How healthy are the healthcare staff in a rural health service? A cross-sectional study

Background

The COVID-19 pandemic has amplified the need to understand the health and wellbeing of healthcare workers in hospital settings. Crises like the COVID-19 pandemic create poor health outcomes for healthcare workers, yet little is understood about underlying patterns of modifiable health determinants.

Objective

The aim of the study was to examine the health and wellbeing data of healthcare workers before and during the COVID-19 pandemic and inform future healthy intervention activities within the workplace.

Design

Repeat cross-sectional study pre-2018 and mid-COVID-19 2020.

Setting(s)

Rural health service in Victoria, Australia.

Participants

All 800 healthcare workers within the health service were invited; of these, 184 (23%) participated at Time 1 and 87 (11%) at Time 2.

Methods

Diet, physical activity, sleep behaviours, and psychological distress were collected via online survey in Qualtrics. Pre-COVID-19 pandemic, anthropometry (height, weight, waist circumference, blood pressure), and type 2 diabetes risk were collected by a trained practitioner. However, to reduce burden on healthcare workers mid-COVID-19 pandemic, only self-reported anthropometry was collected.

Results

The majority of participants were Australian-born females (84% at both timepoints) with half over the age of 45 (63% Time 1, 53% Time 2). Around half worked part-time (49% Time 1, 54% Time 2), over a third full-time (39% Time 1, 36% Time 2), and the majority reported working regular day shifts in the past 3 months (70% Time 1, 65% Time 2). Among this sample, there were few smokers (9% Time 1, 7% Time 2), and two thirds of participants were living with overweight or obesity (64% Time 1, 67% Time 2). Across both time points, compliance with health guidelines was low; 41% (Time 1) and 42% (Time 2) met fruit, 17% (Time 1) and 12% (Time 2) met vegetable, and just under 50% met physical activity guidelines at both time points. Those reporting moderate to very high levels of psychological stress increased from 42% (Time 1) to 59% (Time 2) (p < 0.05). At Time 1, >80% were at intermediate (39%) or high (33%) risk of developing type 2 diabetes within the next 5 years; and a third (32%) were hypertensive. Reasons for physical inactivity at work included already exercising out-of-work hours (28%), living too far from work (18%), available time (9%), and inflexible work hours (8%).

Conclusions

Several high-risk health areas along with opportunities for supporting improved wellbeing were identified in this group of healthcare workers. Psychological distress of healthcare workers urgently needs to be addressed, and this is reinforced by the need to understand the longitudinal impact of COVID-19 on the health and wellbeing of healthcare workers. Workplace settings, such as a health service, is an ideal setting to invest in healthcare workers with individual, organisational, and broader community benefits.