The Moderating Role of Race in Turnover Intention at State and Local Public Health Organizations

Our focus was to assess whether race moderated the relationship between work environment factors and turnover in the public health field. This research aligns with the higher goal of recruiting and retaining public health workers that are reflective of the communities they serve.

The US population is becoming more racially and ethnically diverse, and the population’s health and health care needs are diversifying as well. In order to effectively carry out its functions, assure the population’s health, and advance health equity, the nation’s public health workforce must be as diverse as the population it serves. This requires the recruitment and retention of a diverse workforce. While there are many studies on turnover in the literature, relatively few studies in the field of public health have examined the antecedents and mechanisms of turnover, specifically among minority public health employees.

Our new study in the Journal of Public Health Management and Practice aimed to assess the impact of work environment factors on the turnover intentions of racial and ethnic minorities working in state and local public health departments. Our focus was to assess whether race moderated the relationship between work environment factors and turnover in the public health field. This research aligns with the higher goal of recruiting and retaining public health workers that are reflective of the communities they serve.

Using the Public Health Workforce Interests and Needs Survey (PH WINS), we focused on three public health work environment components — supervisory support, pay satisfaction, and job satisfaction — and assessed whether race moderated their respective relationships with turnover intention. Our findings suggest that:

• Minority public health professionals are more likely to report an intent to voluntarily leave their jobs for reasons other than retirement.
• Job satisfaction is critical to retention – job satisfaction mediates the respective relationships between pay satisfaction and supervisory support, and turnover intention.
• Attention to differences in the drivers of job satisfaction by racial groups may be vital to recruiting and retaining a diverse public health workforce. In this study, pay satisfaction and supervisory support were found to enhance job satisfaction for all races. However, the effect of pay satisfaction on job satisfaction was more pronounced for minorities than for whites. On the other hand, the job satisfaction-enhancing effect of supervisory support was found to be weaker for minorities than for whites.

In light of these findings, how can we improve public health workplace experiences and retain a diverse workforce?

• Focus on Improving Pay Satisfaction — Employers can identify ways to increase pay satisfaction through routine comprehensive and equitable audits of compensation packages. Such efforts to enhance pay equity may improve job satisfaction for all staff, but especially for  racial and ethnic minorities.
• Focus on Supervisor Diversity and Training — Supervisors play an important role in employees’ overall view of an institution and significantly influence their job satisfaction. Previous studies have reported increased job satisfaction among minorities when effective diversity management practices are in place. Enhancing leadership diversity and improving the diversity management skills of public health leaders may enhance employee satisfaction and minimize turnover.

Read the Report in the Journal of Public Health Management and Practice:

• Examining Factors Associated With Minority Turnover Intention in State and Local Public Health Organizations: The Moderating Role of Race in the Relationship Among Supervisory Support, Job Satisfaction, and Turnover Intention

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Ashley K. Mitchell, DrPH, MSPH, is an Assistant Professor in the Department of Medical Education at Morehouse School of Medicine. She holds a Doctor of Public Health in Leadership from Georgia Southern University, a Master of Science in Public Health from Meharry Medical College, and a Bachelor of Science in Psychology from Vanderbilt University. Her research includes the assessment of academic and workplace environmental effects on learning, growth, and retention.

Bettye A. Apenteng, PhD, is an Associate Professor of Health Policy and Community Health at the Jiann-Ping Hsu College of Public Health, Georgia Southern University. She completed her PhD in Health Services Research, Administration, and Policy from the University of Nebraska Medical Center. Her research and practice interests are in the relationships among health organizational structure, behavior and performance, and how these relationships collectively shape (a) health systems capacity and optimal functioning; (b) access to health services; and (c) equitable population health outcomes.

Kwabena Boakye, PhD, is an Associate Professor of Business Analytics at Georgia Southern University. His research interests include service and health care operations strategy, and quality management. His works have appeared in Health Care Management Review, International Journal of Production Economics, Journal of Public Health Management and Practice, among others.