J Public Health Manag Pract. 2026 Jan-Feb 01;32(1S Suppl 1):S60-S67. doi: 10.1097/PHH.0000000000002233. Epub 2025 Nov 18.
ABSTRACT
OBJECTIVE: Describe key characteristics of the rural local public health workforce on a national level, including in comparison to both the overall and urban local public health workforce.
DESIGN: Cross-sectional analysis of the 2024 Public Health Workforce Interests and Needs Survey (PH WINS) data.
SETTING: Local health departments (LHDs) serving rural and urban jurisdictions across the United States.
PARTICIPANTS: The study sample included 172 679 weighted responses from individuals working in LHDs, and 33 214 of them were from rural-serving LHDs.
MAIN OUTCOME MEASURES: Descriptive and bivariate statistics for measures across 4 areas, both overall and by rurality: demographic characteristics, educational background, position information, and intentions to stay or leave.
RESULTS: Greater portions of the rural local public health workforce were female and White relative to their urban counterparts. Compared to the urban workforce, the portions of the rural workforce without a public health degree and with clinical training were both greater. Tenure in position, agency, and public health practice also differed by rurality, with 19.6% of the rural workforce reporting the greatest tenure in public health practice (21 years or above) compared to 17.8% of the urban workforce. Intentions to stay, leave, or retire also differed by rurality, with 15.4% of the rural workforce reporting intentions to leave in the next year for reasons outside of retirement, compared to 21.6% of the urban workforce.
CONCLUSIONS: Characteristics of the local public health workforce vary by rurality, extending prior research demonstrating differences between rural- and urban-serving LHDs across the nation. Findings should guide rural-focused strategies aimed at strengthening and sustaining the public health workforce.
PMID:41248531 | DOI:10.1097/PHH.0000000000002233
