New Workforce Survey: Public Health Turnover Could Pose Threat to Community Health

Are America’s states and cities prepared for the next health epidemic? Not according to new survey research that shows a rise in job turnover among public health professionals. This is despite high levels of job satisfaction.

As states and communities work to address health risks, including natural disasters and disease outbreaks, they face significant disruption of their public health workforce and a major loss of specialized skills needed to protect, promote, and improve health. A new survey of professionals in state and local health departments, the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), shows that nearly half the workforce could leave their organizations within the next five years, including people who will retire and many who may leave the public health field altogether. This is particularly troubling because local health departments have eliminated 56,360 jobs since 2008.

PH WINS, the only nationally representative survey of state and local public health workers, was first conducted in 2014 and has consistently revealed a high rate of job satisfaction. But the results suggest that agencies need to do more to retain skilled employees, as the number of employees who are planning to leave increased 41% from 2014 to 2017. Key findings:

  • Nearly half the workforce is considering leaving their organizations in the next five years, including 22% who plan to retire and 25% who plan to leave within one year for other reasons.
  • Among those planning to leave, the top five reasons are inadequate pay (46%), lack of advancement (40%), workplace environment (31%), job satisfaction (26%), and lack of support (26%).
  • Several populations that are already underrepresented in the workforce are poised to leave in large numbers – Millennials (32% considering leaving), employees with a degree in public health (34%), men (31%), and women executives (24%).
  • Professionals in public health departments work to prevent and respond to major crises, including infectious disease outbreaks, surges in chronic disease, and natural disasters. A decline in the public health workforce could threaten the health and safety of communities, especially when combined with rising health threats, including more frequent disease outbreaks, the opioid epidemic, and increases in chronic diseases.

“Health departments are already understaffed and underfunded,” said Brian Castrucci, CEO of the de Beaumont Foundation. “The consequences of losing nearly half of an already-strapped workforce would put our country at great risk. These professionals do important work that most people don’t even realize is happening, preventing major diseases and outbreaks before they even happen. They also play an essential role in keeping communities healthy and safe, every day.”

Other findings:

  • Public health professionals are motivated by their mission, with 95% saying the work they do is important and they are determined to give their best efforts every day.
  • Generally, public health employees are satisfied with their jobs (81%), but only 48% are satisfied with their salary.
  • The public health workforce is aging. Millennials represent 22% of the workforce, compared with 35% of the national workforce.
  • There is a gap between leadership and line staff. A total of 67% of executives say creativity and innovation are rewarded in their agency, but only 41% of non-supervisory staff say this is so. A total of 69% of executives say communication among leadership and staff is good, but only 48% of non-supervisory staff agree.
  • Women are underrepresented at the executive level. The public health workforce is 79% female (compared with 51% of the national workforce), but for every 100 men, 4 reach the highest level of leadership, compared with only 2 of every 100 women.

Michael Fraser, CEO of ASTHO, said: “We hope that health officials, policymakers, and other stakeholders concerned with the nation’s health will consider these trends when formulating budgets, policies, and regulations that may help address the country’s need for safe, healthy communities.”

Lori Tremmel Freeman, CEO of NACCHO, said: “A skilled public health workforce is essential for protecting and improving the health and wellness of the public and responding to major health threats. We need to address the needs of the current workforce, communicate the value of public health, and equip future public health leaders with the skills necessary to carry out essential responsibilities.”

Chrissie Juliano, executive director of Big Cities Health Coalition, said: “These professionals are on the front lines of emergencies like the Ebola and Zika virus outbreaks, as well as efforts to contain the opioid epidemic, the surge in chronic disease that drives up health costs, and the sharp rise in teen e-cigarette use. These findings show us that this nation needs to get serious about building its health system by investing in the people who protect and promote the public’s health.”

Read the report, learn more, and see the data.

Written by Mark Miller

Mark Miller is the Vice President of Communications at the de Beaumont Foundation. Follow him on Twitter at @mmiller20910.