The Public Health Workforce Interest and Needs Survey (PH WINS) is the first nationally representative survey of the governmental public health workforce. Just about every article in the newly released PH WINS supplement from the Journal of Public Health Management and Practice starts out this way, so I feel like a broken record doing the same. But it’s really important – the reason the de Beaumont Foundation started PH WINS is that there was so little information available about the nation’s public health workers. Without these passionate, committed, highly skilled people, we would have no public health system. So if we want to improve health in this country, we need to know what these professionals think, what they know, and what they need. Here are some things we learned in the latest round of PH WINS:
- The workforce doesn’t reflect the population it serves. It is overwhelmingly female, and largely white and over 40. While health department workforces in big cities are substantially more diverse, we can and must do better. We will be better able to serve underserved populations when we better understand their circumstances, cultures, and options. The more our workforce has similar lived experiences to those we serve, the better job we will do.
- Public health workers are mission-driven and passionate about our collective cause, but almost half are considering leaving their organizations. While retirements are inevitable, we need to do more to prevent the departure of those who are leaving because they see no opportunity for advancement or because the workplace environment is driving them away. We are especially likely to lose millennials, those with a degree in public health, men, and female executives – all of whom are already underrepresented in the workforce.
- We still have wage gaps for women and people of color. Public health is a field that values and promotes social justice. But people of color make about $4,000 less per year than their white counterparts, after controlling for education, experience, type of job, etc. Women make about $3,000 less than men.
- While workers believe health departments should be working toward health equity, they are largely skeptical about the health department’s role in trying to influence the social determinants of health. We will not achieve health equity without using policy to rectify the inequities past policy decisions created. Powerful policy measures in education, urban planning, housing, and other areas, whether intentionally or unintentionally, created the disparities we see today. Every system is perfectly designed to get the results it gets – and our results are shockingly inequitable. The field of public health must be part of the solution that changes these harmful policies to create equity.
- Fewer than half of public health workers say creativity and innovation are rewarded in their workplace. We will not solve the persistent health inequities we’ve seen for generations without empowering workers to develop creative and innovative solutions. Research shows that fostering workers’ creativity may lead to increased satisfaction (including pay satisfaction!), and thereby help stem the flow of skilled workers out of the field of public health.
We launched PH WINS in 2014 because we didn’t know enough about the workforce, and we wanted to do everything we could to build up this critical resource. After conducting our second survey, the implications for policy and practice are clear. We need to invest in the governmental public health workforce in ways that increase its ability to represent the population it serves, keeps passionate public health workers wanting to stay in the field, gives them the training and development they need, pays them equitably, supports their ability to influence the social determinants of health, and fosters their creativity and innovation.