Local Health Department Supervisor Experiences, Resources, and Satisfaction by Rurality.

Objectives. To describe perceptions of local health department supervisors regarding workload, burnout, training, resource availability, and retention by supervisory tier and rurality. Methods. Using national survey data on the local health department workforce from the Public Health Workforce Interests and Needs Survey (PH WINS) in the United States, we conducted survey-weighted descriptive analyses of supervisor characteristics, satisfaction, and perceptions of resource availability by rurality. We also conducted descriptive analyses of nonsupervisors' perceptions of their supervisors. Results. In both rural and urban settings, nearly half of supervisors reported insufficient staffing and funding. Satisfaction with supervisors was significantly higher among rural than urban nonsupervisors but was relatively high in both settings and was commonly cited as a reason for staying. Conclusions. Supervisors play a vital role in their organizations; however, supervisors in both rural and urban settings reported substantial resource constraints, high levels of burnout, and intentions to leave. Public Health Implications. Additional resources are needed to enhance the work of local health department supervisors. A lack of adequate resources and support may have negative implications for the workforce and agency operations. (Am J Public Health. 2026;116(S5):S393-S397. https://doi.org/10.2105/AJPH.2026.308771).