Depression in nursing home workers linked to work-family stress

December 5, 2011

Financial strain, insufficient food often to blame

A study led by Harvard School of Public Health (HSPH) researchers, published November 17, 2011, in the American Journal of Public Health, shows that symptoms of depression are common among low-wage nursing home employees. The researchers found financial strain, concerns about running out of food at home, and preoccupation at work with troubles at home were among the stressors contributing to nearly double the rate of depression among the workers compared to their peers who did not have such stress.

Depression is among the most commonly experienced disorders and the leading cause of disability worldwide, according to the authors. It is a leading cause of absence in the workplace and is associated with worker turnover.

“The high burden of work-family stress and depression in this group has important public health implications for the workers and their families as well as for the quality of care delivered to nursing home residents ,” said Cassandra Okechukwu, assistant professor of society, human development, and health and lead author.

Okechukwu and senior author Lisa Berkman, Thomas D. Cabot Professor of Public Policy and of Epidemiology and director, Harvard Center for Population and Development Studies, and colleagues investigated the relationship of stress in the home and work environment to depression in a 452 ethnically diverse group of workers from New England in 2006 and 2007. Most of the workers in the study were women who were single mothers, recent immigrants unaware of or not eligible for government assistance, and members of racial/ethnic minority groups.

The researchers found a 26% prevalence of depressive symptoms among all study participants. The highest prevalence of depression (52.2%) occurred in the 16% of households classified as food insufficient, followed by a 41.2% prevalence of depression in the 31.5% of households that experienced financial strain. Most of the workers who lacked food also lacked funds. Read the abstract.

“Low wage workers—even those who are working full-time—often have a hard time making ends meet and having essential resources to attend to work and family needs. We hope this study will lead us to solutions to improve the health and well-being of these workers,” said Berkman.

Both researchers are now working on the design and evaluation of an intervention study that is geared towards addressing the work-family problems faced by nursing home workers.

Support for the study was provided by the Work, Family, and Health Network, funded by the National Institute of Aging and the National Institute of Child Health and Human Development.

“Household Food Insufficiency, Financial Strain, Work—Family Spillover, and Depressive Symptoms in the Working Class: The Work, Family, and Health Network Study,” Cassandra A. Okechukwu, Alison M. El AyadiSara Tamers, Erika L. Sabbath, and Lisa Berkman, American Journal of Public Health, online November 17, 2011.

–Marge Dwyer

photo: iStockphoto/guvendemir