Because previous CSTE ECAs did not enumerate local health department epidemiologists, assessment of trends is limited to state-level epidemiologists. The 12.9% increase in epidemiologists since 2009 was unexpected given the sustained national economic downturn, which has resulted in reported reductions in the local and state public health workforce.6,9,10 The data suggest that although the number of state-funded epidemiologists decreased in most states, federal funding appeared to compensate for those losses. New federal funding streams during this time included funding to respond to 2009 pandemic influenza A (H1N1) and federal stimulus funding that supported health-care—associated infection initiatives. Despite this new funding and a boost in the number of epidemiologists, it is troubling that 12 states had overall ≥10% decreases in the number of state-level epidemiologists, given that states consistently have reported a need for additional epidemiologists2-5 and epidemiologists have been identified as a workforce shortage occupation in several studies.6,9,10 The number of epidemiologists decreased in a number of program areas including bioterrorism/emergency response, environmental health, injury, occupational health, and oral health. In all these areas, except bioterrorism/emergency response, epidemiology capacity already was marginally functional.4 Trends in the workforce, and functional epidemiology capacity in these areas especially, require continued monitoring to identify gaps and address future needs. Such monitoring will be particularly important as federal funding fluctuates and states operate under persistent budget deficits.