Facing the Future: Retirements, second careers to reshape state and local governments in the post-Katrina era


As many as 45 percent of public health workers are expected to retire within the next five years.

But this poll of 1,200 adults finds that only one in three Americans see this as a major problem for state governments, and only one in four see it as a problem for local government.

“We count on public health professionals to prevent the spread of disease, protect us from bioterrorist threats, make sure our food is safe to eat, and our air is safe to breathe,” said Elizabeth Kellar, executive director of the Center for State and Local Government Excellence.

“Those closest to the public health infrastructure know that the safety net is fragile. The public sector workforce is older than the private sector’s, and state and local governments are facing their greatest turnover ever. Public health is an area that already faces critical shortages, so there is no time to lose.”

Public health jobs: many vacancies, high turnover

Some states have vacancy rates as high as 20 percent in key public health positions, and turnover rates as high as 14 percent, according to data from the Association of State and Territorial Health Officials (ASTHO).

The most severe shortages are in epidemiology, public health nursing, and environmental health.

  • State health departments estimate they need 47 percent more epidemiologists than they have today, or nearly 1,200 new epidemiologists.

Part of the problem is finding workers to fill these slots.

  • More than half the states report that they lack enough qualified applicants, according to the ASTHO data.
  • Local governments report similar challenges.  Local public health departments say they will have problems finding qualified nursing candidates this year; nurses account for 24 percent of their work force.
  • Nearly 40 percent of local health departments also say they will have problems hiring qualified environmental health professionals, who monitor air and water quality.

Many Americans are interested in working in public health

The poll probed the public’s views of state and local government and found that:

  • Americans see working for state and local governments as a real possibility in the future.
  • One in five workers is very interested in taking a job at some point with state and local governments.
  • The numbers are even higher within specific areas of public health.  Two-thirds are interested in working in a hospital or other public health organization, while nearly 30 percent say they are very interested.

“The perception that jobs in public health would be attractive is an important one, for that is an area where a quiet talent crisis is building in state and local governments in the public health area,” according to the survey report, “Facing the Future.”


  • Some states and localities have provided increased support for education and training.
  • The federal government also can play a major role.  Legislation pending in Congress, “The Public Health Preparedness Workforce Development Act,” would establish loan repayment and grant programs for those pursuing degrees or training in public health preparedness or biodefense.  These kinds of efforts have been effective in recruiting prior generations of public health professionals and could be expanded to reach a wide range of public health workers.
  • Keeping salaries and benefits in-line with the private sector will be another key move.

“As even more of the public sector workforce becomes eligible to retire in the next five to 10 years, states and localities will need to sharpen their employment practices and offer competitive compensation and benefits to attract the talent they need,” said Kellar.


Public Health Workforce Struggles to Keep Up with Evolving Responsibilities

Fact Sheet: The Impending Shortage in the State and Local Public Health Workforce

ASTHO survey shows no improvement in workforce trends over last four years

National Association of County & City Health Officials (NACCHO)

CDC report: Public Health Preparedness: Mobilizing State by State (2/20/08)

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