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.