What does the public health workforce need to stay engaged, supported, and committed, and how can leaders act on those insights? Heather Krasna, Associate Dean of Career and Professional Development, Columbia University Mailman School of Public Health joins us to break down new research on what younger public health workers value most at work. She explains why flexible schedules, remote or hybrid options, professional development, student loan repayment, and family-friendly benefits are increasingly important for retention, and how agencies can think creatively when salary increases aren’t always possible. Then, Omar Khalid, Director of Workforce at ASTHO, walks through key findings from the 2024 Public Health Workforce Interests and Needs Survey (PH WINS), the only nationally representative survey of the governmental public health workforce. He discusses why high turnover, burnout, and loss of institutional knowledge remain urgent concerns, alongside encouraging signs of improved supervisor relationships and workforce commitment.
Journal of Public Health Management and Practice
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This is Public Health Review
Morning Edition for Thursday,
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January 22nd, 2026.
I'm John Sheehan for the
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Association of State and.
Territorial health officials,
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today we take a look at the
public health.
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Workforce and ask what these
professionals need to stay
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engaged, supported and
committed, and how leaders can
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act on those insights.
Heather Krasna, associate Dean
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of career and professional
development at Columbia
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University Mailman School.
Of public health.
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Joins us to breakdown new
research on what younger.
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Public health workers.
Value most at work and later.
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Asto's director.
Of workforce Omar Khalid will.
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Walk us through.
Key findings from the 2024.
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Public health workforce.
Interests and Needs survey or pH
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wins the only nationally
representative survey of the
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governmental public health.
Workforce, he'll discuss.
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Why?
High turnover, burnout and loss
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of institutional knowledge
remain urgent concerns, along
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with encouraging signs of
improved supervisor
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relationships and workforce
commitment.
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But first.
Here's Heather Krasna discussing
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a recent study from the Mailman
School of.
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Public Health.
Showing that younger workers
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prefer non traditional work
benefits.
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To a degree.
More than older workers, things
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like flexible schedules, remote
work, and more training.
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I wanted to know how public
health agencies should interpret
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these responses.
Many local and state tribal and
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territorial health departments
have had trouble keeping younger
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employees at the organization
and there is the opportunity to
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try to improve retention by
offering some of these less
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traditional benefits.
Our study shows that younger
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workers value these sort of non
traditional benefits.
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So as an example, if the
organization has the option to
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offer remote work from time to
time at least, or hybrid
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options, that could be a way of
helping retain some of the
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younger workers.
It's also shown that they
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appreciate flex time if that's
another option.
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Some people have workplaces
where they might work four days
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a week, a few a few extra hours
or extra hour each day and then
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have that maybe the Friday off.
One of the other things that we
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saw in our study was that
certain benefits that have to do
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with childcare, lactation
facilities, things like that are
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also really attractive to
younger workers.
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And one reason possibly is, is
that as probably many people
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know, overall the public health
workforce does tend to skew more
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towards female workers.
So because of that, those
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particular benefits might be a
bit more attractive to this
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group.
And the other thing that we
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noticed is that supporting
lifelong learning, professional
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development or student loan
repayment or forgiveness
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programs are very, very
important for the younger
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workers.
And this also is common sense
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that people who are younger most
likely have finished their
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degrees more recently and they
also unfortunately are more
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likely to have debt.
And so options where there might
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be public service loan
forgiveness or some of the other
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healthcare related loan
repayment programs through the
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National Health Service Corps,
those types of options can be
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really beneficial, especially to
younger workers.
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Yeah.
And it strikes me that's sort of
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the the story of the broader
workforce across the country
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that younger workers have gotten
used to non traditional
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benefits, flex time, remote
work.
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It also strikes me that in
healthcare that's particularly
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challenging.
It sounds like you're sort of
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prescribing a combination of,
you know, of, of flex time, but
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also other, other benefits that
they they want as much such as,
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such as training, such as as
more maneuverability and and
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debt repayment.
And it's true that not every
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single job can offer these types
of flexibilities.
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Not every health department has
that option to allow hybrid
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work.
Certain jobs just can't be done
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remotely.
If you imagine the health
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inspector, for instance,
environmental health specialist,
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for instance, they may not be
able to do that work remotely,
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but there could be days where
they're doing reporting and
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paperwork.
Maybe those days can be done
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remotely.
These are things just to be
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creative and think about if the
job can be structured a certain
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way.
One thing I have to say that is
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really important to say out loud
is that the most beneficial
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thing is often times to increase
the salaries, if that's
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possible.
But knowing how hard that is,
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that's where we would suggest to
think outside the box a little
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bit.
And if you can't increase
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someone's salary, what could you
do that might make the job
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easier for them to stay?
And if that includes helping
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them get student loans forgiven
or repaid, or offering those
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flexibilities or training
benefits, that's something
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that's a little easier to do for
many organizations than to
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increase the salaries.
Absolutely.
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And all of the solutions that
you're talking about, you know?
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There are long term.
Implications there.
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It's, it sounds like a much
bigger culture shift across
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across all workforces, but
particularly in public health, a
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shift that kind of has to happen
and has been happening no matter
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what.
Exactly.
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You know, I would say some
people make a big deal about how
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there are different generations
of people in the workforce, and
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that's somewhat a case.
There's something to be said for
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that.
There may be Gen.
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X and the Millennials and so
forth, and they might have
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different values at work, but
there's also the fact that
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people are in different phases
of their life.
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And if someone is younger, maybe
they're starting a family, they
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may have certain needs or things
that you can do to support them
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with their life in that take in
that phase of their life.
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Or if it's a younger person and
they just want to get as much
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experience as possible and they
want to have the opportunity to
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learn more things or take on new
responsibilities, if there's the
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opportunity to allow that,
that's something that can be
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really beneficial.
So when people are starting out
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their career, which is also what
happens when people are younger,
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what can a supervisor do to be
not just a regular supervisor
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but possibly a mentor or to help
the person identify other people
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that could be a support or a
mentor?
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And Heather, could I ask you to
maybe expand on that?
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A.
Little.
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More for, say, maybe an agency
head who's staring down these
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cultural shifts and is resistant
to change.
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But sees this.
