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Little attention has been given to the mental and physical health impacts of COVID-19 on the academic public health workforce. Academic public health is an important support mechanism for public health practice, providing expertise and workforce training, conducting research, disseminating evidence-based scientific information to both public health and lay audiences, and serving as a supplementary workforce when additional resources are needed. These roles become more important during a public health emergency, particularly during a prolonged public health crisis like the COVID-19 pandemic. As a result of the COVID-19 response, the roles of academic public health have expanded to include developing and implementing contact tracing, surveillance, testing, and vaccination programs for universities and their surrounding communities, all while continuing to prepare students and support the public health practice workforce in their ongoing efforts. As in other responder groups, this has resulted in significant mental health effects and burnout among public health academicians. The authors suggest important steps that can be taken to improve the resilience of the academic public health workforce and to support their contributions during prolonged public health emergencies.

The COVID-19 pandemic, and the measures implemented to control it, collided with another public health emergency – the opioid crisis – with dire consequences. In October of 2017, the Secretary of the US Department of Health and Human Services declared the opioid crisis a public health emergency. That declaration has been renewed several times, including during the COVID-19 pandemic, with the latest renewal set to go into effect on July 4, 2022. The overlap of individual, environmental, and social risk factors for substance use disorder (SUD) and COVID-19 present major challenges to those working as part of the response to both pandemics. The severity of the implications of this dual pandemic – an estimated 100,000 people in the United States died from a drug overdose during the first year of the pandemic – make this an area of the pandemic response where lessons learned had to be rapidly implemented to save lives. Identifying ways in which those lessons can be expanded to other populations at risk, including those with other pre-existing mental disorders, will be important to reducing the inequitable impacts of the pandemic on mental health.

The governmental public health workforce provides essential public health services to communities from public health agencies operations at the local, state, and federal levels of government. The roles and duties of public health workers range from infectious disease tracking and control to healthy eating promotion to checking food service establishments for safety. Unfortunately, most of the time, the general public is unaware of, and unconcerned with, public health’s primary mission of disease prevention. This behind-the-scenes, service-oriented workforce has responded to the COVID-19 pandemic by working long hours, extra days, and ever-changing job roles, all while becoming targets of political attacks and enduring substantially elevated psychological distress and burnout. Though this workforce is not well enumerated, existing studies indicate that public health workers face higher anxiety, depression, post-traumatic stress disorder, and burnout than other frontline healthcare workers during the COVID-19 pandemic response. Several strategies have been suggested to address these vulnerabilities, including increasing the amount and stability of available funding, implementing organizational-level policies and programming to boost resilience, and providing individual-level social support, both instrumental and emotional, to protect against burnout and other psychological distresses.

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

The COVID-19 pandemic, and the responses to it that were required from frontline healthcare providers and others working in healthcare settings including environmental, clerical, and security staff, has challenged our healthcare systems in unprecedented ways. The threats to the financial, physical, and psychological well-being of healthcare professionals – many of whom entered the field due at least in part to a deep commitment to caring for and helping others – will have profound and long-lasting personal and professional impacts. Early in the pandemic response, healthcare professionals knew little about the risks they, their patients, and their loved ones faced from COVID-19 as they operated under crisis standards of care and without adequate supplies of personal protective equipment. As the pandemic response progressed, the lack of clear, science-based guidance, and the politicization of the pandemic presented new medical, ethical, and moral dilemmas. New psychological support mechanisms, including crisis counseling and evidence-based interventions, are needed for all workers in healthcare settings, regardless of their job role.

Prior to the onset of the COVID-19 pandemic, women did nearly three-quarters of the world’s unpaid work. As institutional supports, including in-person school and community-based care for children, the elderly, and the disabled vanished early in the pandemic, many women’s caregiving responsibilities increased. In some cases, opportunities for paid employment disappeared due to layoffs and furloughs, while in others, paid work was no longer possible without access to the missing institutional supports. Either way, access to needed supports – financial, practical, and social – was diminished. The lapse of needed supports also had severe impacts on subgroups of women, including pregnant and post-partum women. A range of considerations – vaccine safety, social interaction and infection risk, disease severity – have posed serious challenges for pregnant and post-partum women. Across the board, women’s need for continuous access to better social, financial, and practical supports at home, in the community, and in the workplace was made even more evident by the COVID-19 pandemic.

The stressors, and subsequent mental health sequelae, associated with being a part of the frontline, patient-facing healthcare response to the COVID-19 pandemic have been clear from the very start of the pandemic. However, a broader group of workers, perhaps typically not considered to be part of the frontlines of a public health emergency response, have also been deemed essential to the response to the COVID-19 pandemic. Protective service workers, including law enforcement and emergency services, those working in food production, processing, and dietetics, maintenance and environmental service workers, and laboratory workers are among those unable to work from home, yet potentially unaccustomed to the stressors of being an essential workers during a public health emergency. Changes to many systems – including health insurance and other benefits, provision of personal protective equipment, and prioritizations for vaccinations and other pharmaceutical and nonpharmaceutical interventions – are needed going forward to retain and protect essential workers during future public health emergencies.