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The State of the States: Workforce Trends and Challenges in State Health Departments From the 2024 Public Health
Lindsey Myers1, Moriah Robins, Omar Khalid
1Author Affiliations: Public Health Workforce and Infrastructure, Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Ms Myers); de Beaumont Foundation, Bethesda, Maryland (Ms Robins); Workforce Department, Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Mr Khalid and Ms Rothenbuecher); Public Health Agency Research, Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Dr Sessions); and Public Health Agency Research and Business Intelligence, Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Dr Jones).
Context:
The 2024 Public Health Workforce Interests and Needs Survey (PH WINS) offers important data on the composition, well-being, and training needs of the public health workforce in the post-COVID-19 era.
Objective:
To characterize the state governmental public health workforce in 2024 and provide a comparison to the 2021 survey.
Design:
State health agency leaders were invited to have their workforce participate in PH WINS 2024. Participating agencies provided staff lists used to send e-mail invitations to employees to participate in this electronic survey.
Setting:
State health agencies.
Participants:
State health agency central office staff.
Main Outcome Measure:
PH WINS 2024 maintains the domains from previous fieldings (ie, workplace engagement, training needs assessment, emerging public health concepts, well-being, and demographics).
Results:
The proportion of staff aged 35 and under increased approximately 4% from 20% in 2021 (95% CI: 20%-21%) to 24% in 2024 (95% CI: 23%-24%). State health agency central office staff with 5 or fewer years in their current agency increased from 49% (95% CI: 48%-50%) in 2021 to 55% (95% CI:54%-56%) in 2024. Self-reported mental health improved with the proportion of those rating their mental and emotional health as poor or fair in 2021, 5% (95% CI:4%-5%) and 18% (95% CI: 17%-19%), respectively, decreasing to 3% (95% CI: 3%-3%) and 15% (95% CI: 14%-15%), respectively, in 2024. The top 3 strategic skill training needs in 2024 were budget and financial management (48%; 95% CI: 47%-49%), policy engagement (38%; 95% CI: 37%-39%), and systems and strategic thinking (34%; 95% CI: 33%-34%).
Conclusion:
The 2024 PH WINS results indicate demographic shifts toward a state health agency central office workforce that is younger in age and tenure and positive improvements in key workforce well-being indicators that can inform future public health infrastructure investments and field practices to ensure a robust public health system.
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