Small but growing cohort of
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their workforce, you know,
asking over and over again for
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these kinds of accommodations.
What's your advice there?
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What's what's what are some baby
steps to getting some changes in
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place?
Great question.
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I think that the very first
thing is to listen to people.
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There are lots of ways you can
do a what they call a climate
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survey or some other way to
gather anonymous feedback from
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people in the workforce.
There's also plenty of data now
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from the public health Workforce
Interest and needs survey. pH
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wins.
And if you are a supervisor of
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people and you need to justify
why you need to make a change in
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the workplace, that data will
probably support that decision.
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And the other thing which I
always will say out loud is that
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turnover is really expensive.
And it's not just expensive
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because your community is now
going to be missing someone
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whose job is is to support the
community's health, whether that
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person is inspecting restaurants
or dealing with the vital
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statistics and birth
certificates and so forth, or an
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epidemiologist that's tracking
some outbreaks.
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The community's health could
suffer if you don't have
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sufficient workers and they're
engaged in their job doing that
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work.
That is a really huge challenge.
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And so putting dollars on that
lack of workforce is something
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that health department leaders
can try to do And to to, you
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know, tie it back to things that
have an impact on the community.
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What is the economic impact if
you suddenly have more cases of
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an infectious disease?
How is that impacting all the
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employers in the region where
their workforce is having to
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call out sick or something?
And then the piece about
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turnover itself is that's also
very expensive.
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If somebody leaves, now you have
a vacancy and you have to fill
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that vacancy.
And it's not just the maybe the
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cost of trying to advertise the
job or something, but you could
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end up taking up so much staff
time to hire a new person to
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train that new person to onboard
them.
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So it's not just harming the
community.
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It's also expensive to the
taxpayer if there is a lot of
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turnover in a health department.
These are all just different
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arguments.
People can try to make the case
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for why public health is so
important and why the people
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doing that hard work who are on
the front lines in public
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health, their work really
matters and supporting them is
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essential.
Heather Krasna is associate Dean
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of career and professional
development at Columbia
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University's Mailman School.
Of public health.
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The results of the 2024 Public
Health Workforce Interests and
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Needs Survey, or pH Wins, were
recently released, and it's the
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only nationally representative
survey of the governmental
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public health.
Workforce.
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Here's Asto's director of
workforce Omar Khalid, to talk
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more about the results,
specifically that a significant
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portion of the workforce is
considering leaving the field.
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Of course, it's a snapshot in
time.
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There was a window in the
second-half of 2024.
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But we know there were some
really big changes after the
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pandemic, right?
Maybe that was a little more
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gradual as things returned
closer to normal, though.
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Never.
Things were never quite the same
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again.
Haven't been since 2020, but we
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also know that the workforce was
struggling and letting us know
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important needs of theirs even
before the pandemic.
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But we did see that even in the
2024 data that there was what is
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really troubling data about the
the conditions of some
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individuals in terms of burnout
and, you know, looking to leave
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the profession.
So we know this is an urgent
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message in the data.
And we also know that things
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have not gotten easier in 2025
and then, you know, the weeks
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really that followed the
completion of the fielding of
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the 2024 survey.
There's still need for support.
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There's still need for enhancing
training around certain topics
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so that people feel more
supported in their day-to-day
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work in public health agencies.
So I think that's one of the
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main takeaways of these findings
in 2024 is that we still have
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some work to do even if things
had stayed at an even keel from
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the time of fielding.
And all the difficulties that
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we've seen since then,
including, you know, reductions
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in force, losses of funding,
some confusion around future
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directions with maybe the
absence of some guidance and how
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to plan for the continuation of
some of these programs has just
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been an additional challenge
that we know we have to meet as
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well.
Yeah.
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And perhaps a complimentary take
away from the most recent report
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shows that there are a lot of
new workforce members, about
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half have been at their agencies
for five years or less.
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So how does that add difficulty
to the situation?
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How does that sort of color the
results?
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Well, it's great.
I think we do always want to,
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you know, welcome new ideas and
new perspectives represented
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from these new people coming to
the workforce.
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That's a a great thing
recruiting and, you know,
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advertising how great public
health is as a career.
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It is something we want to see,
even though it it is always hard
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to replace the institutional
knowledge and the experience of
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the people who have laughed.
So of course there's kind of two
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sides to that coin.
The first one is we have a great
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opportunity to have a fresh
perspective in public health,
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maybe new voices, maybe people
who weren't previously
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represented in health agencies
are being able to see a few more
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of those perspectives.
But at the same time,
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realistically coming to terms
with the fact that especially in
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a relatively short amount of
time, losing a lot of those
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longer tenured employees from
our agencies and thinking about
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how do we address that loss
first and foremost.
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And then also how do we plan for
doing it better?
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How do we plan for those
separations affecting agencies
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and critically, the work that we
provide to keep communities
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healthy without interruption
going forward?
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And I think it's a great
reminder that that's something
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you have to design a system for,
which we're so great at doing in
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public health.
You know, how do we design a
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system to mitigate the damage
from loss of institutional
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knowledge, whether it's
succession planning?
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And, you know, that doesn't just
mean, you know, how are you
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going to replace someone in a
position and say, OK, great,
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that's not a vacancy anymore.
Really succession planning is
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how are you planning for that
transfer of, you know, the most
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important knowledge?
How do you keep some of these
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initiatives on track despite key
personnel leaving?
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And that's really something you
have to be intentional about and
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plan for.
And I think the last few years
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have really highlighted the need
for that.
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And we're hearing a lot of ways
that people are taking that more
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seriously and being more
intentional about doing it, to
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have it be a net positive that
we're getting a lot of new
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staff.
And of course, people are
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choosing to end their careers,
hopefully at a time of their
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choosing, without affecting the
work of public health too
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greatly.
Yeah.
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And the report calls for
investments, serious investments
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in a permanent workforce, moving
away from those temporary roles.
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And you know, that cost money.
How does that happen and who
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needs to be convinced to make
those investments?
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00:14:14,840 --> 00:14:19,920
Well, we're currently operating
under the historic investment in
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public health infrastructure,
including workforce through the
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CD CS public health
infrastructure grant.
