By the de Beaumont Foundation

More than two years into a grueling pandemic, public health practitioners are feeling the strain on their mental health. The toll of COVID-19 has weighed heavily on members of the public health workforce, and this could lead to adverse effects for the communities who depend on them.

New preliminary data from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) — conducted by the de Beaumont Foundation and the Association of State and Territorial Health Officials — point to diminished mental health and wellness among government public health practitioners. Full data, including a dashboard specific to professionals in maternal and child health (MCH), will be released this summer.

According to findings from the latest survey, fielded from September 2021 through January 2022:

• More than half of public health workers (56 percent) reported at least one symptom of post-traumatic stress disorder (PTSD) as a result of the pandemic. One-quarter reported experiencing three or four symptoms, indicating probable PTSD.
• One in five public health workers (22 percent) said their mental health is either “fair” or “poor.”

The mental health of public health practitioners has widespread repercussions. When our workforce is unwell, our communities suffer, and those who are most in need of essential public health services are hit the hardest.

“Public health has been underfunded for decades, but the pandemic has pushed the workforce to their limit,” said de Beaumont Foundation President and Chief Executive Officer Brian C. Castrucci, DrPH, in a statement. “This is an underreported story that affects the health of communities across the country. These data show that the public health workforce is fast approaching a breaking point.”

Public Health Employees in Peril

For some workers, the stress and subsequent burnout of responding to COVID-19 has proven too taxing. Among public health employees who are considering leaving their organization, 39 percent say the pandemic has made them more likely to leave.

Hostility toward public health practitioners has also contributed to the pressures of pandemic response. Public health authority has been weakened as a result of growing anti-science sentiment and disinformation, making it harder for employees to implement measures to curb the spread of infection.

In some cases, just doing their jobs has made members of the public health workforce targets of aggression, especially among the most visible employees of public health agencies. The new PH WINS data show that nearly 3 in 5 executives (59 percent) reported that they have felt their expertise has been undermined or challenged, while more than 2 in 5 executives (41 percent) reported bullying, threats, or harassment from people outside of the health department.

Data-Informed Decision-Making in Maternal and Child Health

Crises in MCH that existed long before COVID-19 have only been compounded by the pandemic. Like many public health workers already stretched thin, MCH practitioners, who account for nearly 9 percent of the workforce, need every resource at their disposal to address longstanding inequities, such as the grave disparities in Black maternal and infant health outcomes. There is no shortage of ongoing challenges, from ensuring access to comprehensive reproductive care to promoting vaccine uptake among children.

As MCH professionals consider how to address these and other priorities, PH WINS data can guide decision-making by helping health agencies understand workforce strengths and gaps, as well as opportunities to improve skills, training, and employee engagement.

“Maternal and child health professionals operate within a broader public health context,” said Caroline Stampfel, AMCHP’s chief strategy and program officer. “PH WINS helps us identify trends that have implications for how our members recruit, retain, and facilitate the leadership trajectories of staff across roles and settings. This and the more detailed data provided by MCH staff from state and territorial health departments guide our organization’s strategic efforts to build workforce capacity in current and anticipated areas of need.”

Intentional Investments in the Public Health Workforce

One bright spot from the PH WINS data: Job satisfaction overall is high. Despite their struggles, public health workers remain committed to their jobs and their communities. Nearly all PH WINS respondents agreed that the work they do is important and that they are determined to give their best effort at work every day.

These findings are heartening, especially given the workforce’s role in COVID-19 pandemic response efforts. However, only long-term, sustained investments in the public health workforce will retain and attract employees. And we cannot afford to lose more members of our state, local, tribal, and territorial health departments while the pandemic endures.

The challenges facing the public health workforce have no quick fixes but sounding the alarm on employees’ mental health and wellness is necessary to make a difference. Recognizing the problem can help to reduce stigma, empowering public health employees to ask for help within and outside their workplaces. Increased awareness of mental health issues among public health practitioners may also spur the development of policy to protect and bolster mental health in the workforce. (For more on supporting mental health and wellbeing during the pandemic, see the mental health action guide from the de Beaumont Foundation and the Well Being Trust)

Championing mental health and wellness is more important than ever for public health workers. We cannot emerge from the pandemic stronger and better prepared for future crises without a thriving public health workforce — and that begins with good mental health.

Stay tuned for the complete findings from PH WINS 2021, which will include an MCH-focused dashboard and will be released this summer. In the full report, you’ll learn more about public health workers’ experience responding to the pandemic, workforce demographics and characteristics, training needs, and the ability to promote health equity and address other pressing issues in public health. Learn more at www.phwins.org.