38 percent of state public health workers plan to leave the public health workforce by 2020 but it isn't just retirement, they want to get out of a health care system that is even more micromanaged and financially motivated that when HMOs and insurance companies were the big problem - government control. 

The article in Journal of Public Health Management and Practice (JPHMP) is based on the Public Health Workforce Interests and Needs Survey (PH WINS), the largest-ever study of the public health workforce.  

Some of the survey findings make sense and some are more bizarre, for example that people would leave a good-paying job because there was not enough diversity - except for Asians, meaning employees are acting discriminately toward Asian fellow workers in the name of tolerance. The big issues:

• Considerable workforce turnover. According to the survey, 38 percent of workers plan to leave their current position before 2020. Of those planning to leave, 25 percent plan to retire and 13 percent plan to leave for a position outside of public health. Of note, those most likely to leave for reasons other than retirement include younger workers and those with fewer than 10 years of experience in public health.

• Pay gaps by gender and race. There is less pay disparity in public health than there is in other areas of government - the Obama administration has very low pay equality - and women and people of color in state public health agencies earn 90 to 95 cents on the dollar compared to their male and white counterparts, after matching for seniority, experience, and educational attainment. This matches engineering, which tops the private sector in equal pay, so it seems strange anyone would quit, but the public health workforce is predominantly female and relatively diverse.  There is no pay gap between Asian staff and their white counterparts.