Factors Associated with Turnover Intention Among Early-Career US Governmental Public Health Employees and a Moderation Role of Race and Ethnicity.

Objective: This study examined the associations between individual characteristics, organizational environmental perceptions, and turnover intention among early-career US governmental public health employees under 35 years of age.

Design: Multivariable logistic regression was used to analyze turnover intention in relation to employee demographics, agency setting, global workplace satisfaction, and organizational environmental perceptions among early-career public health employees from the combined cross-sectional data of the 2017 and 2021 Public Health Workforce Interests and Needs Survey. Moderation effects of race and ethnicity on these relationships were also tested.

Setting: US State Health Agency Central Offices and Local Health Departments.

Participants: A total of 43 638 US governmental public health employees across state and local health agencies participated in this study.

Main outcome measures: Self-reported turnover intention, coded as binary: "No" (0) for staying and "Yes" (1) for intention to leave within a year, excluding retirement.

Results: A 35.7% of early-career US governmental public health employees under 35 years of age reported an intention to leave their agency within a year, exceeding the overall workforce rate of 25.4% ( P < .05). Men, individuals of other gender identities, racial and ethnic minorities, those with higher education, and younger employees were more likely to report turnover intention. In contrast, higher global workplace satisfaction, positive perceptions of talent and expertise utilization, and career development opportunities including training needs assessments and leadership development were associated with lower turnover intention. These relationships were moderated by race and ethnicity, with stronger protective effects for white employees compared to racial and ethnic minoritized employees.

Conclusions: Early-career US governmental public health employees face high turnover risks, especially in certain demographic groups. Higher global workplace satisfaction and positive perceptions of skill utilization and career development opportunities reduce the odds of turnover intention, with stronger effects for white employees. Targeted human resource strategies are essential to improving retention in this workforce.