Public Health Workforce Interests & Needs Survey (PH WINS)
Room: Bluegrass Room I & II
Tuesday, April 21, 2015, 2:00 to 3:30 PM
Moderator: Katie Sellers, DrPH, CPH
Elizabeth Harper, DrPH, MPH, BS
Gaining a National Perspective of the Public Health Workforce: Results from the ASTHO Public Health Interests and Needs Survey (PH WINS)
Co-Investigator(s): JP Leider, PhD; Katie Sellers, DrPH; Brian Castrucci, MA; Kiran Bharthapudi, PhD; & Rivka Liss-Levinson, PhD
Background: Workforce development is a critical area of public health systems and services research. Yet there is very little research that emphasizes the interests, needs, and challenges of public health workers. In partnership with the de Beaumont Foundation, ASTHO conducted a nationally representative survey of governmental health agency workers among state health departments and local health departments in selected states. Research Objective: The objectives of this project were to inform future investments in workforce development, establish a baseline of key workforce development issues in this country, and to explore workforce attitudes, morale, and climate. Data Sets and Sources: Data for this project came from the 2014 Public Health Workforce Interests and Needs Survey. The survey was fielded from September to December of 2014. Study Design: The project grew out of a consensus building process that included representatives from a broad array of public health programs and identified the top issues facing the public health workforce. The PH WINS survey instrument was created with the advice of an expert panel, composed of workforce research and survey design experts. Drafts of the instrument were then pretested and adjusted according to feedback. All 50 states were invited to participate in PH WINS. State health agencies (SHAs) were given the option to survey a nationally representative portion of their staff, a large sample of staff to compensate for a potentially low response rate, or to conduct a census of SHA staff. We used a stratified sampling method based on geographic region, state/local governance, and population. The final dataset was weighted and post- stratified to account for non-response. Analysis: Descriptive statistics were calculated on the preliminary PH WINS dataset. Descriptive results on the survey responses, workplace environment, workforce priorities, perspectives on national trends, and demographics will be finalized for the 2015 Keeneland Conference. Principal Findings: Approximately 20,000 surveys were completed by public health workers from 37 states, 14 urban cities, and over 50 local health departments. Survey respondents were 77% (12,734) female and 80% white non-Hispanic (12,988). The mean age was 48.4 years. 58% (9,732) of respondents work in non-supervisory roles. On average, respondents had been in their current position for 7 years. 25% (3,999) plan to retire before 2020. Preliminary results indicated that 80% (6,904) of individuals were satisfied or very satisfied with their job. The “desire to make a difference” and “the opportunity to use my skills” were the most highly rated reasons for individuals to have entered the field of public health. Conclusions: PH WINS assessed workforce knowledge, skills, and attitudes related to challenges that will face the workforce over the next 3-5 years. PH WINS collected worker perspectives on national trends such as quality improvement, health impact assessments, and electronic health records. In addition, the survey captured aspects of the workplace environment such as morale, culture of learning, and worker empowerment, as well as demographic characteristics of individuals. Implications: PH WINS is a rich data source for exploring job satisfaction, workforce priorities, perspectives and demographic characteristics of the public health workforce.
Katie Sellers, DrPH, CPH
How Satisfied Are Pubic Health Workers? A National Perspective on Workforce Morale
Co-Investigator(s): Brian Castrucci, MA; Elizabeth Harper, DrPH; Kiran Bharthapudi, PhD;; Rivka Liss-Levinson, PhD; & JP Leider, PhD
Background: The field of public health faces multiple challenges in its efforts to recruit and retain a robust workforce. Public health departments offer salaries that are lower than the private sector, and government bureaucracy can be a deterrent for those seeking to make a difference. Research Objective: The objective of this research is to explore the relationship between general employee satisfaction and specific characteristics of the job and the health agency, and make recommendations regarding what health agencies can do to support recruitment and retention. Data Sets and Data Sources: The Public Health Workforce Interests and Needs Survey (PH WINS) is the first, nationally representative survey of governmental public health workers at the state level. With over 20,000 responses from state and local public health workers, this dataset contains rich information on employee satisfaction (including the well-validated job-in-general scale), aspects of a culture of learning, employee reasons for entering public health, and demographic characteristics. Study Design: PH WINS was administered as a cross-sectional, online survey in September-December 2014. The survey was emailed to either a sample or a census of state health agency employees in 37 participating states, depending on the state’s preference. Local health department employees were also surveyed in 14 participating large city health departments and in local health departments throughout 7 states that participated in a pilot test of PH WINS at the local level. Weights were applied to the dataset to account for the complex sampling design. Analysis: The data analysis will include frequencies, bivariate correlations, and multiple regression to explore the relationships between employee satisfaction, characteristics of the health department, reasons for entering public health, and demographics. Principal Findings and Conclusions: Principal findings are expected to highlight which characteristics of a health department are most closely associated with employee satisfaction, which motivations for entering public health are most closely associated with satisfaction in the job, and how these findings vary by demographic characteristics. Demographic variables of interest include age, race, gender, and education. Implications for Public Health Practice and Policy: The implications for public health practice and policy are that health departments should cultivate those health department characteristics that are associated with employee satisfaction. For example, if the analysis finds that employees in agencies with a stronger culture of learning are more satisfied, agencies should work to strengthen the aspects of a culture of learning measured in the survey.
