Earnings, Retention, and Inflation: A Five-Year Analysis of Ohio Local Health Department Employees.

CONTEXT: Examining earnings trends among local health department (LHD) employees has been difficult because of the scarcity of longitudinal data at the individual employee level. Previous research has relied on repeated cross-sectional data sets to investigate earnings patterns, but only longitudinal data enable a nuanced analysis of how earnings evolve over time. OBJECTIVES: To analyze trends in earnings among LHD employees in Ohio between 2019 and 2024. DESIGN: This study analyzed annual financial reports from 52 LHDs in Ohio, serving approximately 60% of the state's population. The data set included individual earnings data for 2557 employees in 2019 and 2929 employees in 2024, with a subset of 1051 tracked across both years. Both cross-sectional and longitudinal analyses were conducted to examine earnings trends based on employees' tenure within their positions. RESULTS: In Ohio, LHD employees' actual annual earnings rose from $67,492 in 2019 to $81,681 in 2024, but inflation-adjusted earnings declined by 1 percent, indicating a loss of purchasing power during this period of high inflation. Employees continuously employed at the same LHD saw greater salary growth, with inflation-adjusted earnings increasing by 9 percent over 5 years, unlike the overall trend. Employees who joined after 2019 made 7% less in inflation-adjusted dollars than those who left before 2024. CONCLUSION: By leveraging individual-level, longitudinal data, this study demonstrates that earnings trajectories differ substantially depending on employees' working trajectory. Overall stagnation in earnings observed in cross-sectional analyses is driven, in part, by workforce turnover. Employees who remained in their positions benefited from sustained wage growth, whereas those who left or were newly hired tended to earn less in real terms. Findings suggest that retention may be a mechanism through which employees realize earnings growth.