High Number of Public Health Workers Consider Leaving Jobs

Originally published by our sister publication Infectious Disease Special Edition

By Ethan Covey

More than 40% of public health workers may leave their jobs during the next five years, according to results from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS).

The findings demonstrate the strain that many public health workers have been under during the COVID-19 pandemic (MMWR Morb Mortal Wkly Rep 2022;71[29]:920-924).

“PH WINS is the only nationally representative survey of state and local government public health workers in the U.S., and it provides important insight on the workforce’s interests and needs,” said Rachel Hare Bork, PhD, the director of research and impact at the de Beaumont Foundation, in Bethesda, Md..

“These findings underscore the need to recruit and retain a diverse, knowledgeable and experienced workforce—characteristics that will be essential as the workforce and our country continues to recover and rebuild from the COVID-19 pandemic,” Dr. Hare Bork added.

The survey included the responses of 41,890 staff members from 47 state health agency central offices and 190 large local health departments (LHDs), serving populations of more than 250,000 people, and 249 medium LHDs serving populations of 25,000 to 250,000 people.

Demographic data showed that a majority of the governmental public health workforce are white (54%), women (79%) and over the age of 40 years (63%). Greater levels of diversity were seen among employees and executives at large LHDs, compared with smaller departments.

“While the governmental public health workforce is more racially and ethnically diverse than the overall U.S. workforce, it is not as diverse as the constituents its services target,” Dr. Hare Bork said. “In addition, there was less racial and ethnic diversity among public health professionals at the executive level than the workforce as a whole.”

A majority of survey respondents (72%) reported working in a COVID-19 response role from March 2020 to January 2022. Approximately 80% of staff at midlevel LHDs reported working to respond to COVID-19, compared with 75% at large LHDs and 62% at state health agency central offices.

The strain of the pandemic was overwhelmingly documented.

Among survey respondents, 44% reported considering leaving their organizations to retire or for other reasons, and 76% reported they had begun thinking about leaving since the start of the pandemic. Over half of the respondents noted that additional staff capacity is necessary in order to continue the COVID-19 response.

“The public health workforce has experienced an unprecedented two years, and despite being committed to their jobs and communities, many are struggling,” Dr. Hare Bork said. “The COVID-19 pandemic has caused ongoing strain for the workforce, who reported high levels of stress, burnout and intent to leave during the survey period. More than half of public health workers reported symptoms of PTSD [post-traumatic stress disorder], and more than two in five executives experienced bullying, threats or harassment during the pandemic.”

Brian C. Castrucci, DrPH, MA, the president and CEO of de Beaumont, noted that the impact of such outcomes would be severe.

“When people leave the workforce, we lose talent and experience that are crucial as we prepare for future public health crises,” he said. “Without them, the public is at greater risk. Retaining the experts we have, investing in public health infrastructure, and staffing up state and local health departments to provide essential services are critical to meeting our current and future public health needs.”