A new study from the University of Minnesota School of Public Health (SPH) adds to a body of research analyzing the alarming state of the public health workforce in the United States, which was understaffed even before the COVID-19 pandemic further eroded it. The SPH analysis integrates four public health workforce surveys to better understand why people leave the public health workforce — and what steps could be implemented to retain these workers

“Public health workforce numbers are unsustainable at best, and dire at worst,” said Nicole Weiss, researcher at SPH’s Center for Public Health Systems. “A better understanding of public health workforce turnover is critical to improving recruitment and retention across the field of public health.”

To examine employee turnover rates, SPH researchers analyzed four public health workforce surveys — the Public Health Workforce Interests and Needs Survey, the National Association of County and City Health Officials (NACCHO) Profile, the NACCHO Forces of Change survey, and the Association of State and Territorial Health Officials Profile.

The study, which was published in Frontiers in Public Health, found:

• 31% of the public health workforce reported considering leaving their positions at some time in the future.
• While stress and burnout were important factors driving these decisions, a lack of a path forward in their careers and a lack of satisfactory supervision were also major factors.
• The majority of public health agencies reported that zero vacancies had been filled in both 2018 and 2019.

The authors note that the findings underscore the need for improvements in the recruitment, retention, and onboarding practices of public health agencies so they are better able to attract and retain the most qualified candidates.

“Future research should seek to translate these findings into policies that help to streamline and simplify the governmental public health hiring and onboarding process,” Weiss said. “Only by properly staffing our public health workforce can we transform public health from a field that reacts to threats into a field that prevents them.”

The research was supported by the Centers for Diseases Control and Prevention and the Health Resources and Services Administration.