{"id":"https://openalex.org/W7128310859","doi":"https://doi.org/10.1093/haschl/qxag032","title":"Recent trends in US government healthcare & behavioral health workforce departures","display_name":"Recent trends in US government healthcare & behavioral health workforce departures","publication_year":2026,"publication_date":"2026-02-01","ids":{"openalex":"https://openalex.org/W7128310859","doi":"https://doi.org/10.1093/haschl/qxag032","pmid":"https://pubmed.ncbi.nlm.nih.gov/41743359"},"language":"en","primary_location":{"id":"doi:10.1093/haschl/qxag032","doi":"https://doi.org/10.1093/haschl/qxag032","is_oa":true,"landing_page_url":"https://doi.org/10.1093/haschl/qxag032","pdf_url":null,"source":{"id":"https://openalex.org/S4387290458","display_name":"Health Affairs Scholar","issn_l":"2976-5390","issn":["2976-5390"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs Scholar","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1093/haschl/qxag032","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5125349936","display_name":"Nichole Fusilier","orcid":"https://orcid.org/0009-0000-0258-0895","observed_orcids":["https://orcid.org/0009-0000-0258-0895"]},"institutions":[{"id":"https://openalex.org/I130238516","display_name":"University of Minnesota","ror":"https://ror.org/017zqws13","country_code":"US","type":"education","lineage":["https://openalex.org/I130238516"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Nichole Fusilier","raw_affiliation_strings":["School of Public Health, University of Minnesota , 420 Delaware St SE, Minneapolis, MN 55455 ,"],"raw_orcid":"https://orcid.org/0009-0000-0258-0895","affiliations":[{"raw_affiliation_string":"School of Public Health, University of Minnesota , 420 Delaware St SE, Minneapolis, MN 55455 ,","institution_ids":["https://openalex.org/I130238516"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009839405","display_name":"Elisabeth Stelson","orcid":"https://orcid.org/0000-0001-5176-2652","observed_orcids":["https://orcid.org/0000-0001-5176-2652"]},"institutions":[{"id":"https://openalex.org/I204465549","display_name":"Washington University in St. Louis","ror":"https://ror.org/01yc7t268","country_code":"US","type":"education","lineage":["https://openalex.org/I204465549"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Elisabeth Stelson","raw_affiliation_strings":["School of Public Health, Washington University , St. Louis, MO 63130 ,"],"raw_orcid":"https://orcid.org/0000-0001-5176-2652","affiliations":[{"raw_affiliation_string":"School of Public Health, Washington University , St. Louis, MO 63130 ,","institution_ids":["https://openalex.org/I204465549"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5084920400","display_name":"Janette Dill","orcid":"https://orcid.org/0000-0002-4044-3127","observed_orcids":["https://orcid.org/0000-0002-4044-3127"]},"institutions":[{"id":"https://openalex.org/I130238516","display_name":"University of Minnesota","ror":"https://ror.org/017zqws13","country_code":"US","type":"education","lineage":["https://openalex.org/I130238516"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Janette Dill","raw_affiliation_strings":["School of Public Health, University of Minnesota , 420 Delaware St SE, Minneapolis, MN 55455 ,"],"raw_orcid":"https://orcid.org/0000-0002-4044-3127","affiliations":[{"raw_affiliation_string":"School of Public Health, University of Minnesota , 420 Delaware St SE, Minneapolis, MN 55455 ,","institution_ids":["https://openalex.org/I130238516"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5084920400"],"corresponding_institution_ids":["https://openalex.org/I130238516"],"apc_list":{"value":3150,"currency":"USD","value_usd":3150},"apc_paid":{"value":3150,"currency":"USD","value_usd":3150},"fwci":10.0467,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.94252707,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":93,"max":96},"biblio":{"volume":"4","issue":"2","first_page":"qxag032","last_page":"qxag032"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11990","display_name":"Global Health Workforce Issues","score":0.8812999725341797,"subfield":{"id":"https://openalex.org/subfields/3604","display_name":"Emergency Medical Services"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11990","display_name":"Global Health Workforce Issues","score":0.8812999725341797,"subfield":{"id":"https://openalex.org/subfields/3604","display_name":"Emergency Medical Services"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.06530000269412994,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11631","display_name":"Retirement, Disability, and Employment","score":0.02280000038444996,"subfield":{"id":"https://openalex.org/subfields/3317","display_name":"Demography"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/public-sector-employment","display_name":"public sector employees","score":0.7179999947547913},{"id":"https://openalex.org/keywords/health-care-workforce","display_name":"healthcare workforce","score":0.8040000200271606},{"id":"https://openalex.org/keywords/behavioral-health-workforce","display_name":"behavioral health workforce","score":0.9890000224113464},{"id":"https://openalex.org/keywords/employee-retention","display_name":"employee retention","score":0.4320000112056732},{"id":"https://openalex.org/keywords/employment-transitions","display_name":"employment transitions","score":0.6650000214576721},{"id":"https://openalex.org/keywords/labour-force-exit","display_name":"labor force exit","score":0.8700000047683716},{"id":"https://openalex.org/keywords/federal-employees","display_name":"federal employees","score":0.8989999890327454},{"id":"https://openalex.org/keywords/state-and-local-government-employees","display_name":"state and local government employees","score":0.753000020980835},{"id":"https://openalex.org/keywords/public-health-infrastructure","display_name":"public health