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Many public health practitioners dissatisfied with pay, 40% plan to leave by 2020

Significant turnover of public health employees is expected as approximately 40% of federal, state and local health department employees planning to leave their job in the next year or retire by 2020, according to data published in the American Journal of Public Health.

Many described dissatisfaction with their pay as a primary factor in the decision to leave their organization, according to the findings. However, the researchers also found that public health practitioners, largely, still enjoy their jobs, with majorities at various levels reporting job satisfaction.

“The mission of public health is to prevent disease, promote health and prolong life for the United States population through the core functions of public health (assessment, policy development and assurance),” Jonathon P. Leider, PhD, of the de Beaumont Foundation, in Bethesda, Maryland, and colleagues wrote. “To fulfill this mission, there are approximately 300,000 public health employees at the federal, state and local levels… High levels of employee turnover lead to a loss of expertise and institutional knowledge, high costs to the organization, and a decrease in organizational performance.”

To examine the demographics and drivers of job satisfaction, and the intent to leave one’s job, among public health practitioners, the researchers reviewed microdata from four groups: A sample of 6,562 federal employees from the CDC; 10,246 central office employees from state health agencies; 2,438 employees from local health departments that are part of the Big Cities Health Coalition; and 8,541 staff from smaller local and regional health departments.

The researchers drew their data from the 2014 Federal Employee Viewpoint Survey (FEVS) and the 2014 Public Health Workforce Interest and Needs Survey (PH WINS). The FEVS is conducted annually by the U.S. Office of Personnel Management and examines perceptions of job satisfaction among all federal employees. The PH WINS was conducted by the Association of State and Territorial Health Officials and the de Beaumont Foundation, which polled employees of state, regional and local health departments.

According to the researchers, approximately 90% of staff across all groups reported feeling their work was important, and between 60% and 65% felt their workload was reasonable.

State health agency staff had the lowest job satisfaction rate at 65%, compared with 67% among CDC staff and 69% for all local health departments. Staff at the CDC, which had the highest proportion of employees who made more than $75,000 per year, had the highest rate of satisfaction with pay, at 66%, compared with 48% at state central offices, 60% among local offices in the Big Cities Health Coalition, and 42% at smaller local and regional health departments. All else being equal, employees who were somewhat or very satisfied with their pay were three times more likely to be satisfied with their job (AOR = 3.11; 95% CI, 2.78-3.49).

Approximately 19% of CDC staff respondents reported they were planning to retire before 2020, compared with 24% at state central offices, 22% at local departments in the Big Cities Health Coalition, and 24% among smaller local health departments. In addition, a little more than a quarter of CDC employees and state central office staff said they were considering leaving their organizations in the next year, compared with a little more than a fifth of participants from local health departments. Overall, 40% of CDC, 42% of state central office, 38% of local health department employees were considering leaving their organization or planning to retire by 2020.

According to the researchers, staff who were somewhat or very satisfied with their job had reduced odds of planning to leave their organization in the next year (AOR = 0.37; 95% CI, 0.33-0.41). In addition, those who were satisfied with their pay, had higher levels of organizational support, and felt more employee involvement were much less likely to report plans to leave in the next year.

“Health agencies must plan for substantial turnover in coming years — both among scientific-technical and administrative staff,” Leider and colleagues wrote. “… If FEVS and PH WINS data are indeed representative of the public workforce nationally, then workforce development broadly, and succession planning specifically, will be among the most important tasks administrators can undertake in coming years.” – by Jason Laday

Disclosure: Leider reports providing consulting services for the de Beaumont Foundation, which funded the Association of State and Territorial Health Officials to conduct the PH WINS. See the full study for additional disclosures.