Childcare Stress Takes Heavy Toll on Healthcare Workers During Pandemic

Survey data finds that 21% of healthcare workers experience childcare stress.

For healthcare workers, childcare stress during the coronavirus pandemic is associated with higher rates of burnout, intent to reduce work hours, and intent to leave jobs, a new research article says.

The pandemic has worsened preexisting childcare accessibility problems and disparities. Before the pandemic, the annual cost of full-time childcare for an infant was $21,700, which is more than one-quarter of an average hospital nurse's salary and more than two-thirds of an average nursing assistant's salary. Childcare is in short supply, with childcare desert designations in three of five rural areas. In addition, it is difficult for healthcare workers to find care outside typical hours such as nights and weekends.

The new research article, which was published by JAMA Network Open, is based on survey data collected from 58,000 healthcare workers, including 15,700 physicians and 11,400 nurses. The study has several key data points.

• Childcare stress (CSS) was reported in 21% of healthcare workers
   
• CSS was more common in women than men (21.1% versus 17.9%)
   
• Compared to healthcare workers without CCS, those with CCS had 115% greater odds of anxiety or depression
   
• Compared to healthcare workers without CCS, those with CCS had 80% greater odds of burnout
   
• High CCS was linked to 91% greater odds of intent to reduce work hours (ITR) and 28% greater odds of intent to leave jobs (ITL)
   
• CCS was more common among racial and ethnic minority healthcare workers than White survey respondents

"The COVID-19 pandemic has had a myriad of effects on [healthcare workers] that put our workforce at risk. These data show an association between CCS and burnout, anxiety and depression, and ITL and ITR. Institutional interventions supporting childcare resources for [healthcare workers] may attenuate burnout, anxiety, depression, ITR, or ITL," the study's co-authors wrote.

Interpreting the data

Efforts to address CCS in healthcare workers should include interventions targeting racial and ethnic minority employees, the study's co-authors wrote. "Recovery based on racial equity needs to include collecting data, involving racial and ethnic minority communities in the process, and increasing access to childcare going forward. Without these efforts, individuals from minoritized groups will probably experience reduced participation in the workforce."

The study's findings also have important implications for female and male healthcare workers, the co-authors wrote. "Attending to CCS may help lower burnout rates for women, who historically have higher burnout rates than men. Given the increased burden women face at home, removing barriers for men in their participation in home duties is critical. Recognizing that men who are experiencing high CCS have strong odds of reporting anxiety and depression is important in discussing ways to support removing CCS burden from both male and female [healthcare workers]."

Childcare considerations should be a priority at healthcare organizations, the co-authors wrote. "We propose a more intentional approach in the health care workplace to assessing and addressing childcare concerns when worker assignments are made. Workplaces that can accommodate change on short notice, provide on-site care for ill children or on-site schools, and are aware of worker concerns about their children will be better positioned to show workers they are a caring environment, one that, we hope, workers would be more likely to remain with rather than leaving for shift work in other settings, a scenario that is currently occurring in large numbers."

Healthcare organizations should consider offering their own childcare services, they wrote. "Work-affiliated childcare reduces CCS and would be a reasonable strategy to mitigate the impact of childcare stress on ITL or ITR."

Related: Expert: Healthcare Worker Burnout Trending in Alarming Direction