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That has really allowed a lot of
really all of the state public
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health agencies and as well as
state and territorial really
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associated States and some big
city, local health departments
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and city health departments to
make those hires to hire people
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that are committed to doing the
work of workforce, right
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thinking about infrastructure
full time and how to support the
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workforce.
And I think that the successes
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and the examples of all of those
jurisdictions, you know, midway
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through roughly that investment
show that this can work.
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An investment in public health
workforce does really have an
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impact.
Of course, nothing is permanent
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in government and especially in
public health funding.
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We're used to a a sort of grant
cycle and that does have a
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natural ebb and flow to it.
But our hope is that we'll be
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able to tout the success of
investments like the Public
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Health Infrastructure Grant and
others that focus on
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00:15:20,000 --> 00:15:24,960
infrastructure to really improve
how health agencies operate so
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that they can do the best job
they can do to keep our
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00:15:28,040 --> 00:15:33,400
community safe.
And the report isn't all bad
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00:15:33,400 --> 00:15:38,040
news. 2024 showed improvements
in workforce commitment and
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00:15:38,040 --> 00:15:40,720
supervisor satisfaction, and a
reduction in burnout.
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00:15:41,040 --> 00:15:46,480
So do we know or can we pinpoint
any policies or shifts that
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00:15:46,480 --> 00:15:49,600
contributed to that?
Well, I'll first give a caveat
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00:15:49,600 --> 00:15:53,720
that it is difficult to provide,
you know, with certainty and
282
00:15:53,720 --> 00:15:56,560
point to something and saying,
you know, this had this effect,
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00:15:56,560 --> 00:15:59,120
especially when you're talking
about things that, you know,
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maybe they're a little fuzzy.
They're talking about how people
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00:16:00,720 --> 00:16:03,880
feel and you know, what's behind
their complex decisions to to
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00:16:03,880 --> 00:16:05,680
stay or to leave or around
morale.
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00:16:05,800 --> 00:16:08,560
But we still know that it's
real, even if we can't draw a
288
00:16:08,560 --> 00:16:11,600
crystal clear line between
inventions that that we do in
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00:16:11,600 --> 00:16:13,920
the workplace and why people
want to stay.
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00:16:13,920 --> 00:16:16,640
We, we can't listen to what
people are saying they want and
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00:16:16,640 --> 00:16:19,640
what is working.
We can start by asking them and
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00:16:19,640 --> 00:16:22,880
communicating with them.
But one of my favorite pieces of
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00:16:22,880 --> 00:16:28,640
data from the 2024 pH wins is
that people have increased
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00:16:28,640 --> 00:16:31,200
support and, and they enjoy
their relationships with their
295
00:16:31,200 --> 00:16:34,640
direct supervisor.
And that is often the number one
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00:16:35,040 --> 00:16:37,480
retention tool than any agency
has.
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00:16:37,960 --> 00:16:40,000
You know, there's the adage that
people don't quit their jobs,
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00:16:40,000 --> 00:16:41,920
they quit their supervisors.
And and, you know, luckily,
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00:16:41,920 --> 00:16:44,760
we're seeing that more people
are satisfied with that
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relationship in public health
agencies.
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00:16:46,880 --> 00:16:49,760
But at the same time, the people
who are reporting the highest
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00:16:49,760 --> 00:16:52,000
levels of burnout are those same
supervisors.
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00:16:52,240 --> 00:16:53,840
So you've got something that's
working.
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00:16:53,840 --> 00:16:56,720
You've got something, you know,
despite all the difficulties
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that face us in the field,
you've got something that's
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00:16:58,960 --> 00:17:02,800
working.
How do we pinpoint that piece of
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00:17:02,800 --> 00:17:05,520
supporting supervisors?
And that means giving them
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00:17:05,520 --> 00:17:07,560
training to be effective?
You know, people are put into
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supervisor roles usually because
of the job, how good of a job
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they do, right?
Not always because they have
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00:17:12,599 --> 00:17:15,760
vast experience they can point
to of what a great job they do,
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00:17:15,760 --> 00:17:17,960
supervising through no fault of
their own.
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00:17:17,960 --> 00:17:20,920
So how do we support them?
With training, with examples.
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00:17:21,240 --> 00:17:25,839
And also supporting them, you
know, in other more logistical
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00:17:25,839 --> 00:17:27,400
ways, right?
Like what is your work day like?
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00:17:27,400 --> 00:17:30,600
Do you have flexibility?
Do you have an unrealistic
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00:17:30,680 --> 00:17:32,360
workload?
You can be the best supervisor
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00:17:32,360 --> 00:17:34,920
in the world, but if you've got
more work to do than hours of
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00:17:34,920 --> 00:17:38,000
the day or more reports, then
you have time to meet with in a
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00:17:38,000 --> 00:17:40,720
meaningful way, then you're not
going to be successful.
321
00:17:42,320 --> 00:17:45,600
Taking that into account, is
there a big take away of the
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00:17:45,600 --> 00:17:49,200
report or is there something
that maybe should be prioritized
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00:17:49,440 --> 00:17:52,880
for the year going forward?
I think that one thing that we
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00:17:52,880 --> 00:17:56,640
know that there is a need for is
better communication.
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00:17:56,640 --> 00:17:59,120
And that's a big term.
And it can show up in a lot of
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00:17:59,120 --> 00:18:01,960
different ways in a health
agency, whether it's executive
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00:18:01,960 --> 00:18:05,120
leadership, talking through and
acknowledging uncertainty and
328
00:18:05,120 --> 00:18:07,960
the difficulty in the field
right now or trying to make
329
00:18:07,960 --> 00:18:10,440
sense of things where there's
not always a lot of information.
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00:18:10,440 --> 00:18:13,680
But it does take some, you know,
very brave leadership to come
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00:18:13,680 --> 00:18:16,720
out and say to the entire
organization, you know, we're
332
00:18:16,720 --> 00:18:18,920
together.
We may not have all the answers
333
00:18:18,920 --> 00:18:21,160
and there may be some tough
times ahead, but we're committed
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00:18:21,160 --> 00:18:23,400
to standing with you.
And the other side of that is
335
00:18:23,400 --> 00:18:25,320
even communication all the way
down to the team level.
