The State Public Health Workforce: Loving and Leaving Public Health

November 10, 2015|1:05 p.m.| Rivka Liss-Levinson

State health agencies play a critical role in protecting and promoting the health and well-being of the people they serve. To most effectively provide their vast array of services and activities, state health agencies need a talented, skilled, diverse, and properly trained workforce. Since the economic downtown in 2008, state health agencies have been forced to make cuts to their budgets, reducing the services they can provide and decreasing the size of their workforce by enacting hiring freezes and eliminating positions. At the same time, the average age of the current state health agency employee has continued to rise, and an increasing number of employees are now approaching retirement.

State public health agencies must retain a skilled workforce of sufficient size and training in order to successfully manage longstanding public health issues, worker attrition, and the continuous arrival of new and serious health threats like Ebola and measles. This is especially important given the substantial costs of recruiting, hiring, and training new staff.

ASTHO and the de Beaumont Foundation recently conducted the Public Health Workforce Interests and Needs Survey (PH WINS), the largest ever study of the U.S. public health workforce. The most recent Journal of Public Health Management and Practice supplement discusses several key PH WINS findings, including the fact that 26 percent of state health agency central office employees are considering leaving their jobs within the next year. Of this number, 5 percent of respondents plan to retire, 5 percent plan to take another governmental job in public health, 4 percent plan to take another governmental job not in public health, 2 percent plan to take a non-governmental job in in public health, 2 percent plan to take a non-governmental job not in public health, and 8 percent plan to leave for another reason.

There are several predictors of intentions to leave among state health agency workers:

  • Job Satisfaction: Employees who are dissatisfied with their jobs, organizations, and pay are less likely to intend to stay at their current jobs than other employees.
  • Workplace Environment: Individuals who feel less organizational support and lower levels of employee engagement are more likely to report intending to leave their positions than other employees.
  • Race and Ethnicity: Racial and ethnic minorities (non-whites) are more likely to report intending to leave their job in the next year than are white employees.
  • Tenure in Public Health: The shorter a state health agency employee’s tenure in public health, the more likely he or she is to intend to leave within the next year.
  • Geographic Region: Employees in the West (HHS regions 9 and 10) are more likely to report intentions to leave in the next year than individuals from other areas of the country.

These results suggest that state health agency human resource departments should focus on how to improve employee engagement and perceptions of organizational support in order to increase job satisfaction. Because the longer an employee is with an agency, the less likely he or she is to consider leaving, state health agencies should look at both organizational policies and informal practices that may encourage or discourage certain individuals from staying in their positions.

Despite the many challenges that state health agencies face regarding decreasing budgets and an increasingly aging workforce, there are many talented individuals dedicated to improving health and well-being through their service at state public health agencies. By recognizing employees’ achievements, encouraging professional development and training, and fostering a positive work environment, state health agencies have the potential to maintain a skilled workforce of adequate size and attract a dynamic, diverse state public health workforce of the future.

Rivka Liss-Levinson

Rivka Liss-Levinson, Ph.D., is the director of survey research at ASTHO. She has primary responsibility for the design and implementation of the ASTHO Profile Survey, develops and implements the Forces of Change Survey, collaborates on the Public Health Workforce Interests and Needs Survey (PH WINS), and responds to internal and external data requests. Liss-Levinson earned her doctorate in Applied Social Psychology from The George Washington University and her bachelor's degree in Psychology from Brandeis University.