infrastructure","score":0.5709999799728394}],"concepts":[{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.6559000015258789},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5439000129699707},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.5098999738693237},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.47699999809265137},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.44119998812675476},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.36149999499320984},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.3197000026702881},{"id":"https://openalex.org/C109986646","wikidata":"https://www.wikidata.org/wiki/Q546113","display_name":"Public policy","level":2,"score":0.3140000104904175},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.29750001430511475},{"id":"https://openalex.org/C100001284","wikidata":"https://www.wikidata.org/wiki/Q2248246","display_name":"Public economics","level":1,"score":0.28600001335144043},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.2793999910354614},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.26969999074935913},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.25940001010894775},{"id":"https://openalex.org/C2986740045","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health services","level":3,"score":0.2565999925136566}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1093/haschl/qxag032","doi":"https://doi.org/10.1093/haschl/qxag032","is_oa":true,"landing_page_url":"https://doi.org/10.1093/haschl/qxag032","pdf_url":null,"source":{"id":"https://openalex.org/S4387290458","display_name":"Health Affairs Scholar","issn_l":"2976-5390","issn":["2976-5390"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs Scholar","raw_type":"journal-article"},{"id":"pmid:41743359","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41743359","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health affairs scholar","raw_type":"Journal Article"},{"id":"pmh:oai:europepmc.org:11747278","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12931559","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12931559/pdf/qxag032.pdf","source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Text"},{"id":"pmh:oai:pubmedcentral.nih.gov:12931559","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12931559/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Health Aff Sch","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/haschl/qxag032","doi":"https://doi.org/10.1093/haschl/qxag032","is_oa":true,"landing_page_url":"https://doi.org/10.1093/haschl/qxag032","pdf_url":null,"source":{"id":"https://openalex.org/S4387290458","display_name":"Health Affairs Scholar","issn_l":"2976-5390","issn":["2976-5390"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs Scholar","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Decent work and economic growth","id":"https://metadata.un.org/sdg/8","score":0.9211000204086304},{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9074000120162964}],"sustainable_development_goals_aurora":[{"display_name":"Decent work and economic growth","id":"https://metadata.un.org/sdg/8","score":0.5678737163543701}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[{"id":"https://openalex.org/G2808991383","display_name":null,"funder_award_id":"U81HP47167","funder_id":"https://openalex.org/F4320332162","funder_display_name":"Centers for Disease Control and Prevention"}],"funders":[{"id":"https://openalex.org/F4320332162","display_name":"Centers for Disease Control and Prevention","ror":"https://ror.org/042twtr12"},{"id":"https://openalex.org/F4320332175","display_name":"Health Resources and Services Administration","ror":"https://ror.org/033jnv181"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":12,"referenced_works":["https://openalex.org/W1507420594","https://openalex.org/W2146075110","https://openalex.org/W2164917275","https://openalex.org/W2563240080","https://openalex.org/W4225783398","https://openalex.org/W4296954279","https://openalex.org/W4306768323","https://openalex.org/W4378172233","https://openalex.org/W4400276464","https://openalex.org/W4409628357","https://openalex.org/W6889704721","https://openalex.org/W7083302929"],"related_works":[],"abstract_inverted_index":{"Introduction:":[0],"Healthcare":[1,131],"and":[2,10,24,39,48,72,89,101,127],"behavioral":[3,73,102,138],"health":[4,18,74,103,139,182],"professionals":[5],"employed":[6],"by":[7],"local,":[8],"state,":[9],"federal":[11,99],"governments":[12],"are":[13,43],"essential":[14],"to":[15,22,26,65,86,141,169],"maintaining":[16],"public":[17],"infrastructure,":[19],"ensuring":[20],"access":[21],"care,":[23],"responding":[25],"emergencies.":[27],"Despite":[28],"their":[29,45,114],"importance,":[30],"limited":[31],"research":[32],"has":[33],"examined":[34],"how":[35],"recent":[36],"policy,":[37],"budgetary,":[38],"labor":[40,95,164],"market":[41],"changes":[42],"influencing":[44],"employment":[46,67,88,119],"stability":[47],"retention":[49],"within":[50],"government":[51,85,111,118,145],"sectors.":[52],"Methods:":[53],"This":[54],"study":[55],"used":[56],"longitudinal":[57],"data":[58],"from":[59,84,93,110,167],"the":[60,78,94,106,180],"Current":[61],"Population":[62],"Survey":[63],"(2015-2025)":[64],"examine":[66],"transitions":[68,83],"among":[69],"government-employed":[70,181],"healthcare":[71,100],"workers.":[75],"We":[76],"estimated":[77],"predicted":[79],"probabilities":[80],"of":[81,116,144],"(1)":[82],"non-governmental":[87],"(2)":[90],"full":[91],"exits":[92],"force.":[96],"Results:":[97],"Historically,":[98],"workers":[104,132,140],"had":[105],"lowest":[107],"exit":[108,152],"rates":[109,153],"employment,":[112],"but":[113],"probability":[115],"leaving":[117],"rose":[120],"sharply":[121],"in":[122,154,163,171,179],"2024-2025,":[123],"converging":[124],"with":[125],"state":[126],"local":[128],"levels":[129],"(8%).":[130],"were":[133],"consistently":[134],"more":[135],"likely":[136],"than":[137],"transition":[142],"out":[143],"roles,":[146],"though":[147],"both":[148],"groups":[149],"experienced":[150],"higher":[151],"2024-2025.":[155,172],"Federal":[156],"employees":[157],"also":[158],"exhibited":[159],"a":[160],"modest":[161],"increase":[162],"force":[165],"exits,":[166],"2.5%-3%":[168],"3.8%":[170],"Conclusion:":[173],"These":[174],"trends":[175],"suggest":[176],"increasing":[177],"instability":[178],"workforce.":[183]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2026-02-09T00:00:00"}