336
00:18:25,320 --> 00:18:29,000
You know, how are supervisors
trained to, you know, filter
337
00:18:29,000 --> 00:18:31,200
down some of that information
and give people the information
338
00:18:31,200 --> 00:18:34,240
that they need to know while
also getting information they
339
00:18:34,240 --> 00:18:36,520
need from their supervisors?
So how are we able to
340
00:18:36,520 --> 00:18:38,640
communicate those things?
What tools are we giving to
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00:18:38,640 --> 00:18:41,720
everyone and our staff, the
entire public health workforce,
342
00:18:42,160 --> 00:18:45,480
to be better communicators?
It's such an important part of
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00:18:45,480 --> 00:18:47,360
our job.
And not asking anybody to be
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00:18:47,360 --> 00:18:51,120
perfect, but making that attempt
and recognizing it as a priority
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is the first step.
Nomar Khalid is Asto's director
346
00:18:54,320 --> 00:18:56,600
of workforce.
Earlier we heard from Heather
347
00:18:56,600 --> 00:19:00,000
Krasna, associate Dean of career
and professional development at
348
00:19:00,000 --> 00:19:02,000
the Columbia University Mailman
School.
349
00:19:02,000 --> 00:19:05,200
Of public health.
Strong public health starts with
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00:19:05,200 --> 00:19:07,880
strong communication.
Getting the right information to
351
00:19:07,880 --> 00:19:10,760
the right people at the right
time can build trust, counter
352
00:19:10,760 --> 00:19:13,200
misinformation, and shape
healthier communities.
353
00:19:13,720 --> 00:19:15,600
That's why Asto is highlighting
practical.
354
00:19:15,600 --> 00:19:18,120
Resources to help health.
Departments strengthen their
355
00:19:18,120 --> 00:19:21,400
communications infrastructure,
from media templates and risk
356
00:19:21,400 --> 00:19:24,000
communication strategies to
tools for talking with
357
00:19:24,000 --> 00:19:28,080
legislators about public health
funding and impact Explorer
358
00:19:28,080 --> 00:19:30,440
training opportunities, tool
kits from the de Beaumont
359
00:19:30,440 --> 00:19:33,800
Foundation, field tested
messaging strategies and expert
360
00:19:33,800 --> 00:19:36,320
insights on crisis communication
and public trust.
361
00:19:36,840 --> 00:19:39,480
And learn how public health
infrastructure grant funding can
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00:19:39,480 --> 00:19:41,480
support this foundational
capability.
363
00:19:41,720 --> 00:19:43,680
You can find links in the show
notes.
364
00:19:45,440 --> 00:19:48,320
The ongoing effects of climate
change impact every part of our
365
00:19:48,320 --> 00:19:52,480
lives, including our individual
and community level health from
366
00:19:52,480 --> 00:19:54,800
rising temperatures.
Increased occurrence and
367
00:19:54,800 --> 00:19:58,440
magnitude of natural disasters.
Expanded vector borne disease
368
00:19:58,440 --> 00:20:01,240
patterns to increase the
transmission of waterborne
369
00:20:01,240 --> 00:20:03,960
diseases.
The changing natural environment
370
00:20:03,960 --> 00:20:06,760
in which we live.
Will affect our health these
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00:20:06,760 --> 00:20:08,560
issues have.
Led to significant negative
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00:20:08,560 --> 00:20:11,520
health effects on both
individuals and populations,
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00:20:12,040 --> 00:20:14,120
particularly high risk
communities.
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00:20:15,000 --> 00:20:16,800
As such.
Public health departments must
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00:20:16,800 --> 00:20:20,400
address how best to respond to
this ongoing crisis, and ASTO
376
00:20:20,400 --> 00:20:22,160
has compiled.
Resources to help.
377
00:20:22,760 --> 00:20:24,680
You can find a link in the show
notes.
378
00:20:25,560 --> 00:20:27,680
This has been Public Health
Review Morning Edition.
379
00:20:27,760 --> 00:20:30,560
I'm John Sheehan for the
Association of State and.
380
00:20:30,560 --> 00:20:31,960
Territorial health officials.
00:00:01,120 --> 00:00:03,680
This is Public Health Review
Morning Edition for Thursday,
2
00:00:03,680 --> 00:00:07,280
January 22nd, 2026.
I'm John Sheehan for the
3
00:00:07,280 --> 00:00:10,120
Association of State and.
Territorial health officials,
4
00:00:10,680 --> 00:00:12,720
today we take a look at the
public health.
5
00:00:12,720 --> 00:00:16,280
Workforce and ask what these
professionals need to stay
6
00:00:16,280 --> 00:00:19,680
engaged, supported and
committed, and how leaders can
7
00:00:19,680 --> 00:00:23,440
act on those insights.
Heather Krasna, associate Dean
8
00:00:23,440 --> 00:00:25,680
of career and professional
development at Columbia
9
00:00:25,680 --> 00:00:27,760
University Mailman School.
Of public health.
10
00:00:28,320 --> 00:00:31,120
Joins us to breakdown new
research on what younger.
11
00:00:31,120 --> 00:00:34,720
Public health workers.
Value most at work and later.
12
00:00:34,800 --> 00:00:37,920
Asto's director.
Of workforce Omar Khalid will.
13
00:00:37,920 --> 00:00:40,640
Walk us through.
Key findings from the 2024.
14
00:00:40,640 --> 00:00:44,320
Public health workforce.
Interests and Needs survey or pH
15
00:00:44,320 --> 00:00:47,960
wins the only nationally
representative survey of the
16
00:00:47,960 --> 00:00:51,280
governmental public health.
Workforce, he'll discuss.
17
00:00:51,280 --> 00:00:53,760
Why?
High turnover, burnout and loss
18
00:00:53,760 --> 00:00:57,520
of institutional knowledge
remain urgent concerns, along
19
00:00:57,520 --> 00:01:00,040
with encouraging signs of
improved supervisor
20
00:01:00,040 --> 00:01:02,160
relationships and workforce
commitment.
21
00:01:03,080 --> 00:01:05,360
But first.
Here's Heather Krasna discussing
22
00:01:05,360 --> 00:01:07,320
a recent study from the Mailman
School of.
