Online Program

RN salary gap in county labor markets: Public health nurses versus hospital nurses

Wednesday, November 4, 2015 : 1:00 p.m. - 1:15 p.m.

L. Michele Issel, PhD, RN, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
Betty Bekemeier, RN, PhD, FAAN, School of Nursing, Department of Psychosocial & Community Health, University of Washington, Seattle, WA
Christine Fitzpatrick, RN, College of Nursing, University of Illinois at Chicago, Chicago, IL

Recruitment of RNs into public health nursing positions has been an enigma, with NACCHO studies indicating that RN positions are among the hardest to fill.  This pilot study sought to describe the extent to which local health departments’ (LHDs’) RN wages are competitive with local hospital wages, with a focus on RN salary changes over 4 years.


A longitudinal, repeated measures design was used, with the county RN labor market as the unit of analysis.  Data were collected in 2010 and 2014 from the director of public health nursing or the hospital human resources department in the six markets. Analysis consisted of descriptive statistics, given the small sample size of county markets.


We have 2010 and 2014 data for 4 LHDs of which 50% had a small wage increase for public health RNs (PHNs) with some experience.  Despite an increased hourly wage in 50% of the LHDs for beginning PHNs, a wage gap persisted between PHNs (average $21.59) and hospital RNs ($28.44). In 2 of 3 markets, the gap between LHD and hospital hourly wages increased from 2010 to 2014 at all years of RN experience. In one market, the PHN and hospital RN wages gap decreased ($20.90 in 2010, $16.92 in 2014), but only at 18 years of experience.


Hourly wages gaps persist between PHNs in LHDs and RNs in hospitals, within the same county and sometimes literally across the street.   LHDs must offer wages competitive within the labor market to overcome recruitment difficulties.

Learning Areas:

Public health or related research

Learning Objectives:
Describe how to measure wage competition based on a labor market analysis.

Keyword(s): Local Public Health Agencies, Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was heavily involved in the data collection and analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.