Succession planning in local health departments: results from a national survey.

CONTEXT

Succession planning has received scant attention in the public health sector, despite its potential to generate operational efficiencies in a sector facing chronic budgetary pressures and an aging workforce.

OBJECTIVES

We examined the extent to which local health departments (LHDs) are engaged in succession planning and assessed the factors associated with having a succession plan.

DESIGN

We conducted a national cross-sectional Web-based survey of workforce recruitment and retention activities in a sample of LHDs responding to the National Association of County & City Health Officials' 2010 Profile Study and then linked these data sets to fit a multivariable logistic regression model to explain why some LHDs have succession plans and others do not.

SETTING AND PARTICIPANTS

Top executives in a national sample of LHDs.

MAIN OUTCOME MEASURE

Presence or absence of succession planning.

RESULTS

Two hundred twenty-five LHDs responded to the survey, yielding a 43.3% response rate, but no statistically significant differences between respondents and nonrespondents were detected. Only 39.5% reported having a succession plan. Performance evaluation activities are more common in LHDs with a succession plan than in LHDs without a plan. In adjusted analyses, the largest LHDs were 7 times more likely to have a succession plan than the smallest. Compared with state-governed LHDs, locally governed LHDs were 3.5 times more likely, and shared governance LHDs were 6 times more likely, to have a succession plan. Every additional year of experience by the top executive was associated with a 5% increase in the odds of having a succession plan. Local health departments that report high levels of concern about retaining staff (vs low concern) had 2.5 times higher adjusted odds of having a succession plan.

CONCLUSIONS

This study provides the first national data on succession planning in LHDs and sheds light on LHDs' readiness to meet the workforce-related accreditation standards.