Chronic disease and mental health prevalence among US child care professionals during COVID-19 pandemic

Chronic disease and mental health prevalence among US child care professionals during COVID-19 pandemic

In a recent study posted to the medRxiv* preprint server, researchers evaluated the prevalence of chronic diseases, depression, and stress among the US child care professionals during the coronavirus disease 2019 (COVID-19) pandemic.

Study: Prevalence of Chronic Diseases, Depression, and Stress among U.S. Child Care Professionals during the COVID-19 Pandemic. Image Credit: Robert Kneschke/Shutterstock


According to the authors, only two other studies investigated the physical and mental conditions of child care professionals in the US before this work. The one conducted in Indiana during the pandemic found that 63% of child care professionals experienced stress levels double the national estimate of 37% for US adults; another one conducted before the pandemic onset found that 36.8% to 62.1% of them experienced moderate to high-stress levels.

Since the well-being of child care professionals directly or indirectly influences children’s academic and emotional learning outcomes, it is crucial to address their condition during the pandemic and beyond.

About the study

In the current large-scale national-level study, researchers collected data of 81,682 child care professionals through an online survey, termed Qualtrics®, from May 22-June 8, 2020, for analyzing several physical and mental conditions.

They analyzed four physical health conditions – heart disease, asthma, diabetes, and obesity. Additionally, mental health conditions, such as depression and stress were also assessed.      The study analysis accounted for their sociodemographic characteristics, including ethnicity/race, age, gender, child care type, medical insurance status, etc.

All the participants, self-identified as child care professionals, aged 18 years or more, resided in a US state or the Columbia district and consented to participate in the study. Of the 94,390 individuals who accessed the survey, only 82,613 met the inclusion criteria, from which 81,682 (98.9%) could provide requisite data for the analyses.

Study findings

The survey results showed that the mean age of study participants was 42.1 years; proportions of female, male and non-binary were 96%, 2.5%, and 0.3%, respectively. 

Regarding the prevalence of asthma, 14.3% of child care professionals reported moderate to severe asthma, about 1.2 times the national average for US adult women. In contrast to asthma, the prevalence rates for diabetes, heart disease, and obesity at 6.5%, 4.9%, and 19.8%, respectively, were below national rates for US adult women. 

A total of 37,376 participants had depression, and 66.5% reported moderate to high stress levels. The prevalence rate of depression within two to three months into the COVID-19 pandemic was greater than US national estimates of 16% to 36.1% before the pandemic, and notably also greater than 27.8% to 32.8% estimates for US adults during the pandemic.

The study analysis evidenced race, gender, and ethnicity disparities for physical health conditions of US child care professionals, but not in association with their mental health conditions during the pandemic.

Of all the physical health conditions examined during the study, the authors observed the most disparities for diabetes in all racial groups. Consequently, Hispanics appeared to be at higher risk of diabetes than White child care professionals. Among the non-binary child care professionals, the authors observed an increased risk of asthma and heart diseases.

Concerning the child care setting they worked for, professionals working in the federally-funded programs appeared to be at greater risk of diabetes and obesity compared to professionals working in for-profit child care centers. These findings showed no association whatsoever with the sociodemographic characteristics of these professionals.

Furthermore, the US child care professionals with asthma, diabetes, or obesity appeared to have greater access to health insurance irrespective of their age or other sociodemographic characteristics. Previous findings showing that individuals with medical insurance use clinical services and therefore receive a primary care diagnosis and treatment rationalizes this finding.


The study highlighted that US child care professionals’ depression rates were much higher during the pandemic than rates observed before the pandemic. During the pandemic, the prevalence rates of depression, stress, and asthma in these professionals went higher than observed among other US adults.

US policymakers and public health officers should pay serious attention to these findings and offer much-needed support to child care professionals. While effective and scalable interventions could improve short-term physical and mental health, addressing issues undermining their overall health is crucial. For instance, long working hours, low wages, and high job demands result in stress, burnout, and turnover among these professionals.

In the future, examining the health behaviors of child care professionals via mixed-methods research could prove beneficial to understanding what health initiatives might improve their overall health.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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