The First Nationally Representative Benchmark of the Local Governmental Public Health Workforce: Findings From the 2017 Public Health Workforce Interests and Needs Survey

Context: A changing public health landscape requires local governmental health departments (LHDs) to have a workforce prepared to meet complex challenges. While previous assessments looked at organizational data on the LHD workforce, the Public Health Workforce Interests and Needs Survey (PH WINS) is the first nationally representative survey to examine individual perceptions of training needs, workplace environment, job satisfaction, and awareness of emerging concepts in public health. Objectives: Characterize key interests and needs of the local governmental public health workforce. Design: Survey invitations were sent to individual LHD employees on the basis of a stratified sampling approach. The LHDs had to employ a minimum of 25 staff and serve a population of 25 000 or greater to be eligible for inclusion. Setting: 399 LHDs across the United States. Participants: A total of 26 533 LHD employees completed the survey (59% response rate). Results: The majority of local public health workers are female (81%, 95% confidence interval [CI]: 78%-84%) and white non-Hispanic (68%, 95% CI: 64%-72%). Of the nearly quarter of workers who declared an intent to leave within the next year excluding retirement (22%, 95% CI: 19%-25%), the most common reasons included pay (46%, 95% CI: 42%-50%), lack of opportunities for advancement (40%, 95% CI: 38%-50%), and workplace environment (30%, 95% CI: 27%-32%). Across jurisdiction size and supervisory level, skills gaps were noted in budget and financial management, systems and strategic thinking, developing a vision for a healthy community, and change management. Conclusions: As the first nationally representative sample of the local governmental public health workforce, these data create a national benchmark against which LHDs can measure their workforce. Given the similarities found across LHDs serving different jurisdiction sizes, a unified approach to workforce development should be employed across all LHDs. The LHD leadership should address retention, reward creativity and innovation, improve communication between leadership and employees, and provide opportunities for advancement.