23
00:01:07,320 --> 00:01:09,520
Public Health.
Showing that younger workers
24
00:01:09,520 --> 00:01:11,920
prefer non traditional work
benefits.
25
00:01:11,960 --> 00:01:15,200
To a degree.
More than older workers, things
26
00:01:15,200 --> 00:01:18,120
like flexible schedules, remote
work, and more training.
27
00:01:18,920 --> 00:01:22,040
I wanted to know how public
health agencies should interpret
28
00:01:22,040 --> 00:01:26,360
these responses.
Many local and state tribal and
29
00:01:26,360 --> 00:01:29,680
territorial health departments
have had trouble keeping younger
30
00:01:29,680 --> 00:01:35,560
employees at the organization
and there is the opportunity to
31
00:01:35,920 --> 00:01:39,880
try to improve retention by
offering some of these less
32
00:01:39,880 --> 00:01:43,440
traditional benefits.
Our study shows that younger
33
00:01:43,560 --> 00:01:47,120
workers value these sort of non
traditional benefits.
34
00:01:47,400 --> 00:01:51,880
So as an example, if the
organization has the option to
35
00:01:51,880 --> 00:01:56,360
offer remote work from time to
time at least, or hybrid
36
00:01:56,360 --> 00:02:00,120
options, that could be a way of
helping retain some of the
37
00:02:00,120 --> 00:02:03,840
younger workers.
It's also shown that they
38
00:02:03,840 --> 00:02:07,400
appreciate flex time if that's
another option.
39
00:02:07,400 --> 00:02:11,440
Some people have workplaces
where they might work four days
40
00:02:11,440 --> 00:02:15,200
a week, a few a few extra hours
or extra hour each day and then
41
00:02:15,200 --> 00:02:18,520
have that maybe the Friday off.
One of the other things that we
42
00:02:18,520 --> 00:02:22,600
saw in our study was that
certain benefits that have to do
43
00:02:22,600 --> 00:02:26,600
with childcare, lactation
facilities, things like that are
44
00:02:26,680 --> 00:02:28,880
also really attractive to
younger workers.
45
00:02:28,880 --> 00:02:33,760
And one reason possibly is, is
that as probably many people
46
00:02:33,760 --> 00:02:38,040
know, overall the public health
workforce does tend to skew more
47
00:02:38,040 --> 00:02:42,760
towards female workers.
So because of that, those
48
00:02:42,760 --> 00:02:46,360
particular benefits might be a
bit more attractive to this
49
00:02:46,760 --> 00:02:49,160
group.
And the other thing that we
50
00:02:49,160 --> 00:02:53,320
noticed is that supporting
lifelong learning, professional
51
00:02:53,320 --> 00:02:57,160
development or student loan
repayment or forgiveness
52
00:02:57,160 --> 00:03:00,320
programs are very, very
important for the younger
53
00:03:00,400 --> 00:03:02,920
workers.
And this also is common sense
54
00:03:02,920 --> 00:03:06,440
that people who are younger most
likely have finished their
55
00:03:06,560 --> 00:03:10,200
degrees more recently and they
also unfortunately are more
56
00:03:10,200 --> 00:03:14,800
likely to have debt.
And so options where there might
57
00:03:14,800 --> 00:03:18,320
be public service loan
forgiveness or some of the other
58
00:03:18,400 --> 00:03:21,720
healthcare related loan
repayment programs through the
59
00:03:21,720 --> 00:03:25,000
National Health Service Corps,
those types of options can be
60
00:03:25,000 --> 00:03:28,360
really beneficial, especially to
younger workers.
61
00:03:29,120 --> 00:03:31,200
Yeah.
And it strikes me that's sort of
62
00:03:31,200 --> 00:03:35,400
the the story of the broader
workforce across the country
63
00:03:35,400 --> 00:03:38,840
that younger workers have gotten
used to non traditional
64
00:03:38,840 --> 00:03:40,680
benefits, flex time, remote
work.
65
00:03:41,160 --> 00:03:44,560
It also strikes me that in
healthcare that's particularly
66
00:03:44,560 --> 00:03:46,440
challenging.
It sounds like you're sort of
67
00:03:46,880 --> 00:03:52,800
prescribing a combination of,
you know, of, of flex time, but
68
00:03:52,800 --> 00:03:57,160
also other, other benefits that
they they want as much such as,
69
00:03:57,160 --> 00:04:01,480
such as training, such as as
more maneuverability and and
70
00:04:01,480 --> 00:04:04,600
debt repayment.
And it's true that not every
71
00:04:04,600 --> 00:04:07,200
single job can offer these types
of flexibilities.
72
00:04:07,200 --> 00:04:10,360
Not every health department has
that option to allow hybrid
73
00:04:10,360 --> 00:04:12,400
work.
Certain jobs just can't be done
74
00:04:12,400 --> 00:04:15,960
remotely.
If you imagine the health
75
00:04:15,960 --> 00:04:18,920
inspector, for instance,
environmental health specialist,
76
00:04:18,920 --> 00:04:21,680
for instance, they may not be
able to do that work remotely,
77
00:04:22,040 --> 00:04:25,600
but there could be days where
they're doing reporting and
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00:04:25,600 --> 00:04:27,320
paperwork.
Maybe those days can be done
79
00:04:27,320 --> 00:04:28,720
remotely.
These are things just to be
80
00:04:28,720 --> 00:04:32,040
creative and think about if the
job can be structured a certain
81
00:04:32,040 --> 00:04:34,800
way.
One thing I have to say that is
82
00:04:34,800 --> 00:04:40,120
really important to say out loud
is that the most beneficial
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thing is often times to increase
the salaries, if that's
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possible.
But knowing how hard that is,
85
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that's where we would suggest to
think outside the box a little
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00:04:51,240 --> 00:04:52,480
bit.
And if you can't increase
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00:04:52,480 --> 00:04:56,160
someone's salary, what could you
do that might make the job
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00:04:56,600 --> 00:05:00,160
easier for them to stay?
And if that includes helping
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00:05:00,160 --> 00:05:04,240
them get student loans forgiven
or repaid, or offering those
90
00:05:04,240 --> 00:05:07,240
flexibilities or training
benefits, that's something
91
00:05:07,240 --> 00:05:10,200
that's a little easier to do for
many organizations than to
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increase the salaries.
