COVID-19 Stress Among Your Workers? Healthy Work Design and Well-Being Solutions Are Critical

Posted on by Jeannie A. S. Nigam, MS, Jessica M. K. Streit, PhD, MS, Tapas K. Ray, PhD, Naomi Swanson, PhD

Experiencing an infectious disease outbreak can cause fear, anxiety, and stress.1-5 Along with overwhelming uncertainty and new behavioral ‘norms’ (e.g., cloth face covering or mask wearing, physical distancing), the COVID-19 pandemic has changed how we meet our daily needs, how we socially interact, and whether, how, and where we work.1,3 Millions of workers have lost their jobs.6 Some workers have continued to report to a physical workplace, while others have transitioned to full-time telework, and for many, the demands of work have changed or intensified. The nature of each situation is unique, but undoubtedly some of these changes are contributing to increasing levels of economic insecurity and occupational stress.3,7 Reducing occupational stress is a fundamental focus of the NIOSH Healthy Work Design (HWD) and Well-Being program. This post is one in a series of HWD-sponsored blogs addressing the effect of COVID-19 on workers. This post generally describes the stress workers may be experiencing and aims to help employers and policy makers better understand and support workers during this pandemic. Other posts in this series address economic and other insecurity, stress associated with jobs that cannot be done remotely, and organizational support.

An outbreak can affect mental health and psychosocial problems comparable to experiencing traumatic incidents.8,9 People can suffer increased feelings of uncertainty, anxiety, irritation, anger, and denial. It is not uncommon to lack motivation, have trouble sleeping or concentrating and to feel tired, overwhelmed, burned out, sad, and even depressed.2 If left unaddressed, experiencing such stress can lead people to engage in maladaptive coping (i.e., increased use of alcohol, tobacco, or other drugs or engaging in other unhealthy behaviors) and chronic health problems and mental health conditions may worsen.2,4 The exact nature of the risks to worker well-being vary according to personal circumstances and work arrangements. It is important for employers and policy makers to recognize the spectrum of stressors that workers face. Some have had to care for or have lost loved ones. Economic insecurity is affecting the millions who have lost their jobs or have seen their income decrease drastically due to reduced work hours or demand for their services. And those whose jobs are temporarily discontinued may worry about being laid-off and not re-hired, which further impacts emotional health.10,11

Physical distancing by working at home and avoiding in-person meetings or social gatherings can help reduce disease transmission – but also affects access to social support and can result in feelings of isolation and added stress.1 Not all jobs are amenable to remote work. Workers who must continue to report to a physical workplace may experience fear about their health and the health of their loved ones, as well as challenges arranging care for elderly or young dependents. Many jobs carry the risk of exposure to sick and asymptomatic individuals with COVID-19 – such as those in healthcare settings and others (i.e., service occupations) that must be done on-site and require frequent contact with the public. Workers’ well-being can be further impaired if they lose access to health-enhancing benefits available at the formal worksite (e.g., access to on-site health clinics and health and well-being programs).12-15 And those who live or usually work alone may be particularly vulnerable to the “loneliness epidemic” as their infrequent person-to-person contact dwindles further.

Additional concerns can include: the struggle to attend to personal and family needs while working; managing a different workload; lack of access to tools and equipment needed to perform work (including limited or no internet access for remote workers); feelings of not contributing enough to work or guilt about not being on the frontline; uncertainty about the future of the workplace and/or employment; and challenges related to learning new communication tools and dealing with technical difficulties.4 Compounding the risk, workers who already struggle with mental health conditions are particularly vulnerable to experiencing additional emotional symptoms and somatoform disorders during an outbreak,16 and those who must undergo quarantine are at additional increased risk for mental distress compared to workers who are not isolated.17,18

Working at home could be considered somewhat of a luxury during this time. Yet, telework presents its own risks. And, as the home has become the workplace for many, the issue of stress spilling over from one domain to the other has very likely increased.19 Many parents feel conflict when juggling dependent care, trying to oversee children’s remote learning, and meet their own work demands. Workers who are not used to telework may be at increased risk of injury if their workspaces are configured without appropriate employer guidance.20 And, while technology use may help workers meet their job demands, it can also extend working hours and further blur work-home boundaries,21-24 which can be consequential for workers and their families. Specifically, workers’ ability to psychologically detach, or “switch off mentally” at the end of the workday can be compromised,25 which has been associated with many indicators of poor well-being, including anxiety, depression, negative affect, emotional exhaustion, and fatigue.26

