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Yeager VA, Krasna H. When Money Is Not Enough: Reimagining Public Health Requires Systematic Solutions To Hiring Barriers. Health Aff (Millwood) 2024; 43:840-845. [PMID: 38830170 DOI: 10.1377/hlthaff.2024.00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Public health departments in the US have experienced workforce shortages and challenges in recruiting new employees for decades. Reimagining the public health system will require sufficiently staffed health departments. This Commentary summarizes what is known about the issues that state and local health departments face during the hiring process, with a focus on civil service and merit-based hiring barriers. Although health departments have recently received funding to recruit new employees, they still struggle to hire them. Recommendations for change include tracking hiring process metrics; implementing formal quality improvement to strategically resolve delays; developing formal pathways for converting fellows, interns, and contractors into staff positions; and initiating workarounds in the short term and legal changes to hiring rules as necessary and feasible.
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Leider JP, Shah GH, Yeager VA, Yin J, Madamala K. Turnover, COVID-19, and Reasons for Leaving and Staying Within Governmental Public Health. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:S54-S63. [PMID: 36223500 PMCID: PMC10573096 DOI: 10.1097/phh.0000000000001634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Public health workforce recruitment and retention continue to challenge public health agencies. This study aims to describe the trends in intention to leave and retire and analyze factors associated with intentions to leave and intentions to stay. DESIGN Using national-level data from the 2017 and 2021 Public Health Workforce Interests and Needs Surveys, bivariate analyses of intent to leave were conducted using a Rao-Scott adjusted chi-square and multivariate analysis using logistic regression models. RESULTS In 2021, 20% of employees planned to retire and 30% were considering leaving. In contrast, 23% of employees planned to retire and 28% considered leaving in 2017. The factors associated with intentions to leave included job dissatisfaction, with adjusted odds ratio (AOR) of 3.8 (95% CI, 3.52-4.22) for individuals who were very dissatisfied or dissatisfied. Odds of intending to leave were significantly high for employees with pay dissatisfaction (AOR = 1.83; 95% CI, 1.59-2.11), those younger than 36 years (AOR = 1.58; 95% CI, 1.44-1.73) or 65+ years of age (AOR = 2.80; 95% CI, 2.36-3.33), those with a graduate degree (AOR = 1.14; 95% CI, 1.03-1.26), those hired for COVID-19 response (AOR = 1.74; 95% CI, 1.49-2.03), and for the BIPOC (Black, Indigenous, and people of color) (vs White) staff (AOR = 1.07; 95% CI, 1.01-1.15). The leading reasons for employees' intention to stay included benefits such as retirement, job stability, flexibility (eg, flex hours/telework), and satisfaction with one's supervisor. CONCLUSIONS Given the cost of employee recruitment, training, and retention of competent employees, government public health agencies need to address factors such as job satisfaction, job skill development, and other predictors of employee retention and turnover. IMPLICATIONS Public health agencies may consider activities for improving retention by prioritizing improvements in the work environment, job and pay satisfaction, and understanding the needs of subgroups of employees such as those in younger and older age groups, those with cultural differences, and those with skills that are highly sought-after by other industries.
