Distress During the COVID-19 Pandemic Among Local Public Health Workers in New York State.

OBJECTIVE: Understanding the challenges public health workers have faced is critical to reinforcing, revitalizing, and strengthening the public health workforce. We measured and identified the level and causes of psychological distress among public health workers during the COVID-19 pandemic in New York State. METHODS: We used a knowledge, attitudes, beliefs, and behaviors survey to ask public health workers at local health departments about their experiences working in public health during the pandemic, including questions relating to harassment from the public, workload, and work/life balance. We used the Kessler-6 scale to measure participants' psychological distress using a 5-point Likert scale, with higher scores indicating greater psychological distress. We calculated descriptive statistics and conducted a regression analysis to determine the factors associated with public health worker psychological distress, and we coded open-ended comments for qualitative analysis. RESULTS: During September 7-20, 2021, 231 public health workers from 38 local health departments completed the survey. Respondents were predominantly non-Hispanic White (89.6%), female (82.1%), full-time employees (95.1%), and located in Upstate New York. On a bivariate level, the strongest predictor of distress was job satisfaction (-0.388), followed closely by COVID-19 fatigue (0.386) and feeling bullied or harassed by the public (0.331). In the regression analysis, 2 additional factors were associated with distress: considering leaving their job due to the pandemic and concerns about exposure. Themes from the qualitative analysis strongly supported these findings. CONCLUSIONS: Understanding the challenges public health workers have faced during the pandemic is critical to inform the actions needed-stronger state laws protecting against harassment, workforce incentives, and commensurate funding-to reinforce and revitalize our frontline public health workforce.

Repetitive flood victims and acceptance of FEMA mitigation offers: an analysis with community-system policy implications.

Of all natural disasters, flooding causes the greatest amount of economic and social damage. The United States' Federal Emergency Management Agency (FEMA) uses a number of hazard mitigation grant programmes for flood victims, including mitigation offers to relocate permanently repetitive flood loss victims. This study examines factors that help to explain the degree of difficulty repetitive flood loss victims experience when they make decisions about relocating permanently after multiple flood losses. Data are drawn from interviews with FEMA officials and a survey of flood victims from eight repetitive flooding sites. The qualitative and quantitative results show the importance of rational choices by flood victims in their mitigation decisions, as they relate to financial variables, perceptions of future risk, attachments to home and community, and the relationships between repetitive flood loss victims and the local flood management officials who help them. The results offer evidence to suggest the value of a more community-system approach to FEMA relocation practices.