In terms of preventing consequences associated with this altered way of working, there are steps that individual workers can take to build resilience and increase their capacity to detach – such as using a journal to set work-related goals27 and participating in mindfulness.2,4,5,28,29 From an organizational perspective, when supervisors support workers and encourage their efforts to manage work and non-work demands (e.g., increasing control over work and schedule flexibility or offering access to Employee Assistance Programs [EAPs] and paid time off), workers report lower levels of work-family conflict30 and improvements to their sleep,31 schedule control,32 job satisfaction, well-being, and physical health.33,34 Early identification of risk factors, strengthening peer support at work, and promotion of mental health services (i.e., through remote access) could help workers cope with the ongoing challenges and prevent the onset of maladaptive behaviors.35

Policy makers and employers face challenges around determining how to redesign work to protect their workers’ and clients’ health, how to assist workers who may not have caregiving arrangements for their dependents, and how to address workers’ mental health needs. It is always important for employers to support workers’ comprehensive well-being through provision of a safe and health-supportive work environment (e.g., one that supports their financial security, does not cause occupational stress, and that advances well-being)39 and it is especially critical that organizations show value for workers and support them during such an abrupt event.40 Additionally, drawing from other countries’ experiences,34 the entire workforce could benefit through flexible scheduling, rest breaks, regular exercise, nutritional meals, and organizational efforts to prepare for future abrupt events (i.e., pandemics, disasters, emergencies).41,42 Supporting the use of paid time off contributes to workers’ happiness with their job, relationships, employer, and health.36 Finally, some workers will be apprehensive about returning to a physical workplace that could expose them to COVID-19, especially if they have concerns about their physical health.38,40 Taking measures to improve workplace hygiene and show genuine concern about worker health can reduce their psychological distress.39 Please see the CDC website for up-to-date employer guidance on COVID-19.

Details of how we live, socialize, and work in this new era will emerge in the coming months. There may be less travel, fewer in-person meetings, and for some, more telework and remote learning – especially if employers see a financial benefit to these approaches without a productivity trade-off. This experience will likely have a significant impact on the flexibility of work arrangements.43 There will be new procedures outlining how workers should interact with the public and those they provide services for. How and whether these changes will benefit, or harm workers is unknown and likely to vary by work arrangement, occupation, socioeconomic status, and a number of other factors. By modifying work to support workers in all arrangements, we can prevent further exacerbating an already stressful experience.

This is a part of the series of blogs sponsored by NIOSH’s Healthy Work Design and Well-Being Program on issues impacted by the COVID-19 pandemic. Other blogs include:

Economic Security during the COVID-19 Pandemic: A Healthy Work Design and Well-being Perspective

Improve Sleep: Tips to Improve Your Sleep When Times Are Tough

 

Jeannie A.S. Nigam, MS, is NIOSH Co-Coordinator of the Healthy Work Design and Well-Being Cross Sector program

Jessica M.K. Streit, PhD, MS,  is a member of the Healthy Work Design and Well-Being Cross-Sector program Steering Committee.

Tapas K. Ray, PhD, is NIOSH Co-Assistant Coordinator for the Healthy Work Design and Well-Being Cross-Sector program

Naomi Swanson, PhD, is NIOSH Co-Manager for the Healthy Work Design and Well-Being Cross-Sector program

 

 

Other blogs in this series include: 

Economic Security during the COVID-19 Pandemic: A Healthy Work Design and Well-being Perspective

Improve Sleep: Tips to Improve Your Sleep When Times Are Tough

Additional NIOSH blogs related to the COVID-19 pandemic and the workplace are available here.

 

The Centers for Disease Control and Prevention is addressing questions related to the Coronavirus Disease 2019 through CDC-INFO and on their webpage. Please visit https://www.cdc.gov/coronavirus/2019-ncov/index.html. You can find the most up-to-date information on the outbreak and get the latest answers to frequently asked questions. If you have specific inquiries, please contact CDC-INFO at https://wwwn.cdc.gov/dcs/contactus/form or by calling 800-232-4636.

