November 20, 2025-- Younger workers in governmental public health place significantly higher value on nontraditional benefits than their older counterparts, according to a new study from Columbia University Mailman School of Public Health. Flexible scheduling and remote-work policies were among the top motivators for younger employees choosing and remaining in public service. The findings are published in the Journal of Public Health Management and Practice.
"Public health workers age 35 or younger consistently show lower retention rates than older workers," said Heather Krasna PhD, EdM, MS, associate dean of Career and Professional Development at Columbia Mailman School, and senior author. "Salaries matter, but because health departments often face limits on salary increases, offering nontraditional benefits may be an effective strategy to attract and retain younger staff."
The research team analyzed data from the 2024 Public Health Workforce Interests and Needs Survey (PH WINS), developed by the Beaumont Foundation and the Association of State and Territorial Health Officials. Responses from permanent, full-time health department employees were divided into two groups—those 35 and younger and those over 35—to compare how each valued nontraditional benefits, reasons for staying and, for younger workers, motivators for initially entering governmental public health. The two groups were similar in gender composition.
Younger workers were significantly more likely to cite nontraditional benefits as important reasons for staying with their organization:
- Flexibility: 38 percent of workers 35 and under vs. 31.5 percent of older workers
- Remote-work policies: 25 percent vs. 20 percent
- Training opportunities: 23 percent vs. 17 percent
Despite modest gains in younger representation in earlier years—26 percent of staff were younger than 40 in 2014 compared with 29 percent in 2017—retention has remained a persistent challenge. For example, workers under age 30 accounted for just 6 percent of the workforce between 2014 and 2017 but 13 percent of all departures. Turnover is costly, especially among skilled staff.
"The state and local governmental health department workforce has undergone dramatic shifts in recent years," said Krasna. "The COVID-19 pandemic and long-standing recruitment and retention challenges—especially among younger staff—have further strained the system."
Key drivers of retention for younger professionals include job satisfaction, meaningful work, recognition, supervisor support, workplace culture, work-life balance, remote-work options, and access to childcare.
"Because salary increases and broader workplace-culture reforms can be slow, innovative benefits may offer a more immediate tool for improving retention," Krasna added. "Our study reinforces a growing body of evidence that nontraditional benefits—such as schedule flexibility, remote work, and professional development opportunities—play a substantial role in job satisfaction and are especially influential for younger public health workers."
"For health departments unable to rapidly boost salaries, options like flex time, professional-development funding, or childcare support could meaningfully encourage younger staff to stay."
Sarika Karra of Columbia Public Health is a co-author.
The study was supported by the Centers for Disease Control and Prevention and the Health Resources and Services Administration, grants U81HP47167 and UR2HP4737.1.
