The COVID-19 pandemic has severely impacted the US public health workforce. High turnover of local health department (LHD) personnel has created concerns about workforce needs and capacity. This strain has been particularly alarming among rural LHDs due to an historical lack of investment and limited workforce capacity compared to their urban counterparts.

This article compares rural and urban local public health workforces, including competencies and training needs, COVID-19 impact, and turnover risk.