A new psychological study from the CV19 Heroes project has been published with the international journal Social Science & Medicine (SSM) Mental Health. In this study, we aimed to understand what factors may be associated with the welfare of frontline workers 12 months into the pandemic, with a particular focus on solidarity. The results show that frontline workers’ perceptions of solidarity from government and the public were important to their welfare, and could be an important protective factor during periods of occupational stress.
Our project, a collaboration between Cardiff Metropolitan University (UK) and University of Limerick (Ireland), has tracked the welfare of frontline workers since the pandemic began in 2020. Across multiple studies, using multiple methods, we explored the experiences of frontline workers from health and social care sectors, essential retail, emergency services, and beyond. While each occupational sector and role faced different challenges, our research is driven by the view that all frontline workers faced novel situations, pressures and prolonged distressing periods triggered by the pandemic, and that their experiences are influenced by broader social and cultural factors.
In late 2020, we carried out interviews with participants to hear about their recent experiences of working on the frontline during the Covid-19 pandemic in the UK and Ireland. The findings from these interviews highlighted something quite novel — feeling solidarity from the government and public mattered very deeply to them. In essence, solidarity refers to the sharing of goals where both sides share that goal and commit to reaching it together, despite encountering some adversity in achieving those goals. Solidarity was palpable at the start of the pandemic (e.g., in relation to protecting each other from coronavirus) but for many frontline workers, this was not sustained over time. Participants noted that the incidences of rule breaking from leadership appeared to be pivotal in the dissolution of solidarity. Inspired by these novel findings, we conceptualised a theory of solidarity appraisal as a potentially important aspect in occupational stress and burnout.
The underlying premise of solidarity appraisal is as follows: that in an occupational context where your outcomes as a worker are contingent on the action (or inaction) of others, their solidarity with you as a worker is important. To put this into the pandemic context, those in healthcare, who have been working to combat the immediate and direct impacts of Covid-19, have needed the public to work with them in order to make their work more manageable. They have needed the public to do what they can to minimise the infection spread so that their workplaces are not overwhelmed and that they can manage the trauma and distress of the consequences of this novel pathogen as best they can.
In the early stages of the pandemic, when leadership was speaking very strongly about supporting frontline workers (sometimes referred to as “key” workers or “essential” workers), and the public painstakingly adhered to the public health regulations, this feeling of solidarity was strong. Over time, however, and with the very notable rule breaking by leadership figures in both the UK and Ireland, this sentiment of solidarity decreased. Yet frontline workers were still working and experiencing the tragedies of Covid-19 every day. The constant struggle and effort, coupled with the very frequent publicization of rule breaking seen through news and social media, led many of our participants to lose their sense of meaning, with one participant saying:
“Every day my team ask me why do they bother? Why do they continue to put their life on the line with no thanks, and to find out that the government have breached so many of their own Covid laws?”.
To test our theory of solidarity appraisal, we analysed data from our 12-month survey to examine the associations between perceptions of solidarity from key groups (the participants’ colleagues, their organisation, their country’s government, and the public) and markers of their physical and mental health. Given that our participants had indicated that lack of solidarity was undermining their sense of meaning in life, and that we have demonstrated that meaning is protective against negative psychological outcomes, we examined frontliners’ feelings of meaning over time. Our data show that participants’ sense of meaning had significantly decreased from baseline (March 2020) to our 12-month point (March 2021). Thus, we used this marker of meaning as a potential way of explaining the relationships between solidarity and workers’ welfare.
To assess frontline workers’ welfare, we measured participants’ levels of burnout, symptoms of post-traumatic stress disorder (PTSD), levels of anxiety, wellbeing, and physical health symptoms that are often associated with severe stress (such as the presence of headaches, difficulty sleeping, or gastro-intestinal problems). At the 12-month survey point, on average, participants reported reasonably high levels of burnout, PTSD symptoms, low levels of wellbeing, and negative physical health symptoms associated with stress. Levels of anxiety varied from person to person. In terms of solidarity, participants indicated that they felt much higher solidarity from their colleagues and their organisations than they did from their respective country’s government or the public. The analysis revealed that participants’ appraisal of solidarity from each group were related to their wellbeing. Participants’ appraisal of solidarity from the public was related to all welfare outcomes — with lower solidarity predicting poorer welfare.
Next, we wanted to see if meaning was a potential mechanism that explained how solidarity may be related to physical and mental wellbeing. Our analyses showed that for levels of anxiety and physical health symptoms, the perception of solidarity from each group was explained fully by its relationship with meaning. For the appraisals of solidarity from colleagues and government, these were all fully explained by their pathway through meaning as well, for each welfare outcome. For solidarity appraisal from the participants’ organisation and the general public, the relationships to burnout, symptoms of PTSD, and levels of wellbeing were only partly explained by the mechanism through meaning, indicating there may be other factors involved in these processes. These findings offer support the idea that experiencing a lack of solidarity from important social groups, whilst working in frontline roles, reduces sense of meaning in life, which in turn negatively influences welfare.
Until now, occupational factors that influence stress and health on workers have usually been considered within the working context. The findings from our study show the importance of often-overlooked factors beyond the workplace in influencing individual’s experience of meaning and health outcomes. Specifically, we show that external factors such as a sentiment of solidarity from government and the public can be important factors in the experience of occupational stress and subsequent impact on health and wellbeing. These findings also reiterate the importance of experiencing meaning when working in highly stressful and demanding contexts. These findings are important because the sentiment of solidarity has changed over time, with many frontline workers feeling that their efforts during the pandemic were not met with solidarity from others. Perhaps if the rhetoric of support from leadership and the public had continued, coupled with behaviour that promotes solidarity, some negative welfare outcomes would have been mitigated.
To buffer harm, leaders must express sentiments of solidarity, speak with the language of compassion and support, and ensure that conduct aligns with that sentiment, during times of societal crises such as pandemic and war. Governments set the tone for the nation and, therefore, must lead with words and deeds of solidarity with those who are risking their health, and their lives, to keep us all safe.
The study, “Solidarity appraisal, meaning, and markers of welfare in frontline workers in the UK and Ireland during the Covid-19 pandemic“, was authored by Rachel C. Sumner and Elaine L. Kinsella.