors on health resource allocation is particularly pronounced in these areas.

4. Discussion

From 2016 to 2020, there has been a consistent decline in the number of health human resources within the CDC system in Urumqi, aligning with a broader national trend that has been studied by various scholars.^[7–9] As of 2020, the health staffing levels in the Urumqi CDC fall significantly short of the projected figure of 890 outlined in the Regional Health Service System Plan for 2016 to 2020.

In past COVID-19 pandemics, CDCs and their staff have played pivotal roles in epidemiological investigations, detection, and containment efforts. Nevertheless, these experiences have also underscored the issue of inadequate health human resources within CDCs. Therefore, to better address the healthcare needs of the population and enhance the CDC’s capacity to respond to significant public health challenges, there is a need to judiciously increase the number of health human resources in CDCs while optimizing departmental functions and augmenting the effectiveness of CDC services.

The level of economic development significantly influences the development and utilization of human resources in the healthcare sector. Urumqi, as the capital city of a western Chinese province, serves as the focal point for the region’s economic resources and social development factors, benefiting from substantial aggregation effects and developmental advantages. While this concentration of resources has yielded substantial progress, it also raises concerns about the fairness of health resource allocation across cities in the region. Furthermore, CDCs, as public welfare institutions, have undergone operational changes during the reform process, transitioning to full government funding to ensure the public service nature of their health services. This shift has had both positive and negative consequences. On one hand, it reinforces the public service aspect of CDCs, enhancing the quality of their social services and benefits. However, it also introduces challenges such as financial compensation and policy adjustments in some areas, increased operational costs, workforce strain, equipment and facility limitations, and reduced employee motivation. These issues can, in turn, affect the standardization of laboratory infrastructure and contribute to shortages or outdated testing equipment.^[10,11] In the context of healthcare reform, CDCs have often received less attention compared to other aspects, such as health insurance, public hospital reform, and primary healthcare. The prevailing focus on treatment rather than prevention remains a dominant trend. Additionally, the work of CDC personnel may not be widely recognized by the public, contributing to personnel loss within the CDC system. These multifaceted challenges highlight the need for comprehensive reform efforts that address not only resource allocation but also the recognition and value placed on the critical role of CDCs in public health and disease prevention.^[12–14].

In light of the medium- and long-term development requirements of the CDC sector, it is imperative for CDCs at all levels to establish robust coordination mechanisms with relevant government departments, fostering a collaborative and efficient working framework. This inter-departmental collaboration is pivotal in addressing complex public health challenges effectively. Especially in the current post-pandemic era, researchers such as Zhao believe^[15] that cooperation is the key to strengthening economic exchanges, fostering technological innovations, and building a global culture of sustainability, which is key to achieving the SDGs. There is an urgent need for systematic action by public health organizations to get the SDG process back on track. A significant part of this strategy involves increasing financial investments in healthcare. It is essential to allocate financial resources strategically, adapting the structure of healthcare expenditure to meet evolving healthcare demands effectively. In light of our research results, which underscore significant resource allocation disparities among different regional units, it is paramount to prioritize efforts to narrow these gaps. Ensuring more equitable resource distribution across regions is essential to guarantee that all communities have equal access to essential healthcare services. This inclusive approach is central to achieving a comprehensive and equitable development of healthcare resources, aligning with the objectives of your study.^[16–18]

Urumqi CDC’s health personnel structure has undergone optimization. Unlike the national CDC staff, Urumqi CDC has a more balanced age group distribution, with a predominant presence in the “35 years old ~” category, and a declining trend in the “55 years old ~” age group. In terms of education, the majority of Urumqi CDC health personnel hold “bachelor’s degrees,” contrasting with the national CDC’s concentration in “college” to “bachelor’s degree” qualifications. Additionally, Urumqi CDC’s health personnel have shifted from primarily holding “primary” academic titles to “intermediate” titles in recent years. This optimization can be attributed to the “agglomeration effect” of Urumqi’s capital city status. However, future development should focus on several key areas. This includes the formulation of recruitment standards in alignment with current needs, an emphasis on attracting highly educated and qualified personnel, internal training, talent cultivation, and the establishment of effective systems for continuous training and career progression. It is also essential to address performance incentives, narrow income gaps with public hospitals, and establish long-term salary growth mechanisms and structured assessment and promotion systems to enhance the CDC’s attractiveness to talent.^[19,20]

In this new era, our CDC faces both opportunities and challenges. To attract and retain healthcare talent, it is crucial to focus on more than just increasing personnel numbers. We must prioritize enhancing their treatment and career prospects. Central to this effort is the optimization of our training and recruitment mechanism for public health professionals. Addressing the mismatch between university training objectives and employer needs is vital. Collaborating with professional colleges and universities can bridge this gap, ensuring that we recruit not only academic postgraduates but also those with practical expertise. Our findings indicate that the qualifications of our talent have improved over the past 5 years, and addressing this issue in the future should not be challenging. Researchers such as Griffith likewise believe that educational equity is very important in healthcare organizations and that public health workers need to be given more ways to learn to help achieve health equity across public health organizations.^[21] Preparing for the retention and selection of graduates enables us to promote an integrated “industry-academia-research” approach, aligning education with real-world requirements. Additionally, leveraging senior medical school students with relevant skills as a “reserve force” during major public health emergencies can alleviate the strain on our medical resources while providing invaluable practical experience to students, enhancing their professional skills, and bolstering their sense of professional identity.

Author contributions

Conceptualization: Tong Yang, Baoling Rui, Chen Zhang.

Data curation: Tong Yang, Baoling Rui, Chen Zhang.

Formal analysis: Chen Zhang.

Validation: Baoling Rui.

Writing – original draft: Tong Yang.

Writing – review & editing: Tong Yang.