Expanding options to recruit, grow, and retain the public health workforce

The public health workforce continues to atrophy due to mass and early retirement, under-funding, slow hiring processes, lack of advancement opportunities, and shifting policies. Organizational research into workforce sustainability is crucial for ensuring a robust, diverse staff capable of delivering essential public health services. We examined career ladders, a potential solution to workforce challenges, through interviews with 10 health departments (HDs) across seven states. Interview participants were recruited from HDs using or planning career ladders held administrative positions, and had a role in the hiring process.Many health department positions have traditionally included steps within certain job classifications that promote pay adjustments with increasing years of service. Career ladder approaches, however, specifically focus on providing opportunities for health continuing education, leadership development, or movement into formal leadership roles.Findings indicate that HDs have begun utilizing career ladders for professional development and critical role maintenance. Career ladders have been applied mostly for retention with limited impact on recruitment and increasing staff diversity. Challenges include civil service requirements, funding limitations, and complex recruitment that might exclude diverse candidates.This study emphasizes the importance of transparent development, engaging front-line staff, offering advancement pathways, and providing insights to enhance workforce recruitment and retention. The public health workforce plays a critical role in ensuring positive health outcomes for patients; however, workforce atrophy is a problem the field faces. Lack of viable advancement opportunities limits both recruitment and retention opportunities in public health systems. This study examined career ladders as a potential solution for recruitment and retention issues within public health agencies. Findings emphasize the challenges facing the public health workforce as well as opportunities for mitigation strategies in public health settings. The American public health workforce faces a crisis in both recruitment and retention of health workers, ranging from clinic staff and health care providers to billing and coding professionals and leadership executives. However, ensuring an efficient and sustainable workforce is a key factor in ensuring optimum public health outcomes For this study, we interviewed staff members in public health settings to assess challenges and opportunities for addressing recruitment and retention barriers. Findings from this study shed light on the ways in which public health systems are using career ladders for recruitment and retention.