Recent events like the Great Recession and the COVID-19 pandemic have strained resources and led to high turnover rates among employees of public health agencies across the United States. A new study from the University of Minnesota School of Public Health (SPH) and the National Association of County and City Health Officials (NACCHO) analyzes how these changes have impacted local health officials (LHOs)—the leaders responsible for directing local health departments in communities across the country.

Using data from two large national surveys—the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) and the 2022 NACCHO National Profile—the study compares newer and more experienced LHOs across a set of variables including age, education, race/ethnicity, and the size and location of their jurisdictions.

The study, published in Frontiers in Public Health, found:

• Nearly one-third of LHOs are new to their roles. Thirty percent of local health departments are headed by LHOs who have served in the position for less than two years.
• Demographic differences between newer and more experienced LHOs. This influx of new leaders are significantly more likely to be under age 40 and to identify as Black, Hispanic, Asian, or Native American.
• Newer LHOs have fewer advanced degrees, more likely to work in smaller health departments. In addition to lacking institutional knowledge, newer LHOs are less likely to have a Master’s or PhD, and more likely to be employed in smaller local health departments.

“Local health departments are the backbone of America’s system of public health, and local health officials play an essential role in making sure their local communities are safe and prepared to meet future health challenges,” said Chelsey Kirkland, SPH researcher and lead author. “We also know that the public health workforce can better serve their community when it is representative of the racial and ethnic composition of the people it is serving. While leadership turnover can disrupt operations and result in the loss of institutional knowledge, it also provides opportunities to diversify public health leadership. To help ensure the success of the next generation of public health leaders, we need renewed investment in training and leadership development programs that will ease the transition of leadership at our local health departments.”

The study calls for renewed investment in training and retention programs, such as the CDC’s Public Health Leadership Institute, NACCHO’s Survive and Thrive initiative, and newer efforts like the Diverse Executives Leading in Public Health (DELPH) program.

Funding support for the study was provided by the Robert Wood Johnson Foundation.