Between 2017 and 2021, 75% of government public health workers 35 and under left their organizations. Workers in this age group currently represent only 25% of the workforce, but as of 2024, 33% of them were planning to leave their organizations in the next year.

What is leading to these numbers, and how can state and local public health agencies attract and keep young employees?

A Confluence of Factors

There are likely several factors influencing the low rates of entry and higher levels of attrition in this group. Public health agencies are, first and foremost, government entities, meaning that they operate within the constraints of limited resources and complex bureaucracy. Recruitment processes and application systems can be long, complex, and onerous. While these challenges can negatively impact all candidates, it may have a greater impact on the youngest generations, who came of age with advanced technology and efficient communication literally at their fingertips.

In previous decades, younger populations joined the government workforce because they were drawn to the job security and comprehensive retirement packages that these positions offered. Today, most government positions do not offer the types of pension plans that were once ubiquitous in this field, and federal cuts to public health funding have the potential to threaten job security in these positions.

Feeling a sense of belonging is essential to retention. The most recent Public Health Workforce Interests and Needs Survey (PH WINS), which was fielded in the fall of 2024, found that overall, 80% of employees 35 and under reported feeling a sense of belonging at their agency, while only 58% of young employees intending to leave felt they belonged. Increasing the number of young people who feel they “belong” at an agency would likely lead to better retention.

Pay is cited as a top reason for leaving public health agencies in PH WINS 2024, and only 52% of government public health employees 35 and under reported being satisfied with their pay.

In many organizations, the transience of younger generations is blamed on the young people themselves; we have heard young people described as flighty, disloyal, or lacking resilience. But as public health practitioners, let’s approach this the way we would any population health issue: by examining and trying to improve the system. In this case, the system is the state and local public health agencies themselves.

Strategies to Improve

Below are some strategies that staff within state and local public health agencies can employ to recruit and retain the youngest generations.

Lead with the mission: In a recent survey by Deloitte, nearly all Gen-Z and Millennial respondents indicated that they want to do meaningful work. Additionally, PH WINS 2024 reveals that 64% of young professionals joined the state and local government public health workforce to be able to serve their community and do meaningful work. Public health work is inherently mission-driven, and emphasizing that in recruitment materials and conversations can help garner interest from young applicants.

Emphasize community engagement: The same Deloitte survey found that 75% of Gen-Z and Millennial respondents said an organization’s community engagement and societal impact is important. Emphasizing the community-facing nature of local public health roles is essential to recruiting these populations.

Embrace work/life balance: Government careers often provide better work/life balance than a job in the private sector, and this is very important to younger generations. PH WINS 2024 found that 91% and 83% of younger employees believe flexible time and ad-hoc remote work, respectively, are important organizational policies. Emphasizing how current employees can balance their work and personal lives is a great way to keep young candidates interested during the application and interview process.

Build agency/school partnerships: Many state and local health departments successfully partner with local colleges and universities to recruit recent graduates. An internship program, in addition, can build an internal pipeline of candidates who have gained a solid understanding of what it is really like to work at a health department. According to PH WINS 2024, 70% of young public health professionals come from other jobs, 60% of which are not in public health. Yet, more young professionals (37%) have public health degrees than their older counterparts (20%).

Communicate during the application process: Having a designated contact person who will answer questions and inquiries from candidates within 1-2 days is key. Also, do everything you can to make the application and interview process efficient! Remember, people today – especially the youngest generations – are used to having technology and communication at their fingertips.

Promote acceptance and belonging: Help young people see themselves in your agency by inviting other young workers to participate in panels and/or introducing young people to their peers once they join. Building meaningful relationships is key to developing a sense of belonging. And the more people who join your agency and stay, the more comfortable other young people will feel joining, too.

Provide flexibility, wellness, and balance: As much as possible, give workers the opportunity to work where and when is best for them. Currently, as reported in PH WINS 2024, 45% of young professionals work fully in-person, whereas only 13% prefer that schedule. Actively encourage and model work/life balance, and support employee wellness through trauma-informed leadership and employee-led wellness initiatives.

Ensure supervisors are effective and skilled: Are supervisors at your agencies nurturing their employees’ growth by using skills like active listening, coaching, and conflict resolution? Among employees who said they intended to leave in 2024, 22% said it was because of dissatisfaction with a supervisor. Consider providing training or coaching to help build these skills among supervisors and create a more supportive environment for all staff.

Offer mentorship: Mentoring programs are a great way to foster relationships between younger and more seasoned staff and offer entry-level employees an opportunity to learn. Further, mentoring can help new employees better understand career trajectories in a workplace and provide them with someone who can help them develop the skills they need to move to a leadership position someday.