Jinghua Li1,2, Jingdong Xu3, Huan Zhou4, Hua You5, Xiaohui Wang6, Yan Li7, Yuan Liang8, Shan Li9, Lina Ma3, Jing Zeng1, Huanle Cai1, Jinzhao Xie1, Chenghao Pan1, Chun Hao1,2, Stuart Gilmour10, Joseph Tak-Fai Lau11, Yuantao Hao1,2, Dong Roman Xu12, Jing Gu13,14. 1. School of Public Health, Sun Yat-sen University, No. 74, Zhongshan Second Road, Guangzhou, 510080, China. 2. Sun Yat-sen University Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, 510080, China. 3. Hubei Province Center for Disease Control and Prevention, Wuhan, 430097, China. 4. West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610000, China. 5. School of Public Health, Nanjing Medical University, Nanjing, 210000, China. 6. School of Public Health, Lanzhou University, Lanzhou, 730000, China. 7. Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China. 8. School of Public Health, Huazhong University of Science and Technology, Wuhan, 430074, China. 9. Zigong Center for Disease Control and Prevention, Zigong, 643000, China. 10. Graduate School of Public Health, St. Luke's International University, Tokyo, 104-0045, Japan. 11. Centre for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. 12. Acacia Lab for Health Systems Strengthening and Department of Health Management, School of Health Management, School of Health Management, Southern Medical University, 1023 South Shatai Road, Guangzhou, 510515, China. romanxu@i.smu.edu.cn. 13. School of Public Health, Sun Yat-sen University, No. 74, Zhongshan Second Road, Guangzhou, 510080, China. gujing5@mail.sysu.edu.cn. 14. Sun Yat-sen University Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, 510080, China. gujing5@mail.sysu.edu.cn.
Abstract
BACKGROUND: Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. METHODS: Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. RESULTS: The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). CONCLUSIONS: Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.
BACKGROUND: Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. METHODS: Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. RESULTS: The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). CONCLUSIONS: Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.
Entities:
Keywords:
COVID-19; China; Front line public health workers; Mental health; Self-rated health; Working conditions
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