The World Health Organization (WHO) estimates there are close to 59 million individuals employed in the healthcare sector worldwide, of which there are over 13 million in the United States alone.  Healthcare employees are also healthcare consumers with additional occupational risks associated with their field.1,2 COVID-19 has brought to light the extreme risks of being a healthcare worker in the face of a pandemic, with NPR reporting in mid-April that over 9,000 healthcare workers have contracted the disease.3

The need to ensure a healthy workplace is imperative to the wellbeing of healthcare providers and, in turn, to those for whom they provide care.4 It is also a financial concern for health systems given that productivity is negatively associated with employee burnout and illness. This post marks the beginning of a series focused on healthcare employees’ barriers to wellness and care. This series will offer solutions to improve wellness in the healthcare workplace, as well as tips for providers to overcome barriers to care when affected by an acute or chronic illness. But first, the big question: is working in healthcare bad for your health? 

Is working in healthcare bad for your health?

It seems ironic that in a profession dedicated to improving the health of others, healthcare professionals have concerning trends in health outcomes themselves. Those who are treating COVID-19 patients are quite literally putting their own personal health at risk every time they interact with a patient who has tested positive. But was working in healthcare bad for health before the pandemic? The American Nurses Association designed the “Healthy Nurse, Healthy Nation campaign because, with the exception of smoking, nurses are less healthy than average Americans.5 An opinion piece in the New York Times highlighted that increasing demands in healthcare settings coupled with the sense of ethical obligation to complete the work on the part of providers is contributing to burnout among healthcare professionals, who also have some of the highest rates of suicide among any profession — another health condition that has come center stage due to COVID-19.6,7 Other health outcomes are equally concerning, including high rates of obesity, diabetes, and cardiovascular disease, potentially contributed to by workplace stress and limited physical activity.8 

What barriers to health affect healthcare providers?

COVID-19 has highlighted the barriers to health for healthcare workers, ten-fold: lack of PPE, long and sometimes traumatizing shifts, and potential exposure to a disease with no treatment. Healthcare workers truly are heroes for their work on the front lines. But even in the day-to-day, outside of a pandemic, barriers continue to exist. Conversations on social determinants of health and occupational health hazards are typically focused on vulnerable populations, but the barriers of a health system employee can easily be understood as social determinant barriers. Beyond COVID-19 and the physical (e.g. slips, trips, and falls), other biologic (e.g. tuberculosis, hepatitis, HIV) and ergonomic (e.g. lifting) risks, there are other environmental and psychosocial factors that may present barriers for this population’s health.  Long hours, high stress, sedentary work, and limited access to healthy foods (or the abundant availability of unhealthy foods) can all affect provider health.9

So what are we going to do about it?

First, we must acknowledge that the healthcare profession will be forever changed after COVID-19. We also must acknowledge that this experience will likely affect the overall health of our healthcare workforce on the other side of the pandemic. It’s essential that we understand that not all experiences of healthcare workers will be homogenous, so a one-size-fits-all approach to action will likely fail. To circle back to the beginning of the article, we must remember: healthcare workers are also healthcare consumers. The difference lies in that we rely on this essential personnel group to support our health when we need it, even sometimes at the expense of their own.

Given that work-life balance is associated not only with health outcomes for professionals, but also with safety culture in the workplace, identifying and addressing barriers to wellness, preventative care, and treatment among health care providers is imperative to a healthy workforce and organizational productivity as we move forward in the pandemic and beyond.10 As our healthcare workers continue to fight, we need to fight for their short and long-term health by providing them with accessible solutions to support their health, such as digital health coaching, counseling, and other personalized solutions. Our healthcare workers have shown up for the world while battling their own fronts of uncertainty, stress, and change. The world has worked to show up for them with innovation, caring, and gratitude — now, it’s a matter of continuing to drive that progress.11

Updated 8/2/2023

Written by Kelly Brassil, PhD, RN, Director of Medical Affairs

REFERENCES
  1. World Health Organization. Occupational health. Accessed August 2, 2023. https://www.who.int/health-topics/occupational-health
  2. Kaiser Family Foundation (KFF). Total Health Care Employment. May 2022. Accessed August 2, 2023. https://www.kff.org/other/state-indicator/total-health-care-employment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D#
  3. Farmer B. At Least 9,000 U.S. Health Care Workers Sickened With COVID-19, CDC Data Shows. NPR. April 15, 2020. Accessed August 2, 2023. https://www.npr.org/sections/health-shots/2020/04/15/834920016/at-least-9-000-u-s-health-care-workers-sickened-with-covid-19-cdc-data-shows
  4. ACCC Editorial Staff. Removing the blame from burnout. Published 19 March 2019. Accessed August 2, 2023. https://www.tandfonline.com/doi/citedby/10.1080/10463356.2019.1580067?scroll=top&needAccess=true&role=tab
  5. Healthy Nurse, Healthy Nation. Accessed August 2, 2023. https://www.healthynursehealthynation.org/
  6. Ofri D. The Business of Health Care Depends on Exploiting Doctors and Nurses. The New York Times. June 8, 2019. Accessed August 2, 2023. https://www.nytimes.com/2019/06/08/opinion/sunday/hospitals-doctors-nurses-burnout.html
  7. Watkins A, Rothfeld M, Rashbaum WK, Rosenthal BM. Top E.R. Doctor Who Treated Virus Patients Dies by Suicide. The New York Times. Updated April 29, 2020. Accessed August 2, 2023. https://www.nytimes.com/2020/04/27/nyregion/new-york-city-doctor-suicide-coronavirus.html?referringSource=articleShare
  8. Luckhaupt SE, Cohen MA, Li J, Calvert GM. Prevalence of obesity among U.S. workers and associations with occupational factors. Am J Prev Med. 2014;46(3):237-248. doi:10.1016/j.amepre.2013.11.002
  9. Wurtman JJ. Why are Health Care Workers Unhealthy? HuffPost. Accessed August 2, 2023. https://www.huffpost.com/entry/why-are-healthcare-worker
  10. Schwartz SPAdair KCBae J, et al. Work-life balance behaviours cluster in work settings and relate to burnout and safety culture: a cross-sectional survey analysis
  11. Ehrlich H, McKenney M, Elkbuli A. Protecting our healthcare workers during the COVID-19 pandemic. Am J Emerg Med. 2020;38(7):1527-1528. doi:10.1016/j.ajem.2020.04.024