Workers in state and local governmental public health carry an average debt of $48,000, though many have higher burdens.
Photo by Liubomyr Vorona, courtesy iStockphoto
Student loan debt is common among the nation's state and local public health workforce, with more than 40% of workers still paying off loans, a new study in APHA's American Journal of Public Health finds.
The research, published online in January, revealed that staff working in state and local governmental public health carried an average debt of $48,000, though some had much higher burdens. Indebted workers with a doctoral degree averaged a loan balance of $86,000, followed by those with master's degrees, at $67,000, and bachelor's degrees, at $38,500. Nearly a quarter of workers with loans still owed about 75% of their balance.
While about 16% of U.S. adults overall have a student loan balance, average debt levels for public health workers were higher compared to the general population, according to the study, which used data from the 2024 round of the Public Health Workforce Interests and Needs Survey.
Also troubling: Governmental public health workers with greater student loan debt were more likely to have their foot out the door. People who said they were planning to leave their jobs within the next year carried an average debt of $24,000, about 8% more than those not considering leaving.
When researchers examined their findings by race and ethnicity, they found wide gaps in how much governmental public health workers owed. About 35% of Black and 20% of Native Hawaiian and Pacific Islander employees said they had a balance above $40,000, compared to up to 17% of white, Asian and Hispanic employees. Black workers averaged a mean loan balance of $60,500, compared to about $44,500 for white workers.
Younger workers were more likely to owe money than older workers, with more than a third of workers ages 35 and younger still owing between $20,000 and $100,000 on their loans, the study found. Women were likely to owe more than men. Student loan debt also varied by job level, with public health managers and supervisors owing more than executive-level workers.
The findings come as the nation continues to struggle with a shortage of public health personnel within the governmental public health workforce. Previous research has found many of the 45,000 U.S. public health students who graduate each year choose private or nonprofit jobs over state and local government work. Large loan balances are likely a contributing factor, said study author Jonathon Leider, PhD, an associate professor at the University of Minnesota School of Public Health.
“Inside and outside of governmental public health, increasing levels of student loan debt are directly associated with staff seeking higher-paying positions,” he told The Nation's Health.
Student loan repayment can help boost public health capacity, and erasing or lowering student debt may motivate some public health professionals to choose government work over higher-paying jobs.
But the Trump administration is dismantling U.S. student loan relief programs that have helped thousands of students. In addition, Grad PLUS Loans, which for 20 years offered federal financial aid to graduate students, will end in July. At the same time, the U.S. Department of Education's January redefinition of “professional degrees” — which omits public health, physical therapy, social work, nursing and other degrees — places new federal borrowing limits on student loans.
The changes will likely reduce applications to public health schools, Leider predicts.
To provide a minimum set of public health services, the nation's state and local governmental public health departments need an 80% increase in workers, according to a 2021 analysis by the de Beaumont Foundation. Shortages in epidemiologists, nurses, operations support workers and other professions are making it harder for the public health system to carry out key public health functions, such as disease control investigation, the Government Accountability Office said in a report last year.
“It is a difficult time to be in public health,” Leider said. “I do think things will get worse before they get better — but I do expect them to get better. Just like police or fire, public health is needed to make sure we all stay safe.”
For more information on the AJPH study, visit www.ajph.org.
- Copyright The Nation’s Health, American Public Health Association
