By Dr. Srivathsan V. Raghavan, DrPH

Keywords: public health workforce burnout, public health employee retention, remote work and burnout, workplace harassment in public health, turnover intention in health departments, mental health of public health workers, PH WINS survey, hybrid work job satisfaction, local health department staffing crisis, physician perspective on workforce wellbeing.

As someone with a Doctor of Public Health (DrPH), I spend most of my time thinking about the health of entire communities and the systems built to protect them. But there’s a population I’ve come to worry about just as much: the public health workforce itself. There is no bias in this week’s article, as I have previously highlighted other fields and occupations, and I plan to write more about other occupations over the coming weeks and months. These are the epidemiologists tracking outbreaks, the nurses running vaccine clinics, the environmental health specialists inspecting restaurants, and the program managers holding it all together at the local level. When they are exhausted, unsupported, or driven out of their jobs, the ripple effects reach every one of us — because a weakened public health system means slower outbreak response, gaps in health education, and more vulnerable communities when the next crisis hits.

A handful of recent studies published in the Journal of Public Health Management and Practice, all drawing on the Public Health Workforce Interests and Needs Survey (PH WINS), give us a clearer picture than ever of what’s driving public health professionals toward the exit door — and, more encouragingly, what might keep them in the field. I want to walk you through what these researchers found, why it matters, and what it means for anyone who cares about a functioning public health system, whether you work in it, fund it, or simply rely on it.

The Weight Public Health Workers Are Carrying

Let’s start with the most recent of these studies. McCall and colleagues (2026) analyzed a nationally representative sample of local public health professionals, using the 2024 PH WINS data to examine how burnout, sense of belonging at work, and self-rated mental and emotional well-being relate to one another — and ultimately to whether someone plans to leave their job. The findings, while not shocking to anyone who has worked in a stretched-thin agency, are striking in their clarity: burnout was consistently linked to worse self-rated mental and emotional health, while a stronger sense of belonging within one’s agency was linked to better mental and emotional health among local public health professionals surveyed nationally through the 2024 PH WINS effort (McCall et al., 2026). All three factors — burnout, belonging, and mental well-being — were tied to whether someone intended to leave their organization within the next year (Leider et al., 2023; McCall et al., 2026; Stone et al., 2021). To make matters worse, the inability to enumerate and to have an inclusive workforce, along with challenges in recruiting and retaining new employees, takes the cake in both the short term and the long term (Leider et al., 2023).

What I find most useful about this study, as a DrPH, is that it doesn’t treat burnout as an isolated problem to be solved with a wellness webinar. It frames burnout as part of a chain reaction: when people feel disconnected from their teams and mission, their emotional health suffers, and when their emotional health suffers, they start planning their exit. This matters because the local public health workforce had only just begun rebuilding after more than a decade of decline when the pandemic further strained it (McCall et al., 2026). Losing experienced staff now, just as the field is trying to recover its footing, could set the system back years.

When “Where You Work” Becomes a Retention Strategy

The second study takes a different but complementary angle: the role of remote and hybrid work. Gee and Yeager (2026) used the same 2024 PH WINS dataset — over 55,000 government public health employees — to ask a deceptively simple question: does it matter whether someone’s actual work arrangement matches what they’d prefer?

The answer was a resounding yes. About half of respondents reported that their current work situation (fully in-person, hybrid, or fully remote) matched their preference, while the other half experienced a mismatch. Employees whose situation matched their preferences—what the researchers called “concordance”—reported higher satisfaction with their jobs, organizations, pay, and benefits. Those who have an understanding and a preferential alignment with their job based on their original expectations, collectively grouped as a “concordant alignment”, tend to experience fewer negative outcomes, including burnout, and are less likely to leave their job in the future, compared to those who do not have such a “concordant alignment”. They were also substantially less likely to report burnout symptoms or an intention to leave their jobs within the year (Gee & Yeager, 2026; Valdez et al., 2023).

To put some numbers on it: employees whose work arrangement matched their preference were roughly twice as likely to report high job satisfaction and about 40% less likely to report burnout or an intent to leave compared with employees stuck in a mismatched arrangement (Gee & Yeager, 2026). That’s not a marginal effect — that’s the kind of difference that could meaningfully change staffing trajectories at a health department. Another problem that needs to be highlighted is the inability to appease younger age-group workers in the public health domain, esp., in governmental employment, and public-sector undertakings, due to lower pay and related benefits compared to the offers they can aspire to get in the private sector, leading to more “discordant alignment” adding to attrition, burnouts, and the inability to retain long-term workforce (Sellers et al., 2020).