 

References

  1. Van Bavel JJ, Baicker K, Boggio PS, et al. Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour. 2020:1-12.
  2. Centers for Disease Control and Prevention. COVID-19 Stress and Coping. 2020; https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html.
  3. American Psychological Association. Stress in the Time of COVID-19. STRESS IN AMERICATM 2020. 2020; https://www.apa.org/news/press/releases/stress/2020/stress-in-america-covid.pdf.
  4. Centers for Disease Control and Prevention. Employees: How to Cope with Job Stress and Build Resilience During the COVID-19 Pandemic. 2020; https://www.cdc.gov/coronavirus/2019-ncov/community/mental-health-non-healthcare.html
  5. Centers for Disease Control and Prevention. Healthcare Personnel and First Responders: How to Cope with Stress and Build Resilience During the COVID-19 Pandemic. 2020; https://www.cdc.gov/coronavirus/2019-ncov/community/mental-health-healthcare.html.
  6. Bureau of Labor Statistics. THE EMPLOYMENT SITUATION — MAY 2020. 2020; https://www.bls.gov/news.release/pdf/empsit.pdf
  7. Kochhar R, Passel J. Telework may save U.S. jobs in COVID-19 downturn, especially among college graduates. 2020. https://www.pewresearch.org/fact-tank/2020/05/06/telework-may-save-u-s-jobs-in-covid-19-downturn-especially-among-college-graduates/
  8. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatric Services. 2004;55(9):1055-1057.
  9. Page LA, Seetharaman S, Suhail I, Wessely S, Pereira J, Rubin GJ. Using electronic patient records to assess the impact of swine flu (influenza H1N1) on mental health patients. Journal of Mental Health. 2011;20(1):60-69.
  10. Benach J, Vives A, Amable M, Vanroelen C, Tarafa G, Muntaner C. Precarious employment: Understanding an emerging social determinant of health. Annual Review of Public Health. 2014;35:229-253.
  11. Ray T, Sauter S. Economy and Work Stress: Are They Related and How? LERA For Libraries. 2015;15(1-2).
  12. Cedeño-Laurent J, Williams A, MacNaughton P, et al. Building evidence for health: green buildings, current science, and future challenges. Annual review of public health. 2018;39:291-308.
  13. Kahn-Marshall JL, Gallant MP. Making healthy behaviors the easy choice for employees: a review of the literature on environmental and policy changes in worksite health promotion. Health Education Behavior. 2012;39(6):752-776.
  14. Neuhaus M, Eakin EG, Straker L, et al. Reducing occupational sedentary time: a systematic review and meta‐analysis of evidence on activity‐permissive workstations. Obesity reviews. 2014;15(10):822-838.
  15. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing occupational sitting time and improving worker health: the take-a-stand project, 2011. Preventing chronic disease. 2012;9:110323. DOI: http://dx.doi.org/10.5888.pcd9.110323
  16. Kamara S, Walder A, Duncan J, Kabbedijk A, Hughes P, Muana A. Mental health care during the Ebola virus disease outbreak in Sierra Leone. Bulletin of the World Health Organization. 2017;95(12):842.
  17. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. 2020;395:912-920.
  18. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Diseases. 2004;10(7):1206-1212.
  19. Edwards K, Evans G, D S. Parenting Through the Pandemic: Who’s Working, Who’s Caring for the Kids, and What Policies Might Help. The RAND Blog 2020; https://www.rand.org/blog/2020/04/parenting-through-the-pandemic-whos-working-whos-caring.html.
  20. Ellison JK. Ergonomics for telecommuters and other remote workers. Interface. 2012:8-11.
  21. Adkins CL, Premeaux SA. The use of communication technology to manage work-home boundaries. Journal of Behavioral and Applied Management. 2014;15(2):82-100.
  22. Berkowsky RW. When you just cannot get away: Exploring the use of information and communication technologies in facilitating negative work/home spillover. Information, Communication, Society. 2013;16(4):519-541.
  23. Boswell WR, Olson‐Buchanan JB, Harris TB. I cannot afford to have a life: Employee adaptation to feelings of job insecurity. Personnel Psychology. 2014;67(4):887-915.
