Will there be enough public health workers when baby boomers retire?

While there might be sufficient replacement staff, complications remain, according to a new study in the American Journal of Preventive Medicine


Ann Arbor, MI, January 17, 2018

Baby boomers are beginning to retire in large numbers and many professions will have to attract and train replacements. In particular, the governmental public health workforce will experience significant losses through retirement and attrition due to budgetary constraints. In a study in the American Journal of Preventive Medicine, researchers estimate that over one quarter of this workforce will disappear. They further project that while enough students graduate each year to replace retirees and others who voluntarily quit, they question whether the public health sector can compete with the private sector to hire qualified candidates.

According to Jonathon P. Leider, PhD, Associate Faculty at the Johns Hopkins Bloomberg School of Public Health, “the state and local public health workforce has shrunk by over 50,000 staff since the beginning of the 2008 Great Recession. Our estimates suggest almost one quarter of the governmental public health workforce plans to leave or retire in coming years. This represents the largest potential change to the workforce in decades, if not ever. But there are enough highly-educated students to meet this challenge – if public health can compete with the private sector to do so.”

In order to evaluate the current public health workforce and project future needs, researchers used large datasets on governmental public health staff and state health agencies: Association of State and Territorial Health Officials (ASTHO) and National Association of County and City Health Officials (NACCHO) 2016 profile surveys, the 2014 Public Health Workforce Interests and Needs Survey (PH WINS), and the 2016 Workforce Gaps Survey (WGS). They measured workforce size, assessed demand due to retirements and workforce reductions, and collected data on retirement eligibility vs. actual retirements.

Potential workforce supply was extracted from the US National Center for Education Statistics (NCES), which collects graduation, financial, staffing, and enrollment data from 7,400 US colleges and universities.

NACCHO data indicate that local health departments employed 147,000 full- and part-time staff in 2016, with about 103,000 employed by local governments and the remainder by state or local/state partnerships. State governments employ 50,000 staff directly and another 54,000, who work in the agency’s local or regional offices.

Researchers triangulated the number of staff planning to retire or quit, and how many followed through. In total, more than 65,000 staff will leave their organizations during fiscal years 2016–2020, with 100,000 staff leaving if all planned retirements occur by 2020. However, US colleges and universities now award more than 25,000 undergraduate and graduate degrees in public health each year, which could meet the demand for new staff caused by retirements and voluntary separations. They note that in some states, more than 50 percent of their workforce is eligible to retire, which could lead to localized problems with replacements.

“Because of the Great Recession beginning in 2008 and other economic considerations, staff are delaying retirement in unprecedented numbers,” noted Dr. Leider. “However, this can't last forever, and agencies will see the 'silver tsunami' show up if they haven't already. Our research helps quantify this challenge.”

On the supply side, the NCES estimates approximately 200,000 individuals received a formal public health degree at some level during 2000–2015. By 2020, an additional 55,000 undergraduate and 77,000 graduate public health degrees will be awarded, according to conservative estimates.

Although it appears that the mass retirements of baby boomers will be a manageable issue, “Workforce shortages are more than a mere numbers game, since the potential supply of workers far exceeds potential demand. We have to assist health departments recruit and retain highly qualified, trained staff to sufficiently meet future demands,” noted co-author Elizabeth Harper, DrPH, of the Association of State and Territorial Health Officials, Arlington, Virginia.

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Notes for editors
The article is “Reconciling Supply and Demand for State and Local Public Health Staff in an Era of Retiring Baby Boomers,” by Jonathon P. Leider, PhD, Fatima Coronado, MD, MPH, Angela J. Beck, PhD, MPH, Elizabeth Harper, DrPH (https://doi.org/10.1016/j.amepre.2017.10.026). It appears in advance of the American Journal of Preventive Medicine, volume 54, issue 3 (March 2018) published by Elsevier.

Full text of this article is available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734-936-1590 or ajpmmedia@elsevier.com. Journalists wishing to interview the authors should contact Elizabeth Harper, DrPH, Senior Director, Research and Evaluation, Association of State and Territorial Health Officials, at +1 571-318-5428 or eharper@astho.org.

Funding for this work was provided by the Centers for Disease Control and Prevention through a Cooperative Agreement with the Association of State and Territorial Health Officials (NU38OT000161). The authors thank staff at the National Association of County and City Health Officials for their assistance with the study and the de Beaumont Foundation for their support of the Public Health Workforce Interests and Needs Survey (PH WINS).

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. www.ajpmonline.org

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals advance healthcare, open science, and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com

Media contact
Jillian B. Morgan, MPH
Managing Editor, AJPM
+1 734-936-1590
ajpmmedia@elsevier.com