Key Government Public Health Positions Pay Well Below Private Sector

Public sector salary inequalities could weaken preparedness for next pandemic

February 13, 2024

A majority of public health occupations in health departments around the country pay substantially less to their workers compared to workers in the same occupations in the private sector, according to a new study by researchers at Columbia University Mailman School of Public Health. While earlier studies have compared salaries between different occupations within health departments or asked respondents if they are satisfied with their salary, until now few contrasted salaries for the same occupations within government versus the private sector or asked directly about wage competition. The findings are published in the American Journal of Public Health.

“Considering the potential recruitment challenges caused by salary disparities, several policy solutions might be considered, including improvements in federal data on the public health workforce, with clearer salary information and workforce remuneration,” said Heather Krasna, PhD, EdM, associate dean, Career and Professional Development at Columbia Mailman School. “For occupations paying lower wages, increases in salary should be considered if this is an option. Otherwise, job seekers should focus on benefits, work-life balance, and meaningful public service work as a motivator.”

Using the U.S. Department of Labor’s Occupational Employment and Wage Survey (OEWS), a semiannual mail survey on employment and wage estimates, Krasna and colleagues used May 2022 OEWS data, the most recent information available. OEWS estimates are based on data from every state, across all surveyed industries, and from establishments of varying sizes.

Referencing previous studies matching Standard Occupational Classification (SOC) codes with health department occupations, the researchers selected 44 standard codes and contrasted median salaries in OEWS for workers in each occupation within state or local government with workers in the same occupations outside government.

Of 44 occupations, 30 paid at least 5 percent less in government than in the private sector. Occupations with the severest salary disparities—those with median annual salaries paying between 20 percent and up to 47 percent lower in either local or state government as compared with the private sector—included management, leadership, program management, program evaluation, and policy occupations, as well as computer-related occupations and epidemiologists. 

Some occupations had higher salaries in local and state government than in private industry, and six occupations, primarily in social work or counseling, paid 24 percent to 39 percent more in government. Overall, those with the largest wage advantage in government were primarily in community and social service occupations or related human services roles. (The paper includes a full list of salary differentials.)

Salary differences for many, but not all, occupations appear substantial, especially for technical, research, management, and leadership roles, according to Krasna. “Based on the limited federal data available, many public health occupations in local or state government appear to face serious wage competition, especially from the for-profit sector, and particularly from professional, scientific, and technical services, and from large health care organizations,” she noted.

“We urge that health departments consider adjusting their salaries, marketing their strong benefits or public service mission, or use creative recruitment incentives such as student loan repayment programs for hard-to-fill roles for a sustainable public health workforce,” Krasna continued. “When epidemiologists can earn $23,000 more and emergency management directors $33,460 more by quitting their jobs in health departments to work in private industry, we might wonder who will respond to the next pandemic or public health emergency.”

Co-authors are Malvika Venkataraman and Isabella Patino, Columbia Mailman School of Public Health.

The study was supported by the Centers for Disease Control and Prevention and Health Resources and Services Administration (grants U81HP47167 and UR2HP47371).

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