What struck me most was who experiences the biggest mismatch. It’s not the people you might assume. Younger employees and those with graduate or public health degrees — precisely the early-career, highly trained staff that agencies most need to recruit and retain — were the least likely to be working in the arrangement they actually wanted. Many wanted hybrid or remote options but were working full-time in person instead. Meanwhile, older and less-credentialed staff were more likely to already be working in their preferred setting, typically in-person (Gee & Yeager, 2026).

There’s an important nuance here, though, and it’s one I appreciate as someone who values complete pictures over simple slogans: remote work isn’t a universal fix. Interns, for example, overwhelmingly preferred in-person work, likely because early-career professionals rely on face-to-face relationships to build the networks that help them land permanent jobs (Gee & Yeager, 2026). The lesson isn’t “send everyone home” — it’s that flexibility and choice, tailored to where someone is in their career, seem to matter more than any one-size-fits-all mandate. The authors also note that this research lands at a genuinely uncertain moment, as federal and some state policies have recently pushed toward mandatory returns to in-person work, making the question of how agencies balance flexibility with operational needs more urgent, not less (Gee & Yeager, 2026).

The Harm That Doesn’t Show Up on an Org Chart

The third study, published a few years earlier by McCall and colleagues (2023), looked at a darker but equally important piece of this puzzle: harassment. Drawing on the 2021 PH WINS data — collected while the COVID-19 pandemic was still actively reshaping the public health workforce — the researchers examined how experiences of harassment, threats, and bullying related to local public health professionals’ mental and emotional well-being and their intent to leave their jobs.

The pattern was unambiguous. Professionals who experienced harassment reported worse mental and emotional health, and they were more likely to say they intended to leave their organization (McCall et al., 2023). This came at a time when, as the researchers describe, news coverage and workforce surveys were documenting a wave of harassment and bullying directed at local health officials and their staff — often tied to pandemic-era public health measures like mask mandates and vaccination campaigns — occurring alongside an already severe shortage of public health workers nationwide (Barry-Jester, 2021; McCall et al., 2023; Yeager, 2022).

As a public health professional, I want to sit with this finding for a moment, because it’s easy to file “harassment of health officials” under news headlines about extreme, isolated incidents. But this study reframes it as a widespread occupational health hazard — one with a measurable, negative effect on the mental well-being of the very people we depend on to protect community health. When someone’s job includes tracking disease outbreaks or communicating evolving public health guidance, and that job also comes with a real risk of being threatened or harassed for doing it, we shouldn’t be surprised when talented people decide the trade-off isn’t worth it.

Summary

Read together, these studies tell a coherent story rather than a collection of disconnected findings. Burnout, disconnection from one’s agency, mismatched work arrangements, and exposure to harassment all chip away at the same thing: a public health professional’s mental and emotional well-being. And that well-being, in turn, is one of the strongest predictors of whether someone stays in the field or leaves it.

This matters beyond the individual worker. Every experienced epidemiologist, environmental health inspector, or program coordinator who leaves takes institutional knowledge with them — knowledge about local community relationships, regulatory nuances, and crisis response protocols that can’t be rebuilt overnight. A health department that is constantly retraining new staff is, almost by definition, less prepared for the next public health emergency.

As someone trained to think in terms of population-level prevention, I see this the same way I see any upstream public health problem. We don’t wait for a community to face a full-blown disease outbreak before investing in access to vaccination and health education. Similarly, we shouldn’t wait for a public health agency to be gutted by turnover before we address the upstream, modifiable risk factors: workplace culture and belonging, flexibility in how and where people work, and protection from harassment. All these studies point to concrete, actionable levers rather than vague calls to “improve morale.”

What Can Actually Be Done

Based on the collective findings of this research, a few practical directions stand out:

• Invest in belonging, not just wellness perks. Programs that build genuine connection and inclusion within an agency appear to buffer against the mental health toll of burnout (McCall et al., 2026). That could mean better onboarding, mentorship structures, or simply leadership that checks in meaningfully rather than performatively.
• Offer real choice in work arrangements where the job allows it. Rigid, one-size-fits-all return-to-office mandates may be counterproductive for a workforce in which roughly half of employees already have their preferences unmet and younger, highly trained staff are disproportionately affected (Gee & Yeager, 2026).
• Tailor flexibility policies to career stage. Recognize that early-career staff and interns may benefit from more in-person structure for mentorship and network-building, even as many prefer hybrid arrangements once established (Gee & Yeager, 2026).
• Treat harassment as an occupational safety issue, not background noise. Agencies need clear protocols for supporting staff who face threats or bullying, along with public communication strategies that reduce the likelihood of such incidents occurring in the first place (McCall et al., 2023).
• Track these metrics over time. All these studies rely on the PH WINS survey precisely because ongoing measurement makes it possible to see whether interventions are actually working, rather than assuming they are.

