Public Health Workforce Development Needs: A National Assessment of Executives’ Perspectives

Jonathon P. Leider, Fatima Coronado, Kyle Bogaert, Elizabeth Gould

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Workforce development is one of the ten essential public health services. Recent studies have better characterized individual worker perceptions regarding workforce interests and needs, but gaps remain around workforce needs from program managers’ perspectives. This study characterized management perspectives regarding subordinate's abilities and training needs and perceived challenges to recruitment and retention. Methods: In 2017, the Directors Assessment of Workforce Needs Survey was sent to 574 managers at state health agencies across the U.S. Respondents were invited based on the positions they held (i.e., to be included, respondents had to be employed as managers and oversee specific program areas). In 2018, descriptive statistics were calculated, including Fisher's exact for inferential comparisons and Tukey's test for multiple comparisons, as appropriate. Results: Response rate was 49% after accounting for undeliverable e-mails; 226 respondents met the inclusion criteria. The largest perceived barriers to staff recruitment were wages or salaries (74%) and private sector competition (56%). Similarly, wages or salaries were identified as the main cause of turnover by 70% of respondents, followed by lack of opportunities for advancement (68%), and opportunities outside the agency (67%). Conclusions: The Directors Assessment of Workforce Needs Survey fills important knowledge gaps and complements previously identified evidence to guide refinement of workforce development efforts. Although competition from the private sector remains challenging, these findings indicate that recruitment and retention must be top priorities in state health agencies nationwide. Prioritizing individual state health agency workforce gaps and committing to provide specific local-level interventions to those priorities is crucial for individual health agencies.

Original languageEnglish (US)
Pages (from-to)e153-e161
JournalAmerican journal of preventive medicine
Issue number5
StatePublished - May 2019

Bibliographical note

Funding Information:
The Directors Assessment of Workforce Needs Survey project was funded by the U.S. Centers for Disease Control and Prevention through a cooperative agreement with the Association of State and Territorial Health Officials. Dr. Leider was a contractor to ASTHO for this project. The authors thank Caitlin Langhorne, Christina Whang, and Purni Abeysekara for their assistance.

Publisher Copyright:
© 2019 American Journal of Preventive Medicine


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