Social Determinants of Health-Informed Healthcare Worker Well-being: Findings from a Cross-Sectional Study

Abstract

Abstract Background: There is limited research on the prevalence across sociodemographic groups of environmental and social factors associated with healthcare worker (HCW) burnout, and findings are often inconclusive or inconsistent. Evidence suggests individuals from historically underrepresented minority groups may experience burnout differently, yet those data that do exist rarely explore variations among the HCW job categories and sub-groups, including the impact of sociodemographic factors. The purpose of this analysis, was to assess variations in the social determinants of health (SDOH) across HCW job categories, as a first step in understanding differences in social needs and identifying targeted employee wellness strategies. Methods: This study included 12,715 HCWs (e.g., Physicians; RNs and LVNs; Scientists/Research/Information Systems; Administrative Support; Allied Health Professionals; Management; Trades/Crafts/Engineering/Facilities; Unlicensed Assistive Personnel [UAP], Security; Food Services; and Environment [EVS]/Transportation Services), across 586 California zip codes. The California Healthy Places Index (HPI) data file was used to examine the impact of SDOH on HCWs based on their reported zip codes. Analysis of variance with Bonferroni Correction to adjust for multiple comparisons was used to assess differences across job categories, and Two-step Cluster Analysis was used to evaluate how job categories might form distinct clusters on SDOH. Results: While physicians had the highest HPI percentiles across all HPI sub-categories, the lower-wage workers including EVS/ Transport Services, Food Services, and Security consistently ranked lower, below the state average (50th percentile). Overall, the HPI percentile was lowest for environmental living conditions and pollution for all HCWs and considerably lower than the statewide standardized average. The education and economic components of the HPI were higher on average than the state average. Ranking by job category put Physicians at, or near, the top for most HPI components; while Security, Food Service, and Environmental Services and Transportation employees at, or near, the bottom rank for most components. Conclusions: The findings from this highlight the importance of SDOH-informed employee wellness programs and research studies. Findings also underscore the importance of a call to action for policymakers to act upon health disparities in the HCW population.