An Exploration of Workplace Environment Factors and Mental Health in the Public Health Workforce Restricted; Files Only

Abstract

Background: The 21st U.S. Surgeon General identified both health worker burnout and workplace mental health and wellbeing as key health priorities of concern. However, the governmental public health workforce remains understudied in these areas. Using the 21st U.S. Surgeon General’s Framework for Workplace Mental Health and Well-Being, this study explored factors of the workplace environment and their associations with mental and emotional health in the governmental public health workforce.

Methods: The study was a secondary analysis of the nationally representative Public Health Workforce Interests and Needs Survey (PH WINS) data collected in 2021. Analysis included descriptive statistics, an exploratory factor analysis (EFA) of the workplace environment scale, and ANOVAs to assess differences in factor scores and mental and emotional health by sample characteristics. A multivariable hierarchical regression was performed to assess the association between the identified factors, demographic characteristics, employment characteristics, and work experience and satisfaction characteristics with mental and emotional health.

Results: The exploratory factor analysis returned a three-factor solution in which each factor contained at least three items, had eigenvalues greater than one, and explained at least five percent of the variance. The full scale and each of the factors had good internal consistency indicating measurement reliability. Bivariate analyses identified significant relationships between each of the factors with mental and emotional health and additional assessment of relationships of the factors and mental health with the covariates informed the inclusion of covariates in the multivariable regression. The results of the multivariable hierarchical regression showed that each of the factors remained significant across four models in addition to several of the covariates of interest.

Discussion: This study contributes to the literature on workplace mental health with a specific focus on the public health workforce. The factors identified in the EFA aligned with existing literature and elements of the guiding framework; however, opportunities remain for further scale refinement and framework adaptation in public health contexts. Further, the regression analyses demonstrated that perceptions of the workplace environment were significantly related to mental and emotional health even when accounting for other significant variables. These findings have important implications for measurement, future research, and the governmental public health workforce.

Table of Contents

TABLE OF CONTENTS

ABSTRACT .......................................................................................................................4

CHAPTER 1: INTRODUCTION ....................................................................................1

CONCEPTUAL FRAMEWORK ...........................................................................................5 

STUDY PURPOSE ..............................................................................................................7 

RESEARCH QUESTIONS ...................................................................................................7 

SIGNIFICANCE .................................................................................................................7

DEFINITION OF TERMS ...............................................................................................9

CHAPTER 2: REVIEW OF THE LITERATURE.......................................................10

INTRODUCTION..............................................................................................................10 

WORK AND MENTAL HEALTH.......................................................................................10 

Work as a Determinant of Mental Health ...............................................................10 

Burnout and Engagement ........................................................................................ 11 

FINANCIAL CASE FOR MENTAL HEALTH......................................................................11 

Economic Costs of Poor Mental Health ..................................................................12 

Economic Benefits of Positive Mental Health.........................................................12 

PUBLIC HEALTH WORKFORCE .....................................................................................13 

Workforce Exodus ....................................................................................................13 

Intent to Leave vs Actual Separations......................................................................14 

Reasons for Leaving or Staying ...............................................................................15 

MENTAL HEALTH BURDEN IN THE PUBLIC HEALTH WORKFORCE.............................15 

Risk Factors for Burnout in Public Health.............................................................16

Protective Factors for Burnout in Public Health....................................................16 

THE FRAMEWORK EXPANDED ......................................................................................17 

Protection from Harm ..............................................................................................17 

Connection and Community.....................................................................................18 

Work-Life Harmony..................................................................................................19 

Mattering at Work.....................................................................................................20 

Opportunity for Growth............................................................................................21 

SUMMARY OF THE CURRENT PROBLEM .......................................................................22 

STUDY RELEVANCE .......................................................................................................22

CHAPTER 3: METHODS..............................................................................................24

INTRODUCTION..............................................................................................................24 

STUDY DESIGN...............................................................................................................24 

PARTICIPANTS AND SAMPLING PROCEDURES ..............................................................25

MEASURES.....................................................................................................................25

The Workplace Environment....................................................................................26 

Mental and Emotional Health..................................................................................28 

Demographic Characteristics...................................................................................28 

Employment Characteristics ....................................................................................28 

Work Experience and Satisfaction Characteristics .................................................29

DATA ANALYSIS PLAN ...................................................................................................30 

Descriptive Statistics .................................................................................................30

Exploratory Factor Analysis ....................................................................................30 

Linear Regression Analysis ......................................................................................31

POSITIONALITY ...........................................................................................................33

CHAPTER 4: RESULTS ................................................................................................34

Description of Sample...............................................................................................34 

Exploratory Factor Analysis Results .......................................................................40 

Regression Analysis Results .....................................................................................42 

Summary of Findings...............................................................................................54

CHAPTER 5: DISCUSSION, IMPLICATIONS, AND CONCLUSIONS .................55

INTRODUCTION AND SUMMARY OF STUDY ...................................................................55 

DISCUSSION OF KEY FINDINGS .....................................................................................55 

Discussion of Research Aim One.............................................................................55 

Discussion of Research Aim Two.............................................................................59 

STRENGTHS AND LIMITATIONS .....................................................................................60 

Strengths ...................................................................................................................60 

Limitations ................................................................................................................60 

IMPLICATIONS ...............................................................................................................61 

Measurement Implications.......................................................................................61 

Future Research Implications..................................................................................62 

Workforce Implications ............................................................................................62 

CONCLUSIONS ...............................................................................................................62 

REFERENCES .................................................................................................................64

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	public health workforce mental health workplace wellbeing
Committee Chair / Thesis Advisor	Robin McGee, Emory University
Committee Members	Elizabeth Walker, Emory University

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