Absolutely.
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00:05:12,400 --> 00:05:16,280
And all of the solutions that
you're talking about, you know?
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00:05:16,640 --> 00:05:18,600
There are long term.
Implications there.
95
00:05:18,600 --> 00:05:24,320
It's, it sounds like a much
bigger culture shift across
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00:05:24,440 --> 00:05:28,800
across all workforces, but
particularly in public health, a
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00:05:29,360 --> 00:05:32,280
shift that kind of has to happen
and has been happening no matter
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00:05:32,280 --> 00:05:34,160
what.
Exactly.
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00:05:35,240 --> 00:05:39,000
You know, I would say some
people make a big deal about how
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00:05:39,000 --> 00:05:42,680
there are different generations
of people in the workforce, and
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that's somewhat a case.
There's something to be said for
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00:05:45,960 --> 00:05:47,120
that.
There may be Gen.
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00:05:47,120 --> 00:05:50,240
X and the Millennials and so
forth, and they might have
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00:05:50,240 --> 00:05:54,720
different values at work, but
there's also the fact that
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people are in different phases
of their life.
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00:05:56,920 --> 00:06:00,320
And if someone is younger, maybe
they're starting a family, they
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may have certain needs or things
that you can do to support them
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with their life in that take in
that phase of their life.
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Or if it's a younger person and
they just want to get as much
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experience as possible and they
want to have the opportunity to
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learn more things or take on new
responsibilities, if there's the
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00:06:21,440 --> 00:06:23,720
opportunity to allow that,
that's something that can be
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really beneficial.
So when people are starting out
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00:06:26,080 --> 00:06:29,560
their career, which is also what
happens when people are younger,
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00:06:30,240 --> 00:06:34,080
what can a supervisor do to be
not just a regular supervisor
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00:06:34,080 --> 00:06:39,560
but possibly a mentor or to help
the person identify other people
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00:06:39,560 --> 00:06:41,520
that could be a support or a
mentor?
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00:06:42,440 --> 00:06:46,160
And Heather, could I ask you to
maybe expand on that?
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00:06:46,160 --> 00:06:46,520
A.
Little.
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00:06:46,520 --> 00:06:52,400
More for, say, maybe an agency
head who's staring down these
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cultural shifts and is resistant
to change.
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But sees this.
Small but growing cohort of
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their workforce, you know,
asking over and over again for
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00:07:02,320 --> 00:07:05,480
these kinds of accommodations.
What's your advice there?
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What's what's what are some baby
steps to getting some changes in
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place?
Great question.
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I think that the very first
thing is to listen to people.
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There are lots of ways you can
do a what they call a climate
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survey or some other way to
gather anonymous feedback from
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people in the workforce.
There's also plenty of data now
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from the public health Workforce
Interest and needs survey. pH
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00:07:31,760 --> 00:07:34,200
wins.
And if you are a supervisor of
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people and you need to justify
why you need to make a change in
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00:07:39,160 --> 00:07:42,840
the workplace, that data will
probably support that decision.
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00:07:43,120 --> 00:07:47,240
And the other thing which I
always will say out loud is that
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turnover is really expensive.
And it's not just expensive
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00:07:50,920 --> 00:07:55,080
because your community is now
going to be missing someone
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00:07:55,240 --> 00:07:59,920
whose job is is to support the
community's health, whether that
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00:07:59,920 --> 00:08:03,840
person is inspecting restaurants
or dealing with the vital
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00:08:03,840 --> 00:08:07,760
statistics and birth
certificates and so forth, or an
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00:08:07,760 --> 00:08:10,480
epidemiologist that's tracking
some outbreaks.
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The community's health could
suffer if you don't have
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sufficient workers and they're
engaged in their job doing that
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work.
That is a really huge challenge.
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00:08:20,360 --> 00:08:25,720
And so putting dollars on that
lack of workforce is something
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00:08:25,720 --> 00:08:30,760
that health department leaders
can try to do And to to, you
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00:08:30,760 --> 00:08:34,080
know, tie it back to things that
have an impact on the community.
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What is the economic impact if
you suddenly have more cases of
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an infectious disease?
How is that impacting all the
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00:08:44,480 --> 00:08:47,400
employers in the region where
their workforce is having to
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00:08:47,400 --> 00:08:50,320
call out sick or something?
And then the piece about
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turnover itself is that's also
very expensive.
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If somebody leaves, now you have
a vacancy and you have to fill
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that vacancy.
And it's not just the maybe the
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00:09:00,360 --> 00:09:04,400
cost of trying to advertise the
job or something, but you could
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00:09:04,400 --> 00:09:08,680
end up taking up so much staff
time to hire a new person to
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train that new person to onboard
them.
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00:09:11,320 --> 00:09:13,400
So it's not just harming the
community.
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It's also expensive to the
taxpayer if there is a lot of
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turnover in a health department.
These are all just different
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00:09:20,120 --> 00:09:22,600
arguments.
People can try to make the case
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for why public health is so
important and why the people
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00:09:25,520 --> 00:09:28,720
doing that hard work who are on
the front lines in public
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00:09:28,720 --> 00:09:32,400
health, their work really
matters and supporting them is
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00:09:32,400 --> 00:09:36,320
essential.
Heather Krasna is associate Dean
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00:09:36,320 --> 00:09:38,480
of career and professional
development at Columbia
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00:09:38,480 --> 00:09:40,840
University's Mailman School.
Of public health.
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The results of the 2024 Public
Health Workforce Interests and
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Needs Survey, or pH Wins, were
recently released, and it's the
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only nationally representative
survey of the governmental
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public health.
Workforce.
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00:09:55,080 --> 00:09:58,400
Here's Asto's director of
workforce Omar Khalid, to talk
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more about the results,
specifically that a significant
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00:10:01,400 --> 00:10:04,600
portion of the workforce is
considering leaving the field.
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00:10:05,160 --> 00:10:06,600
Of course, it's a snapshot in
time.
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There was a window in the
second-half of 2024.
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But we know there were some
really big changes after the
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pandemic, right?
