Public Health Departments Face Workforce Challenges Amid Salary Disparities

Recent research from Columbia University's Mailman School of Public Health highlights significant salary discrepancies between state and local health department positions and their counterparts in the private sector. The study reveals that many roles within public health departments are underpaid, which poses a risk to the recruitment and retention of staff essential for managing public health crises.

Published in the Journal of Public Health Management & Practice, this research is among the first to analyze extensive job posting data to compare salaries and job requirements in public health sectors. Until now, comprehensive federal data on salaries for state and local health department employees has been sparse.

According to the findings, the compensation for many public health roles is significantly lower compared to similar positions in other sectors. Dr. Heather Krasna, who led the study, emphasized the importance of these findings for health departments looking to establish competitive salaries that can enhance recruitment and retention, particularly in critical positions such as management and IT, as well as nursing roles, where pay is notably inadequate.

Utilizing a database called Lightcast, which compiles job postings from over 160,000 online sources, researchers gathered information on salaries, educational requirements, and experience levels for 44 different public health occupations. They found that, out of the 16,284 job postings from state and local health departments, 27 roles offered lower salaries than similar positions in the private sector, while only six positions paid more. Additionally, 37 of the analyzed roles in public health departments had less stringent educational requirements compared to those in the private sector.

These findings suggest a troubling trend where essential public health roles may not require the same level of education as their private sector equivalents, raising concerns about the preparedness of government employees to handle public health challenges. The disparity in educational requirements may reflect the inability of health departments to attract highly educated candidates due to lower salaries.

Recent estimates indicate that state and local health departments are short-staffed by at least 80,000 workers. While temporary funding, such as the Public Health Infrastructure Grant, offers some support for hiring, it does not necessarily translate into higher salaries for these positions. This situation is exacerbated by the fact that many key roles, particularly in leadership and technical fields, often require only a bachelor's degree in public health departments, in contrast to the private sector, where advanced degrees are typically required.

Dr. Krasna pointed out that the lower educational requirements might be a strategy to attract a broader range of candidates, including those with limited access to higher education. Future studies could provide further insights into how these educational and experience disparities affect public health outcomes in communities served by local health departments.

Despite potential benefits such as superior health benefits, the significant salary gaps--often exceeding 25%--make it increasingly difficult for health departments to fill certain roles, further complicating recruitment and retention efforts. Health departments may have limited control over salary structures due to civil service regulations, yet understanding these salary disparities could empower them to advocate for necessary wage increases from policymakers.

This research serves as a call to action for public health departments to leverage job posting data in their salary benchmarking efforts, ensuring they can attract and retain the workforce needed to effectively respond to public health needs.