Violence Against Public Health Workers

Many workers who were on the frontlines during the COVID-19 pandemic experienced increased physical and mental stress. One study found that 70% of U.S. workers felt more stressed at work during COVID-19 than at any other point in their professional careers [1]. Public health workers, including epidemiologists, contact tracers, laboratory scientists, community health workers, and data analysts, served on the front lines of the pandemic delivering information, providing services, and conducting research. However, public health workers have been relatively understudied during the pandemic. A new project examines violence directed against public health workers during the COVID-19 pandemic.

Numerous media reports described public health workers facing unparalleled hostility, harassment, discrimination, and threats. There have been concerns about both the well-being of the public health workforce and their ability to confront future public health crises. Researchers from the Centers for Disease Control and Prevention (CDC) developed a survey assessing the impact of the pandemic on symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation among public health workers across the nation. The findings reveal that half of the respondents reported symptoms of at least one mental health condition during the pandemic. [2]

Researchers at the National Institute for Occupational Safety and Health (NIOSH), a part of the CDC, were interested in further analyzing the survey to better understand the prevalence of nonphysical workplace violence against public health workers during the pandemic and how it impacted their mental health.

Workplace Violence and the Mental Health of Public Health Workers During COVID-19, published in the American Journal of Preventive Medicine, is the first known project to document the prevalence and impact of violence directed towards the public health workforce during an ongoing public health emergency.

The findings revealed that nearly one out of three public health workers experienced at least one form of workplace violence such as receiving job threats, being bullied or harassed, or experiencing stigma due to their public health work. Several work factors including increased hours worked per week and increased interaction with the public were associated with increased workplace violence.

The more workplace violence public health workers experienced, the greater the impact on their mental health. After controlling for many variables including whether the public health worker had COVID-19 or lost a family member to COVID-19, workplace violence was associated with a:

• 21% greater risk of reporting depression or anxiety,
• 31% greater risk of reporting PTSD,
• 26% greater risk of reporting suicidal thoughts.

A sound and healthy public health workforce is imperative to protecting and supporting the country during public health emergencies. Any workplace violence directed at a public health worker is detrimental to the worker as well as the communities they serve. Workplace violence against public health workers is an alarming outcome of the COVID-19 pandemic. A better understanding of the scope and consequences of workplace violence as well as an understanding of differences across the type of public health agencies; geographic locations; and sociodemographic groups is needed.

Future efforts to mitigate violence could include training, workplace support, and greater communication after a workplace violence incident occurs. It is also important to increase the capacity of public health departments to prevent and adequately respond to workplace violence, especially when working in the field during times of crisis such as the COVID-19 pandemic.

Hope M. Tiesman, PhD, and Scott A. Hendricks, MS, are with the National Institute for Occupational Safety and Health, Division of Safety Research.

Douglas M. Wiegand, PhD, is with the National Institute for Occupational Safety and Health, Division of Field Studies & Engineering.

Barbara Lopes-Cardozo, MD, and Carol Y. Rao, ScD, are with the Centers for Disease Control and Prevention, Center for Global Health.

Libby Horter, MPH, and Ramona Byrkit, MPH, are with the Centers for Disease Control and Prevention, COVID-19 Response Team.

Charles E. Rose, PhD, is with the Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities.

References

[1]  Ginger; San Francisco, CA: 2020. Workforce attitudes towards mental health.https://f.hubspotusercontent40.net/hubfs/5327495/2020%20Workforce%20Attitudes%20Toward%20Mental%20Health.pdf Accessed August 4, 2022.

[2] Symptoms of Depression, Anxiety, Post-Traumatic Stress Disorder, and Suicidal Ideation Among State, Tribal, Local, and Territorial Public Health Workers During the COVID-19 Pandemic — United States, March–April 2021 | MMWR (cdc.gov)