Maybe that was a little more
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gradual as things returned
closer to normal, though.
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Never.
Things were never quite the same
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00:10:19,120 --> 00:10:22,560
again.
Haven't been since 2020, but we
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00:10:22,560 --> 00:10:25,640
also know that the workforce was
struggling and letting us know
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00:10:25,640 --> 00:10:28,240
important needs of theirs even
before the pandemic.
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But we did see that even in the
2024 data that there was what is
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00:10:33,440 --> 00:10:37,120
really troubling data about the
the conditions of some
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00:10:37,120 --> 00:10:40,520
individuals in terms of burnout
and, you know, looking to leave
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the profession.
So we know this is an urgent
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00:10:43,880 --> 00:10:46,280
message in the data.
And we also know that things
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have not gotten easier in 2025
and then, you know, the weeks
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really that followed the
completion of the fielding of
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00:10:52,640 --> 00:10:56,320
the 2024 survey.
There's still need for support.
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There's still need for enhancing
training around certain topics
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so that people feel more
supported in their day-to-day
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00:11:03,000 --> 00:11:05,640
work in public health agencies.
So I think that's one of the
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00:11:05,640 --> 00:11:10,520
main takeaways of these findings
in 2024 is that we still have
196
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some work to do even if things
had stayed at an even keel from
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the time of fielding.
And all the difficulties that
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we've seen since then,
including, you know, reductions
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in force, losses of funding,
some confusion around future
200
00:11:24,600 --> 00:11:28,600
directions with maybe the
absence of some guidance and how
201
00:11:28,600 --> 00:11:31,920
to plan for the continuation of
some of these programs has just
202
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been an additional challenge
that we know we have to meet as
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well.
Yeah.
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00:11:37,560 --> 00:11:41,200
And perhaps a complimentary take
away from the most recent report
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shows that there are a lot of
new workforce members, about
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00:11:45,840 --> 00:11:49,640
half have been at their agencies
for five years or less.
207
00:11:50,080 --> 00:11:53,840
So how does that add difficulty
to the situation?
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How does that sort of color the
results?
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00:11:55,880 --> 00:11:58,280
Well, it's great.
I think we do always want to,
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you know, welcome new ideas and
new perspectives represented
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from these new people coming to
the workforce.
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00:12:05,360 --> 00:12:08,200
That's a a great thing
recruiting and, you know,
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00:12:08,200 --> 00:12:11,160
advertising how great public
health is as a career.
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00:12:11,360 --> 00:12:14,960
It is something we want to see,
even though it it is always hard
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00:12:14,960 --> 00:12:18,160
to replace the institutional
knowledge and the experience of
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00:12:18,160 --> 00:12:21,320
the people who have laughed.
So of course there's kind of two
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00:12:21,320 --> 00:12:23,480
sides to that coin.
The first one is we have a great
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00:12:23,480 --> 00:12:26,800
opportunity to have a fresh
perspective in public health,
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00:12:26,800 --> 00:12:29,360
maybe new voices, maybe people
who weren't previously
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represented in health agencies
are being able to see a few more
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00:12:33,080 --> 00:12:35,200
of those perspectives.
But at the same time,
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realistically coming to terms
with the fact that especially in
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a relatively short amount of
time, losing a lot of those
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longer tenured employees from
our agencies and thinking about
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how do we address that loss
first and foremost.
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And then also how do we plan for
doing it better?
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How do we plan for those
separations affecting agencies
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and critically, the work that we
provide to keep communities
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healthy without interruption
going forward?
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And I think it's a great
reminder that that's something
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you have to design a system for,
which we're so great at doing in
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public health.
You know, how do we design a
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system to mitigate the damage
from loss of institutional
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knowledge, whether it's
succession planning?
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And, you know, that doesn't just
mean, you know, how are you
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going to replace someone in a
position and say, OK, great,
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that's not a vacancy anymore.
Really succession planning is
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how are you planning for that
transfer of, you know, the most
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00:13:26,040 --> 00:13:27,840
important knowledge?
How do you keep some of these
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initiatives on track despite key
personnel leaving?
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00:13:31,360 --> 00:13:33,920
And that's really something you
have to be intentional about and
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plan for.
And I think the last few years
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have really highlighted the need
for that.
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And we're hearing a lot of ways
that people are taking that more
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seriously and being more
intentional about doing it, to
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have it be a net positive that
we're getting a lot of new
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staff.
And of course, people are
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choosing to end their careers,
hopefully at a time of their
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choosing, without affecting the
work of public health too
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greatly.
Yeah.
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And the report calls for
investments, serious investments
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in a permanent workforce, moving
away from those temporary roles.
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And you know, that cost money.
How does that happen and who
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needs to be convinced to make
those investments?
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00:14:14,840 --> 00:14:19,920
Well, we're currently operating
under the historic investment in
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public health infrastructure,
including workforce through the
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CD CS public health
infrastructure grant.
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That has really allowed a lot of
really all of the state public
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00:14:30,200 --> 00:14:34,360
health agencies and as well as
state and territorial really
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associated States and some big
city, local health departments
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00:14:37,760 --> 00:14:41,200
and city health departments to
make those hires to hire people
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that are committed to doing the
work of workforce, right
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thinking about infrastructure
full time and how to support the
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workforce.
And I think that the successes
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and the examples of all of those
jurisdictions, you know, midway
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through roughly that investment
show that this can work.
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An investment in public health
workforce does really have an
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00:15:01,320 --> 00:15:03,560
impact.
Of course, nothing is permanent
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in government and especially in
public health funding.
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We're used to a a sort of grant
cycle and that does have a
271
00:15:08,920 --> 00:15:12,760
natural ebb and flow to it.
But our hope is that we'll be
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able to tout the success of
investments like the Public
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Health Infrastructure Grant and
others that focus on
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00:15:20,000 --> 00:15:24,960
infrastructure to really improve
how health agencies operate so
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that they can do the best job
they can do to keep our
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community safe.
And the report isn't all bad
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news. 2024 showed improvements
in workforce commitment and
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supervisor satisfaction, and a
reduction in burnout.
