Anxiety and depression among public health workers during the COVID-19 pandemic




COVID-19, mental health, anxiety, depression, emergency response


Introduction: The public health workforce plays an essential role in the response to disasters and emergencies. Little is known about the prevalence of anxiety and depression among the public health emergency preparedness workforce responding to COVID-19 or the potential for social support to protect public health workers from adverse outcomes.

Methods: A cross-sectional online survey was conducted among a sample of the public health workforce participating in the response to COVID-19. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using Poisson regression with robust standard errors.

Results: Overall, 39.6 percent (140 of 345) of respondents reported anxiety and 29.4 percent (104 of 345) reported depression. The prevalence of anxiety and depression was higher among those who worked more hours (PR = 1.5; 95% CI: 1.2, 2.0) and days (PR = 1.3; 95% CI: 0.9, 1.8) per week. Anxiety was 40 percent more prevalent (PR = 1.4; 95% CI: 0.8, 2.4) among those with between 1 and 4 years of work experience, while depression was 60 percent more prevalent (PR = 1.6; 95% CI: 0.8, 3.1) among those with 5 to 9 years of experience. Compared to those with a bachelor’s degree, those with a master’s degree reported 30 percent more anxiety (PR = 1.3; 95% CI: 0.9, 1.9). Having at least three sources of social support related to comfort and caring reduced the prevalence of depression among those working the most hours per week (PR = 1.5; 1.1, 2.3 compared to PR = 2.0; 95% CI: 0.9, 4.5). Economic and practical support was more consistently protective, with a reduced prevalence of anxiety and depression among those working the most hours per week, days per week, and those with more education when at least three sources of support were reported.

Discussion: Anxiety and depression symptoms and diagnoses have been associated with burnout and suicide among frontline disaster responders. The public health workforce on the frontlines of the COVID-19 emergency response has high rates of depression and anxiety, which must be addressed through robust individual- and organizational-level supports.

Author Biographies

Emily J. Pfender, MA

Department of Communication, University of Delaware, Newark, Delaware

Kahler W. Stone, DrPH, MPH

Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, Tennessee

Kristina W. Kintziger, PhD, MPH

Department of Public Health, University of Tennessee, Knoxville, Tennessee

Meredith A. Jagger, MPH

Nonaffiliated Researcher, Austin, Texas.

Jennifer A. Horney, PhD, MPH

Epidemiology Program, University of Delaware, Newark, Delaware


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