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Affiliation(s)
- Jonathon P. Leider
- University of Minnesota School of Public Health (SPH) and SPH Center for Public Health Systems (CPHS), Minneapolis, Minnesota (Dr Leider); Departments of Health Policy and Community Health (Dr Shah) and Biostatistics, Epidemiology, and Environmental Health Sciences (Dr Yin), Jiann-Ping Hsu College of Public Health Georgia Southern University, Statesboro, Georgia; Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Dr Yeager); and Oregon Health Authority, Public Health Division and Multnomah County Health Department, Portland, Oregon (Dr Madamala)
| | - Gulzar H. Shah
- University of Minnesota School of Public Health (SPH) and SPH Center for Public Health Systems (CPHS), Minneapolis, Minnesota (Dr Leider); Departments of Health Policy and Community Health (Dr Shah) and Biostatistics, Epidemiology, and Environmental Health Sciences (Dr Yin), Jiann-Ping Hsu College of Public Health Georgia Southern University, Statesboro, Georgia; Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Dr Yeager); and Oregon Health Authority, Public Health Division and Multnomah County Health Department, Portland, Oregon (Dr Madamala)
| | - Valerie A. Yeager
- University of Minnesota School of Public Health (SPH) and SPH Center for Public Health Systems (CPHS), Minneapolis, Minnesota (Dr Leider); Departments of Health Policy and Community Health (Dr Shah) and Biostatistics, Epidemiology, and Environmental Health Sciences (Dr Yin), Jiann-Ping Hsu College of Public Health Georgia Southern University, Statesboro, Georgia; Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Dr Yeager); and Oregon Health Authority, Public Health Division and Multnomah County Health Department, Portland, Oregon (Dr Madamala)
| | - Jingjing Yin
- University of Minnesota School of Public Health (SPH) and SPH Center for Public Health Systems (CPHS), Minneapolis, Minnesota (Dr Leider); Departments of Health Policy and Community Health (Dr Shah) and Biostatistics, Epidemiology, and Environmental Health Sciences (Dr Yin), Jiann-Ping Hsu College of Public Health Georgia Southern University, Statesboro, Georgia; Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Dr Yeager); and Oregon Health Authority, Public Health Division and Multnomah County Health Department, Portland, Oregon (Dr Madamala)
| | - Kusuma Madamala
- University of Minnesota School of Public Health (SPH) and SPH Center for Public Health Systems (CPHS), Minneapolis, Minnesota (Dr Leider); Departments of Health Policy and Community Health (Dr Shah) and Biostatistics, Epidemiology, and Environmental Health Sciences (Dr Yin), Jiann-Ping Hsu College of Public Health Georgia Southern University, Statesboro, Georgia; Department of Health Policy & Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana (Dr Yeager); and Oregon Health Authority, Public Health Division and Multnomah County Health Department, Portland, Oregon (Dr Madamala)
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Fischer F, Wicherski J, Tobollik M, McCall T. Experiences Shared by the (Future) Public Health Workforce during the COVD-19 Pandemic in Germany: Results of a Survey on Workload, Work Content, and Related Challenges among Students and Young Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11444. [PMID: 36141717 PMCID: PMC9517565 DOI: 10.3390/ijerph191811444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Although previous studies have focused on the adverse effects of the COVID-19 pandemic on various professional groups (particularly in the health and nursing care sector), this study aims to close a research gap by assessing perspectives of students and young professionals in epidemiology and public health in Germany in terms of shifts in workload, work content, and related challenges caused by the pandemic. We conducted a cross-sectional survey between mid-February and mid-March 2022. Quantitative data were analyzed via standardized mean differences. Qualitative data based on answers to open-ended questions were analyzed via a qualitative content analysis. Overall, 172 individuals participated in this survey. Results indicate that students felt burdened the most by lack of exchange with other students and lecturers. Study participants employed in public health experienced changes in their employment because they had changes in their work content- and administration, which was accompanied by a high burden due to the workload. Multiple demands that can have an impact on both acquired skills and mental health during the professional qualification phase were mentioned by the participants. Therefore, more in-depth analyses are needed to investigate the impact the pandemic will have on the (future) public health workforce in the long run.
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Affiliation(s)
- Florian Fischer
- Institute of Public Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, 87437 Kempten, Germany
| | - Julia Wicherski
- Division 5 Research, Federal Institute for Drugs and Medical Devices, 53175 Bonn, Germany
| | - Myriam Tobollik
- Section II 1.5 Environmental Medicine and Health Effects Assessment, German Environment Agency, 14193 Berlin, Germany
| | - Timothy McCall
- Medical School OWL, Bielefeld University, 33615 Bielefeld, Germany
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