279
00:15:41,040 --> 00:15:46,480
So do we know or can we pinpoint
any policies or shifts that
280
00:15:46,480 --> 00:15:49,600
contributed to that?
Well, I'll first give a caveat
281
00:15:49,600 --> 00:15:53,720
that it is difficult to provide,
you know, with certainty and
282
00:15:53,720 --> 00:15:56,560
point to something and saying,
you know, this had this effect,
283
00:15:56,560 --> 00:15:59,120
especially when you're talking
about things that, you know,
284
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maybe they're a little fuzzy.
They're talking about how people
285
00:16:00,720 --> 00:16:03,880
feel and you know, what's behind
their complex decisions to to
286
00:16:03,880 --> 00:16:05,680
stay or to leave or around
morale.
287
00:16:05,800 --> 00:16:08,560
But we still know that it's
real, even if we can't draw a
288
00:16:08,560 --> 00:16:11,600
crystal clear line between
inventions that that we do in
289
00:16:11,600 --> 00:16:13,920
the workplace and why people
want to stay.
290
00:16:13,920 --> 00:16:16,640
We, we can't listen to what
people are saying they want and
291
00:16:16,640 --> 00:16:19,640
what is working.
We can start by asking them and
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00:16:19,640 --> 00:16:22,880
communicating with them.
But one of my favorite pieces of
293
00:16:22,880 --> 00:16:28,640
data from the 2024 pH wins is
that people have increased
294
00:16:28,640 --> 00:16:31,200
support and, and they enjoy
their relationships with their
295
00:16:31,200 --> 00:16:34,640
direct supervisor.
And that is often the number one
296
00:16:35,040 --> 00:16:37,480
retention tool than any agency
has.
297
00:16:37,960 --> 00:16:40,000
You know, there's the adage that
people don't quit their jobs,
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00:16:40,000 --> 00:16:41,920
they quit their supervisors.
And and, you know, luckily,
299
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we're seeing that more people
are satisfied with that
300
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relationship in public health
agencies.
301
00:16:46,880 --> 00:16:49,760
But at the same time, the people
who are reporting the highest
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00:16:49,760 --> 00:16:52,000
levels of burnout are those same
supervisors.
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So you've got something that's
working.
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You've got something, you know,
despite all the difficulties
305
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that face us in the field,
you've got something that's
306
00:16:58,960 --> 00:17:02,800
working.
How do we pinpoint that piece of
307
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supporting supervisors?
And that means giving them
308
00:17:05,520 --> 00:17:07,560
training to be effective?
You know, people are put into
309
00:17:07,560 --> 00:17:10,680
supervisor roles usually because
of the job, how good of a job
310
00:17:10,680 --> 00:17:12,280
they do, right?
Not always because they have
311
00:17:12,599 --> 00:17:15,760
vast experience they can point
to of what a great job they do,
312
00:17:15,760 --> 00:17:17,960
supervising through no fault of
their own.
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So how do we support them?
With training, with examples.
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And also supporting them, you
know, in other more logistical
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ways, right?
Like what is your work day like?
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Do you have flexibility?
Do you have an unrealistic
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workload?
You can be the best supervisor
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in the world, but if you've got
more work to do than hours of
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the day or more reports, then
you have time to meet with in a
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meaningful way, then you're not
going to be successful.
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Taking that into account, is
there a big take away of the
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report or is there something
that maybe should be prioritized
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for the year going forward?
I think that one thing that we
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know that there is a need for is
better communication.
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And that's a big term.
And it can show up in a lot of
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different ways in a health
agency, whether it's executive
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leadership, talking through and
acknowledging uncertainty and
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the difficulty in the field
right now or trying to make
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sense of things where there's
not always a lot of information.
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But it does take some, you know,
very brave leadership to come
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out and say to the entire
organization, you know, we're
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together.
We may not have all the answers
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and there may be some tough
times ahead, but we're committed
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to standing with you.
And the other side of that is
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even communication all the way
down to the team level.
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You know, how are supervisors
trained to, you know, filter
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down some of that information
and give people the information
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that they need to know while
also getting information they
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need from their supervisors?
So how are we able to
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communicate those things?
What tools are we giving to
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everyone and our staff, the
entire public health workforce,
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to be better communicators?
It's such an important part of
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our job.
And not asking anybody to be
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perfect, but making that attempt
and recognizing it as a priority
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is the first step.
Nomar Khalid is Asto's director
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of workforce.
Earlier we heard from Heather
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Krasna, associate Dean of career
and professional development at
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the Columbia University Mailman
School.
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Of public health.
Strong public health starts with
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strong communication.
Getting the right information to
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the right people at the right
time can build trust, counter
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misinformation, and shape
healthier communities.
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That's why Asto is highlighting
practical.
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Resources to help health.
Departments strengthen their
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communications infrastructure,
from media templates and risk
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00:19:21,400 --> 00:19:24,000
communication strategies to
tools for talking with
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00:19:24,000 --> 00:19:28,080
legislators about public health
funding and impact Explorer
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00:19:28,080 --> 00:19:30,440
training opportunities, tool
kits from the de Beaumont
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00:19:30,440 --> 00:19:33,800
Foundation, field tested
messaging strategies and expert
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insights on crisis communication
and public trust.
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00:19:36,840 --> 00:19:39,480
And learn how public health
infrastructure grant funding can
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support this foundational
capability.
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You can find links in the show
notes.
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The ongoing effects of climate
change impact every part of our
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lives, including our individual
and community level health from
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rising temperatures.
Increased occurrence and
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00:19:54,800 --> 00:19:58,440
magnitude of natural disasters.
Expanded vector borne disease
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patterns to increase the
transmission of waterborne
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diseases.
The changing natural environment
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in which we live.
Will affect our health these
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00:20:06,760 --> 00:20:08,560
issues have.
Led to significant negative
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health effects on both
individuals and populations,
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particularly high risk
communities.
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As such.
Public health departments must
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00:20:16,800 --> 00:20:20,400
address how best to respond to
this ongoing crisis, and ASTO
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00:20:20,400 --> 00:20:22,160
has compiled.
Resources to help.
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You can find a link in the show
notes.
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This has been Public Health
Review Morning Edition.
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I'm John Sheehan for the
Association of State and.
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Territorial health officials.