“As public health professionals, we’re feeling stressed out, exhausted, overwhelmed. Whether we specifically work on COVID-19 or we work on the myriad of other public health issues that need our attention, we’re affected by this pandemic in all parts of our lives, professional and personal.”

–  Kristi McClamroch, PhD, MPH, Founder & Executive Director of Public Health Connected

INTRODUCTION

As we pass the two year since COVID-19 was declared a pandemic by the World Health Organization, I want to ask you, my fellow public health professionals, how are you doing? Are you still feeling energized by the spotlight the pandemic has shone on public health, enthusiastically showing up for work every day? Or are you, like me, feeling stressed out, exhausted, cynical and disconnected from your work, dreading the sound of your alarm clock going off every morning?

If you’re feeling like me, you might be experiencing burnout. 

In this blog post, I will provide an overview of the following:

• What is burnout?
• Why are some in the public health workforce experiencing burnout?
• How can we address burnout in the public health workforce?

What is burnout?

Burnout is a state of chronic stress that leads to physical and emotional exhaustion, cynicism, detachment, and feelings of ineffectiveness and lack of accomplishment. If you are emotionally exhausted, feel that you are unappreciated even though you continue to work hard, overwhelmed, are finding it hard to care about your work, or find yourself hating a job you used to love, you may be approaching or already in a state of burnout. Other symptoms can include poor sleep, headaches, stomach or gut issues, difficulties concentrating, lack of empathy or compassion for others, and no longer enjoying activities you used to enjoy. While not considered a mental illness, burnout is an important mental health issue. 

Over the past 8 months, I have experienced the majority of these symptoms, with many worsening over time. Cynicism, detachment, inability to concentrate, and hating a job I previously loved have become particularly prominent for me at work. Doing my job has become almost impossible, as have “extracurricular” public health activities that I used to thrive on, such as writing this blog post. On this Burnout Self-Test, my score is currently 48, meaning I am at risk of burnout. 

My anecdotal experience is also starting to be reflected in actual data. In a survey of 225 American public health workers from September 2020, 66.2% of respondents reported burnout, and 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to January of 2020 (Stone et al., 2021). Another more recent survey of 366 public health professionals found that 45% were experiencing burnout (Ibrahim et al., 2022), and another survey from the Centers for Disease Control and Prevention in the United States found that 52.8% of state, tribal, local, and territorial public health workers reported symptoms of at least one mental health condition in the two weeks prior to the survey (Bryant-Genevier et al., 2021). Public health officials from across the United States are beginning to resign from their positions (Shihipar, 2021). 

So what is happening? Why are some in the public health workforce starting to burnout?

Why are some in the public health workforce experiencing burnout?

In March of 2020, when COVID-19 first began to make waves in Canada, I was fascinated, glued to all pandemic updates from the government and experts, and I was so excited to act as a resource for my friends and family. Other people in my life (outside of my fellow public health nerd friends) were finally interested in the field I had devoted my studies and career to. I welcomed all questions, and did my best to share accurate sources of the latest pandemic information on social media for my friends and family to learn from. I enthusiastically listened to every COVID-19-related podcast I could get my hands on, and filled my own social media feeds with credible science communicators. This was public health’s time to shine, and thus it was also my time to shine! 

However, things took a turn fairly quickly. Within a few weeks, it became clear to me that the general public, including many of my friends and family members, did not understand the difference between public health and medicine and were unaware that someone with the letters MD behind their name wasn’t necessarily a credible source of public health information and statistical interpretation. Doctors began to misuse their credentials, and conspiracy theorists and anti-vaxxers began to capitalize on the uncertainty by spreading misinformation online. Even more disconcerting, were the people I knew that believed false information over the credible information I was sharing, and who constantly attempted to gaslight myself and discredit other public health professionals. This has only worsened over time, especially in recent weeks, sometimes leading me to question my credentials and doubt my abilities to interpret the science. 

Without a doubt, this has contributed to my feelings of burnout. Staying up-to-date with the latest COVID-19 developments has become a burden, something I now only do out of obligation. These days, I rarely listen to government pandemic updates, and I am relatively out of touch with the latest COVID data. I still share COVID-19-related information on social media when I can, but it has become a struggle rather than a joy. Every once in a while, a friend sends me a message saying they appreciate what I share and my commitment to providing accurate information. I even had one acquaintance let me know that they got vaccinated because of the information I shared. These comments keep me going. In the Fall of 2021, I attended what can only be described as an online support group for public health professionals hosted by Public Health Connected. It was so comforting to hear from other public health professionals experiencing similar challenges, to know that I was not alone in the struggle. Recently, Public Health Connected summarized those discussions in a short series of videos. Some of the challenges being experienced by the public health workforce that may be contributing to burnout include:

• Feeling unsupported at work
• Experiencing hostility from people in the communities in which we work
• The constant barrage of misinformation about COVID-19 and the distrust of public health professionals from the general public
• The sense that other people have moved on from the pandemic, when it is still very much active
• Physical and ideological separation from those we care about, including experiencing hostility from loved ones about the work we do
• Feeling like you have to choose between personal and professional parts of life
• COVID-19 shining a new light on racism and discrimination and the pain of seeing the disproportionate effects of COVID-19 on marginalized communities
• The ways COVID-19 amplified the racism and discrimination many public health professionals experience in their own lives
• Anger at lack of support from government, other leaders, and the people closest to us
• Sadness at loss, both the loss of loved ones and the loss of our profession, in that we thought this was the time for public health to shine and it hasn’t happened 

So where do we go from here? The work being done by public health professionals is more important than ever, but it is becoming increasingly difficult to keep doing it. What can be done to prevent burnout?

How can we address burnout in the public health workforce?

Burnout is a state that is not fixed overnight. It is different from having a stressful day and it requires time to recover. Some general strategies for preventing and managing burnout that could be adapted by public health professionals include:

• Reprioritizing work tasks to reduce stress
• Taking your breaks during the work day
• Making life about more than work, ensuring a healthy work-life balance
• Incorporating self-care
• Developing resiliency skills
• Connecting with others at work and outside of work
• Seeking out support, from friends, family, colleagues or professionals like a therapist.

Specific to the COVID-19 pandemic and the experience of public health professionals, other strategies may include taking a break from social media or pandemic-related news, connecting with other public health professionals on a regular basis to discuss concerns and challenges to know that you are not alone in your experience, and perhaps even taking a break from public health all together.

In addition, Public Health Connected has recently launched a new support program for public health professionals called Public Health Recharge, which provides the opportunity to connect and engage with other public health professionals to help you navigate the current challenges of working in public health. The program includes monthly group peer support sessions with other public health professionals, as well as an online community to stay connected with others and receive support between sessions. This is a great new resource to help address burnout in public health professionals. You can check out their website for the next enrollment period. 

As much as it pains me, taking a break from public health is the route I am likely to take. My current job ends in June, and I plan to take at least 6 months away from the profession after that to recover my love of public health. In the meantime, I will cope with my feelings of burnout at work with some of the above-mentioned strategies, such as disconnecting from social media, joining Public Health Recharge and working on self-care, including getting adequate sleep and getting outside in nature as often as possible. 

Key Takeaways

While the COVID-19 pandemic has been an exciting time for public health professionals, it has also been incredibly challenging. Some public health professionals, including myself, are beginning to experience burnout. It is important that this burnout is addressed to improve the wellbeing of public health professionals and to keep these valued, experienced professionals in their jobs for years to come. 

Written by: Lindsay Belvedere, MPH, CPH