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Future of the profession

The amount of stress, burnout and ultimate turnover among public health officials has both Freeman and Fraser concerned about the future of the field.

\"We have seen recruitment taking a while,\" Fraser said, pointing to Ohio as one example. Acton's replacement, Dr. Joan Duwve, declined the job hours after Gov. Mike DeWine, a Republican, announced her appointment in September. Duwve told a South Carolina newspaper that she reconsidered the role in light of the harassment Acton endured.

\"PHOTO:
Megan Jelinger/AFP via Getty Images
PHOTO: A woman holds up a sign against Dr. Amy Acton outside of the Ohio State House in Columbus, Ohio on April 18, 2020, to protest the stay home order that is in effect until May 1st.
>

\"I don't think Ohio is unique,\" DeWine said during a press briefing at the time. \"We've seen protests against governors. We've seen protests against health directors throughout this country. We know that these are issues that can be divisive.\"

A new state health director was named in November, as Ohio started reporting record COVID-19 cases.

For Freeman, the loss of experienced leadership is a concern because \"there's not a bench waiting. And you don't have a lot of people raising their hands.\"

Among its efforts to support local health departments, NACCHO is working on a workforce bill that would create a loan repayment program for people who work in public health departments. Though that may not see any movement until after the pandemic, she said.

For now, many health officers are still committed to their posts. McKenney said she has had fleeting thoughts of quitting, but they're just that.

\"PHOTO:
Courtesy Dr. Jennifer Bacani McKenney
PHOTO: Dr. Jennifer Bacani McKenney, a health officer in Wilson County, Kansas.
>

\"This is my hometown, these are my people, even if everybody is not exactly unified or, at this point, all supportive,\" said McKenney, who, in addition to her part-time work as county health officer, runs a family medicine practice with her father and works at the regional hospital where she was born. She is also a member of her school board and the wife of the local mayor.

If McKenney sounds a little bit like her town's Leslie Knope -- the dedicated public servant on the TV show \"Parks and Recreation\" -- she's heard that a few times before.

\"The people here are worth it. I wouldn't live here, I wouldn't work here, I wouldn't want to raise my kids here if it weren't for the people,\" she said. \"It's not that I couldn't give up on the job; instead, I can't give up on the people. And I really just want to keep helping the people that I know and love.\"

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