  24. Butts MM, Becker WJ, Boswell WR. Hot buttons and time sinks: The effects of electronic communication during nonwork time on emotions and work-nonwork conflict. Academy of Management Journal. 2015;58(3):763-788.
  25. Sonnentag S, Bayer U-V. Switching off mentally: predictors and consequences of psychological detachment from work during off-job time. Journal of Occupational Health Psychology. 2005;10(4):393-414.
  26. Sonnentag S, Fritz C. Recovery from job stress: The stressor‐detachment model as an integrative framework. Journal of Organizational Behavior. 2015;36(S1):S72-S103.
  27. Smit BW, Barber LK. Psychologically detaching despite high workloads: The role of attentional processes. Journal of Occupational Health Psychology. 2016;21(4):432-442.
  28. Michel A, Bosch C, Rexroth M. Mindfulness as a cognitive–emotional segmentation strategy: An intervention promoting work–life balance. Journal of Occupational and Organizational Psychology. 2014;87(4):733-754.
  29. Querstret D, Cropley M, Fife-Schaw C. Internet-based instructor-led mindfulness for work-related rumination, fatigue, and sleep: Assessing facets of mindfulness as mechanisms of change. A randomized waitlist control trial. Journal of Occupational Health Psychology. 2017;22(2):153-169.
  30. Hammer LB, Kossek EE, Zimmerman K, Daniels R. Clarifying the construct of family-supportive supervisory behaviors (FSSB): A multilevel perspective. In: Perrewe P, Ganster D, eds. Research in occupational stress and well-being. Vol 6. Amsterdam: Elsevier Ltd.; 2007:171-211.
  31. Crain TL, Hammer LB, Bodner T, et al. Work–family conflict, family-supportive supervisor behaviors (FSSB), and sleep outcomes. Journal of Occupational Health Psychology. 2014;19(2):155-167.
  32. Kelly EL, Moen P, Oakes JM, et al. Changing work and work-family conflict: Evidence from the work, family, and health network. American Sociological Review. 2014;79(3):485-516.
  33. Kelly EL, Moen P. Rethinking the clockwork of work: Why schedule control may pay off at work and at home. Advances in Developing Human Resources. 2007;9(4):487-506.
  34. Hammer LB, Kossek EE, Anger WK, Bodner T, Zimmerman KL. Clarifying work–family intervention processes: The roles of work–family conflict and family-supportive supervisor behaviors. Journal of Applied Psychology. 2011;96(1):134-150.
  35. Kang L, Li Y, Hu S, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry. 2020;7(3):e14.
  36. U.S. Travel Association. State of American Vacation 2018. 2018; https://www.ustravel.org/sites/default/files/media_root/document/2018_Research_State%20of%20American%20Vacation%202018.pdf.
  37. Pope C. How will COVID-19 (Coronavirus) change the shape of work? 2020; https://diginomica.com/how-covid-19-coronavirus-change-shape-work.
  38. Tan W, Hao F, McIntyre RS, et al. Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce. Brain, Behavior, Immunity. in press.
  39. Acemoglu D, Autor D. Chapter 12 – Skills, Tasks and Technologies: Implications for Employment and Earnings. In: Card D, Ashenfelter O, eds. Handbook of Labor Economics. Vol 4. Elsevier; 2011:1043-1171.
  40. Eisenberger R, Stinglhamber F. Perceived Organizational Support. Washington, DC: American Psychological Association; 2011.
  41. McAlonan GM, Lee AM, Cheung V, et al. Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers. The Canadian Journal of Psychiatry. 2007;52(4):241-247.
  42. Kim S-W, Su K-P. Using psychoneuroimmunity against COVID-19. Brain, Behavior, Immunity. in press.
  43. Spurk D, Straub C. Flexible employment relationships and careers in times of the COVID-19 pandemic. Journal of Vocational Behavior. 2020;119:103435.
Posted on by Jeannie A. S. Nigam, MS, Jessica M. K. Streit, PhD, MS, Tapas K. Ray, PhD, Naomi Swanson, PhD

Post a Comment

Your email address will not be published.

All comments posted become a part of the public domain, and users are responsible for their comments. This is a moderated site and your comments will be reviewed before they are posted. Read more about our comment policy »

Page last reviewed: June 29, 2020
Page last updated: June 29, 2020