A public health worker exodus is coming: Many are ready to leave

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Bracing for a public health worker exodus: Many are burned out, frustrated and ready to quit

America’s public health workforce has been the backbone of the nation’s pandemic response. But after two-and-a-half years of working in an increasingly polarized environment, many are fed up and want to leave, according to a study published today by the Centers for Disease Control and Prevention.

Forty-four percent of public health workers reported considering leaving their jobs within the next five years, three-quarters of whom started thinking that since the start of the pandemic, according to the analysis in the CDC’s latest Morbidity and Mortality Weekly Report. Such an exodus from an already depleted workforce could further hamstring public health departments’ ability to respond to new and ongoing threats, such as the emerging monkeypox outbreak, and fulfill basic duties.

“It puts us hugely at risk,” said Lisa Carlson, former president of the American Public Health Association and current executive administrator for research administration at Emory School of Medicine. “Some studies say we’re 80,000 public health workers short now. If as many as 50 percent of those leave their jobs, we are in beyond crisis mode for whatever comes next.”

Even if a surge of new public health workers emerged to fill those gaps, a wave of retirements now would mean an overall loss of expertise — including the hard-won lessons learned during the rise of covid.

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“All the resources that we, as a nation, have put into the response aren’t going to be well leveraged if we lose all that expertise and don’t have it for the next crisis,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials.

The pandemic has driven burnout among many healthcare workers on the front lines of the response, but perhaps no profession has drawn as much negative attention as public health workers. Nearly 60 percent of local health departments experienced harassment during the first 10 months of the pandemic, according to a recent study in the American Journal of Public Health, and over 250 officials quit as a result. Additionally, many conservative state legislatures are stripping health officials of the authority to institute policies that protect public health.

“I think that our public health workers feel like they’re shouting into the void,” Carlson said. “We give evidence-based advice, which is largely not being heeded by a large number of people who are at risk. That’s hard to do day after day.”

The cumulative effect has been profound. “It’s not surprising to see so many considering leaving the field after two-and-a-half years of fighting the hardest challenge they’ve ever had to deal with,” said Casalotti, who spoke with Grid from a national conference of local public health officials. “Folks are tired, they’re traumatized. … The number of times someone giving a talk breaks down and says, ‘I’m sorry it’s just been a hard two years’ is incredible,” she said.

The public health workforce was stretched thin even before the pandemic, losing more than 20 percent of its capacity from 2009 to 2019, Casalotti said. While federal relief funding helped bolster those ranks during the covid crisis, public health departments face compounding problems that received less attention during the pandemic. “There’s so much to catch up on,” in addition to dealing with covid, said Casalotti. That’s going to be a lot harder with fewer workers.

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In addition to dealing with the growing monkeypox outbreak, public health departments are also battling the country’s deepening opioid abuse crisis, increases in sexually transmitted diseases and a worrisome dip in routine childhood vaccination rates during the pandemic.

Thanks to Lillian Barkley for copy editing this article.

  • Jonathan Lambert
    Jonathan Lambert

    Public Health Reporter

    Jonathan Lambert is a public health reporter for Grid focused on how science, policy and the environment shape our collective well-being.

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CDC