Factors Associated with Deferred Enrollment in Master of Public Health Programs: An Analysis of 99,000 Accepted...

44% of the governmental public health workforce plans to retire by 2026, creating an urgent need to strengthen public health academic pathways. While prior research has examined various aspects of public health education, no studies have investigated Master of Public Health (MPH) deferral patterns. We identified demographic, institutional, and temporal factors associated with deferred enrollment among individuals accepted to MPH programs and evaluated whether associations varied across MPH concentrations in the five core public health disciplines (biostatistics, epidemiology, environmental sciences, health policy & management, and health education & behavioral sciences). We pooled data from the Schools of Public Health Application Service (SOPHAS) spanning the 2012-2013 through 2023-2024 application cycles. The outcome was deferred enrollment (deferred vs. immediately enrolled). Independent variables included demographic (age, sex, race/ethnicity, U.S. citizenship), institutional (type, Ivy League status, MPH program delivery format), and temporal (COVID-19 era indicator, time, time squared) characteristics. Modified Poisson regression estimated adjusted associations between each factor and deferral status. Of 99,143 accepted students, 8,196 (8.3%) deferred enrollment. Primary analyses indicated that older age, minoritized racial/ethnic identity, admission to hybrid MPH programs, and admission during the COVID-19 era were significantly associated with deferring MPH enrollment. Conversely, female sex, U.S. citizenship, and admission to public, Ivy League, or distance-based programs were significantly associated with immediate enrollment. Secondary analyses showed that associations varied across the five core public health disciplines. Future research should examine the specific reasons why accepted students choose to defer MPH enrollment through targeted follow-up data collection.