Retention of Community Health Workers in the Public Health Workforce: Public Health Workforce Interests and Needs Survey, 2017 and 2021

Abstract

Objectives: To investigate the organizational factors contributing to the intent of community health workers (CHWs) to quit their jobs in local and state health departments in the United States. Methods: We used the 2017 (n5844) and 2021 (n51014) Public Health Workforce Interests and Needs Survey data sets to predict CHWs’ intent to leave with Stata 17 balanced repeated replication survey estimations. Results: CHWs dissatisfied with organizational support, pay, or job security had high probabilities of reporting an intent to leave (50%, P < .01; 39%, P < .01; and 42%, P < .01, respectively) relative to satisfied or neutral workers (24%, P < .01; 21%, P < .01; and 26%, P < .01, respectively). Conclusions: Improving organizational support, pay satisfaction, and job security satisfaction in public health agencies can significantly improve CHW retention, potentially lowering overall organizational costs, enhancing organizational morale, and promoting community health. Public Health Implications: Our findings shed light on actionable ways to improve CHW retention, including assessing training needs; prioritizing diversity, equity, and inclusion; and improving communication between management and workers.