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DENVER (KDVR) — Pandemic pressures seem to have taken a toll on public health governance.

Health workers are leaving their field across Colorado from a combination of pandemic pressures including burnout, the lure of higher pay and vaccination mandates.

According to U.S. Bureau of Labor Statistics data, there have been 589,000 health and social workers who have left their jobs nationwide in September, the highest in 20 years.

Pressures have been eating away at more than just clinical workers. According to the Colorado Association of Local Public Health Officials, there have been 22 resignations from Colorado’s 53 local public health agencies.

While there have been some resignations in the Denver metro area, most of the directors left their positions in rural local public health agencies.

Resignations include the directors in Alamosa, Baca, Bent, Boulder, Clear Creek, Costilla, Custer, Fremont, Grand, Jackson, Jefferson, Kit Carson, Lincoln, Pitkin, Rio Grande, Routt, Saguache, Teller and Weld counties.