Much of health care work happens thanks to a solid foundation of support: childcare, housework, and other jobs that allow health care workers to show up every day at the clinic or hospital.
During the COVID-19 pandemic, “that base fell,” says Elizabeth Harry, MD, associate professor of general internal medicine at the University of Colorado School of Medicine. “It was like a house of cards and everything collapsed because the base was gone.”
In a recently published research, Harry and his co-researchers found that out of more than 58,000 healthcare professionals surveyed between April and December 2020, 21% reported experiencing childcare stress. Those with childhood stress were 115% more likely to experience anxiety or depression and 80% more likely to burnout than those without childhood stress.
In addition, high childcare stress was associated with 91% greater likelihood of intent to reduce hours and 28% more likely to leave the healthcare profession.
“It’s interesting to see the reaction to this data,” says Harry. “Not much is surprising, but I think it validated people’s experiences. It is definitely hitting a nerve, which is good because hopefully organizations will look at these numbers and look for ways to invest more in their workers. “
High childhood stress
Harry and his co-researchers collaborated with the American Medical Association to add a question about childhood stress to Coping with COVID, a brief survey of the working life and well-being of US healthcare professionals. The survey was distributed to doctors and staff of participating health organizations with more than 100 doctors. Participants completed the survey during the first months of the pandemic.
“Because everything was happening so quickly, the AMA was trying to start collecting data as soon as possible,” explains Harry. “So, there are certainly limitations, but it was necessary to decide whether to publish something quickly or do all the validation studies, so the decision was made to start collecting data right away.”
Respondents rated whether they were experiencing child care concerns due to COVID-19 on a scale of 1 to 4. The Coping with COVID survey also asked respondents about anxiety, depression, workload, as well as measures burnout singles, plans to reduce hours and plans to leave the healthcare profession.
“One of the key insights that emerged is the intent to reduce hours,” says Harry. “The high stress on childcare has led to 91% intentions to reduce hours and often I don’t think we fully appreciate the huge impact it can have on healthcare. It has an impact on child access. patients to treatment, it has an impact on the expenses for an organization. Reduced hours may seem like a small thing, but they can have a very strong impact “.
Addressing structural inequalities
Another finding from the survey data is that 39% of male respondents with low childhood stress experienced burnout, while 53% of men with high childhood stress experienced burnout. While the rates were higher for women – 63% of women with high childhood stress had burnout – “it’s worth discussing whether men face a different kind of prejudice, which is always someone else. that he will take care of them for housework or childcare, that they can stay late at work and don’t need to worry about those things, ”says Harry.
The data also showed that health workers from racial or ethnic minorities were 40% to 50% more likely to report childcare stress than white respondents. Furthermore, childhood stress has been noticed more often among medical assistants, nursing assistants, speech therapists, and pharmacists.
“Looking at this as a structural inequity issue is really important,” says Harry. “We need to think about the average cost of childcare and someone’s salary percentage, and ask as an organization how we can support healthcare professionals in every role. Here at CU we are very lucky to have a school on campus, but it is very unusual. We also have a crèche, but the waiting list is so long that it is often not accessible to people ”.
Further research can delve into not only the dimensions of childcare stress, but other aspects of caregiver stress as well, says Harry. “People who do not report childhood stress may still be stressed by caring for aging parents or other loved ones. It is important to understand how this is leading to burnout, the intention to cut down on hours, and the intention to leave. We have people who are trained in health care and we want them to stay in health care and stay full time if it fits into their career goals. “