A Call to Action

If you work in public health, I hope this research validates something you may already feel in your bones: burnout, harassment, and rigid policies are not just personal struggles to push through — they are measurable, agency-level problems with agency-level solutions. Advocate for the flexibility and support systems the evidence points toward, and don’t hesitate to voice concerns about harassment as the occupational hazard it truly is.

If you’re a health department leader, policymaker, or funder, consider these findings a call to look upstream. Investing in workplace culture, flexible arrangements, and staff protection isn’t a soft, secondary priority — it’s a direct investment in the resilience of the systems that keep communities safe from the next outbreak, environmental hazard, or health crisis.

And if you’re simply a member of the public who has never thought much about who staffs your local health department: the next time you see a public health worker, a little patience and civility goes a long way. The data are clear that how these professionals are treated shapes whether they stay in the jobs that protect all of us.

---

Dr. Srivathsan Raghavan is a researcher and practitioner dedicated to solving systemic vulnerabilities within industrial infrastructure. As a Doctor of Public Health, he emphasizes Occupational Health and Safety. He bridges translational science and large-scale corporate execution. Dr. Raghavan integrates rigorous academic theory with real-world operations management to analyze and mitigate environmental health threats. His writing provides evidence-based insights into HAZMAT RMP (Hazardous Materials Responsible Management Person) compliance, offering clinical, scientific, and administrative peers a clear view of how operational design directly affects workforce longevity, population health outcomes, and institutional risk.

---

References

Barry-Jester, A. M. (2021, April 25). ‘We’re coming for you’: For public health officials, a year of threats and menace. KFF Health News. https://kffhealthnews.org/public-health/public-health-officials-year-of-threats-menace-santa-cruz-california/.

Gee, M., & Yeager, V. A. (2026). Remote work opportunities and preferences among public health employees: Implications for job satisfaction, burnout, and retention. Journal of Public Health Management and Practice, 32(1S Suppl 1), S95–S108. https://doi.org/10.1097/PHH.0000000000002273.

Leider, J. P., Yeager, V. A., Kirkland, C., Krasna, H., Hare Bork, R., & Resnick, B. (2023). The State of the US Public Health Workforce: Ongoing Challenges and Future Directions. Annual Review of Public Health, 44, 323–341. https://doi.org/10.1146/annurev-publhealth-071421-032830.

McCall, T. C., Alford, A. A., Cunningham, M. C., Hall, K., & Royster, J. (2023). The role of harassment in the mental well-being of local public health professionals and its relationship with an intent to leave their organization during the COVID-19 pandemic. Journal of Public Health Management and Practice, 29(Suppl 1), S45–S47. https://doi.org/10.1097/PHH.0000000000001655.

McCall, T. C., Perkins, K., & Alford, A. A. (2026). Burnout, belonging, and mental well-being: Predictors of turnover intent among local public health professionals. Journal of Public Health Management and Practice, 32(1S Suppl 1), S25–S32. https://doi.org/10.1097/PHH.0000000000002274.

Sellers, K., Leider, J. P., Lamprecht, L., Liss-Levinson, R., & Castrucci, B. C. (2020). Using Public Health Workforce Surveillance Data to Prioritize Retention Efforts for Younger Staff. American Journal of Preventive Medicine, 59(4), 562–569. https://doi.org/10.1016/j.amepre.2020.03.017.

Stone, K. W., Kintziger, K. W., Jagger, M. A., & Horney, J. A. (2021). Public Health Workforce Burnout in the COVID-19 Response in the U.S. International Journal of Environmental Research and Public Health, 18(8), 4369. https://doi.org/10.3390/ijerph18084369.

Valdez, I. D., Ramirez, C. E., Khansari, A., Momin, I., Sitzmann, C., Dehghanpour, M., & Clark, K. R. (2023). Leading past COVID-19: An analysis of remote work now and beyond. Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists, 48(3), 161–164. https://doi.org/10.1016/j.meddos.2023.03.003.

Yeager V. A. (2022). The Politicization of Public Health and the Impact on Health Officials and the Workforce: Charting a Path Forward. American journal of public health, 112(5), 734–735. https://doi.org/10.2105/AJPH.2022.306744.