Jonathon Leider, PhD
What’s a Good Salary in Public Health? A Cross-section of 18,500 State Public Health Workers Salary and Wages in 2014
Co-Investigator(s): Brian Castrucci, MA; Rivka Liss-Levinson, PhD; Katie Sellers, DrPH, MPH; Elizabeth Harper, DrPH; & Kiran Bharthapudi, PhD
Background: The potential for earnings and a livable wage has been shown to be universally important to the recruitment and retention of employees in the United States. In public health and other public sector jobs, dissatisfaction with earnings has been shown to be correlated with higher rates of job dissatisfaction. The recently-fielded Public Health Workforce Interests and Needs Survey (PH WINS) provides a unique opportunity to characterize salary and wages earned by the public health workforce in the United States at the state and local levels. Research Objective: Conduct descriptive statistics for the earnings of public health employees in the United States, examine associations between earnings and job satisfaction, and examine the associations between demographic characteristics, workplace characteristics, position, educational attainment and total earnings. Data Sets and Sources: Data come from the 2014 fielding of PH WINS, a survey of public health workers at the state health agency level. Study Design: One part of PH WINS was fielded as a nationally-representative frame of permanent employees working in state health agency central offices. Staff were sampled from state health agencies on a stratified (regional) basis. Appropriate weights and post-stratification was conducted to account for non-response. Analysis: Descriptive statistics are presented. Bivariate comparisons were conducted using Student’s t-test and Tukey’s test for multiple comparisons of means. Additionally, we conducted a multi-level, mixed effects linear regression with random effects at the state level for state health agency (SHA) staff. Independent variables included gender, time in public health, educational attainment, race/ethnicity, position, with random effects assigned at the state level. Principal Findings: Approximately 18,500 public health staff responded to the PH WINS survey. On average, full-time staff earned between $45,000 and $55,000. Among SHA employees, 20% of staff earned more than $75,000. Among employees who were somewhat or extremely dissatisfied with their job, 65% were somewhat or extremely dissatisfied with their pay. Comparatively, 35% of employees who felt neutral or positively about their job were somewhat or extremely dissatisfied with their pay. Preliminary results from a mixed-effects model showed those with a bachelor’s degree earned approximately $5,500 more on average than those without a college education (95% CI $4,686 – $6,403), a masters degree yielded $9,497 more on average ($8,131-$10,862) and a doctoral degree over $17,000 more on average compared to those without a college education, all else equal ($15,707-$20,114). After accounting for other covariates, including education, experience, and position type, women earned about $1,700 less than men ($703-$2,686). Conclusions: After accounting for state and regional effects on salary, education, experience, supervisory status, and gender all had meaningful relationships with salary and wages. This project and other research show a multi-factorial, complex relationship between pay satisfaction and job satisfaction. Further research is needed to identify more modifiable factors associated with earnings differentials, and to map state and regional variability for earnings among similar job types. Implications: Education and supervisor status were highly correlated with greater earnings, and state-level variation in earnings were significant.
Rivka Liss-Levinson, PhD
Loving and Leaving Public Health: State Health Agency Workers’ Reasons for Joining and Departing from the Public Health Workforce
Co-Investigator(s): Kiran Bharthapudi, PhD; Katie Sellers, DrPH, CPH; JP Leider, PhD; Elizabeth Harper, DrPH; & Brian Castrucci, MA
Background: Recent research in public health workforce development has primarily focused on the enumeration and job classification of state health agency workers. The ability to count the workforce, while an important task, does not indicate why individuals join and leave the public health workforce. These are key factors in the recruitment and retention of a talented and diverse workforce of sufficient size and capabilities. Research Objective: The goal of the current study was to examine the factors that influenced state health agency workers’ original decision to join the public health workforce, their intentions to leave their current job, and demographic and job characteristics that are associated with both. Data Sets and Sources: The data source for this study is the Public Health Workforce Interests and Needs Survey (PH WINS), a web-based survey distributed to a nationally representative sample of state health agency workers and a sample of local health department workers in the fall of 2014. Study Design: PH WINS was completed by a nationally representative sample of state health agency workers and a sample of local health department workers. The study is cross-sectional. Analysis: Descriptive statistics were calculated to determine respondents’ reasons for entering and leaving the public health workforce. The relationships between these factors and demographic characteristics (gender, age, race/ethnicity, region, degrees earned) and job characteristics (primary program area, salary, supervisory status, and tenure in current position, at agency, and in public health) were examined using multiple regression analyses. Principal Findings: Overall, the most common factors that influenced state health agency workers’ original decision to join the public health workforce were opportunity to use my skills, desire to make a difference, and importance of public health. The most frequently endorsed reasons for intentions to leave the public health workforce in the next year were retiring, taking another governmental job (in public health), and taking another governmental job (not in public health). Multiple regression analyses revealed multiple demographic and job characteristics to be significant predictors of original decision to join public health workforce and intentions to leave public health in the next year. Conclusions: By identifying reasons why state health agency workers originally decided to enter into public health, their intentions to leave their job, and demographic and job characteristics associated with each, state health agencies can improve their recruitment and retention efforts in state public health. Implications for Public Health Practice and Policy: PH WINS contributes to the field of PHSSR by providing rare insight into the reasons why state health agency workers join and depart from the public health workforce – from the workers themselves. The results from this study can be used to better understand motivations for entering and leaving the public health workforce, which can in turn guide recruitment and retention efforts at state health agencies.