Mental and Physical Health Status of U.S. Health Care Workers

Abstract

This study is a cross-sectional analysis of the 2017 wave of the Panel Study of Income Dynamics (PSID), which is part of a longitudinal survey of the general US population. Individuals aged 18 years or older that were employed or were actively looking for a job categorized by whether they worked in health care or not were included in the study. We examined the prevalence of self-reported mental and physical health conditions such as cardiovascular diseases, cancer and respiratory illnesses among health care professionals compared to all other employed individuals in the US. We compared health status across health care occupations and three health care settings: hospitals, ambulatory care, and long-term care. Using multivariate regressions, we examined the risk factors associated with health conditions among health care providers by occupation and work setting. Survey weights were applied to generalize results to the national population. The following were key study findings:

• Our sample included 10,375,357 health care workers and 104,999,133 non-health care workers.
• Health care workers compared to workers in other industries were slightly younger (41.7 vs 42.4), fewer were female (76.3% vs. 79.2%) and more likely to have a bachelor’s degree or higher (60.7% vs. 48.1%).
• Compared to workers in other industries, health care workers had a higher prevalence of any mental illness (14.6% vs. 9.6%), especially depression (8.0% vs. 4.9%) and anxiety (2.9% vs. 1.9%).
• Health care workers also had a higher prevalence of some physical health conditions such as other chronic illnesses (19.2% vs. 12.3%) and cancer (4.6% vs. 4.2%) compared to other workers.
• Among health care workers, the prevalence of 3 or more chronic illnesses was highest among those who worked in long-term care (36.9% compared to 34.9% for the overall health care group).
• Multivariate regression analysis showed that long-term care workers had a higher prevalence of cardiovascular diseases, diabetes, and cancer, while ambulatory care workers had higher prevalence of respiratory illnesses and hospital workers had higher prevalence of having arthritis. These prevalences were not statistically significant across settings, however.
• No consistent pattern or significant differences were found in the adjusted probabilities of the prevalence of physical health conditions by occupation other than physicians generally having the lowest probability of having any physical health condition except for cancer where they had the highest probability. Licensed practical nurses/licensed vocational nurses followed by aides/assistants had the highest probability of having any mental illness, including depression, compared to other occupations, though the differences were not statistically significant.

Health care workers generally reported worse mental health and more comorbidities than non-health care workers, though the prevalences of physical health conditions were similar. It should be noted that given the survey relies on self-report, mental health conditions may be particularly underreported due to stigma associated with them. Nonetheless, findings from this study provide important baseline information about the prevalence of illnesses in health care workers in the pre-COVID era. Ongoing follow-up will be crucial in informing policymakers on the most prevalent mental and physical health conditions to help develop policies targeting the most at-risk health care workers.

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