In Pursuit of Representation: Women in Public Health Leadership

The Consortium’s Working Group is focused on what needs to be done to recruit and retain a diverse and skilled workforce that is well-prepared to achieve health equity in their communities.

According to the PH WINS data released last summer, there is work to be done to improve gender diversity in leadership positions. While only 20 percent of the governmental public health workforce identify as men, men constitute 36 percent of those in executive leadership roles (i.e., members of Senior Executive Service or its equivalent). In contrast, women make up 79 percent of the governmental public health workforce but constitute 64 percent of executive leaders. These disparities are experienced to an even greater extent by women of color.

And it is not solely today’s executives; PH WINS data indicate increased disparities between men and women as staff move from non-supervisory to supervisory and executive-level positions — suggesting that the current gender disparities could widen in the future.

These disparities exist across the government as a whole. A recent 25-year analysis of federal Senior Executive Service (SES) positions highlights similar gaps, with a greater gap between men and women in SES positions relative to the federal workforce more broadly.

This dynamic is not limited to the public health field. According to a March 2023 report from McKinsey, these numbers are consistent with those in the healthcare industry, where women make up 75 percent of the workforce, but 32 percent of C-suite leadership.

Representation matters. Seeing women in leadership positions can build confidence and help chart career paths for other women working in governmental public health. Executives in governmental public health oversee significant public health programs and policies, and often dictate strategic direction for thousands of employees. Gender disparity in executive-level positions means that fewer women are contributing to decision-making that directly impacts the health and well-being of individuals across the country.

Our first step as a field is to acknowledge the current situation. The governmental public health workforce needs to understand how gender disparities in executive leadership affect their work and executive leaders need to understand the structural or cultural factors within their own departments that may be preventing women from advancing.

Hiring practices within state and local health departments are complex and can be difficult to understand and navigate. We must ensure the qualifications to move to the next level are clear and, support staff to pursue pathways into leadership and executive positions. Given that men are more likely than women to apply for jobs or seek out promotions even when they think they are underqualified, it is easy to see how gender can impact who receives opportunities within health departments. To mitigate those differences, health departments must conduct internal assessments of how gender may be influencing hiring, training, and mentoring, looking at the entire career pathway — from non-supervisor to supervisor to executive.

Let us begin by acknowledging the strengths of female leaders and the need to increase their presence in executive roles. We must continue to collaborate and learn from each other to uncover the solutions.

The 2021 Public Health Workforce Interests and Needs Survey (PH WINS) was conducted by the de Beaumont Foundation and the Association of State and Territorial Health Officials (ASTHO) between September 2021 and January 2022. The survey provides data on workforce demographics, job characteristics, training needs, intent to stay or leave, professional engagement and satisfaction, and other areas. Previously conducted in 2014 and 2017, PH WINS is the only nationally representative survey of state and local government public health employees in the United States. Access the PH WINS demographics dashboard to explore further.