Signs point to imminent public health workforce exit

New studies of the public health workforce reveal signs of unprecedented change ahead. Notably, 38 percent of state public health workers plan to leave the public health workforce by 2020, either to retire or to pursue positions in other sectors.

"We have been concerned for some time that an aging state agency workforce would be retiring. This survey shows that many younger workers also plan to leave their public health positions," said Association of State and Territorial Health Officials (ASTHO) Executive Director Paul Jarris, MD, MBA. "Maintaining a vibrant, well-educated, and agile public health workforce is vital to supporting our efforts to serve the health of the nation, and we face a larger challenge than we expected in retaining a talented, effective public health workforce."

The Journal of Public Health Management and Practice (JPHMP) compiled the new studies in a special supplemental edition that analyzes data from the Public Health Workforce Interests and Needs Survey (PH WINS). PH WINS is the largest-ever study of the public health workforce and was conducted by the de Beaumont Foundation and ASTHO. The JPHMP supplement is made up of peer-reviewed research and expert commentaries examining workforce characteristics, public health skills and capacities, and policy trends. PH WINS infographics based on the supplement are available on the ASTHO website.

"This survey points to issues we must work together to address," said Edward L. Hunter, CEO of the de Beaumont Foundation. "We need to redouble our efforts to reinvent workforce structures to reward creativity and innovation, provide opportunities for ongoing professional development, and engage with young and mid-level public health professionals in order to retain our best and brightest and build the workforce we need for the future."

Key findings included:

• Considerable workforce turnover. According to the survey, 38 percent of workers plan to leave their current position before 2020. Of those planning to leave, 25 percent plan to retire and 13 percent plan to leave for a position outside of public health. Of note, those most likely to leave for reasons other than retirement include individuals aged 25-40, racial and ethnic minorities, and those with fewer than 10 years of experience in public health.
• Progress on pay gaps by gender and race. Pay disparity in public health is better than the private sector and other areas of government, but more work remains to be done. Women and people of color make less than their white male counterparts despite the fact that the public health workforce is predominantly female and relatively diverse. On average, both women and people of color in state public health agencies earn 90 to 95 cents on the dollar compared to their male and white counterparts, after matching for seniority, experience, and educational attainment. There is no pay gap between Asian staff and their white counterparts.
• Need for continued efforts to improve diversity. Only 7 percent of public health workers are Hispanic/Latino, compared to 17 percent of the general population. However, both the Black and Asian public health workforce are represented in proportion to the population as a whole, at 13 percent and 5 percent, respectively. Nevertheless, 70 percent of the workforce identifies as white, indicating room for improvement in supporting people of color in public health.