Perceptions of Workplace Demands and Intentions to Leave Among the Rural and Urban Local US Public Health Workforce, 2024: Wearing Multiple Hats.

Objectives. To quantify local public health workforce perceptions of workplace demands by rurality, individual characteristics, and position characteristics, and examine relationships between perceived workplace demands, burnout, and intentions to stay. Methods. This cross-sectional, national study of the local public health workforce used data from the 2024 Public Health Workforce Interests and Needs Survey in the United States. Four measures of workplace demands were used: working in 4 or more program categories, ability to easily manage job demands, ability to complete work within working hours, and need to take on responsibilities outside of one's job description. Descriptive and design-adjusted analyses are presented. Results. Perceived workplace demands varied by setting, individual, and position characteristics. Nineteen percent of the local workforce worked in 4 or more program area categories, including more than 30% of the rural local workforce. Multivariable analyses show that in all but 1 instance, each of the 4 workplace demands was associated with greater odds of burnout and intentions to leave. Conclusions. The local public health workforce faces high workplace demands, which are related to burnout and intentions to leave. (Am J Public Health. 2026;116(S5):S406-S414. https://doi.org/10.2105/AJPH.2026.308738).