Social protection must include essential workers during pandemic: study

Essential workers, particularly at a Singapore hospital, have endured such a heavy burden during the COVID-19 pandemic, exposing themselves to risks of infections while putting up with increased workloads and workplace stress, longer hours in uncomfortable working conditions, as well as public stigmatization, results of a recent study show.

The researchers conducted a cross-sectional study of 246 outsourced essential workers, including housekeeping, maintenance staff, and porting staff. They measured psychological distress using the Kessler-6 scale. A questionnaire was also used to survey respondents regarding the main concerns that worried them, supportive resources available, and additional resources that would be of help to them.

Respondent-reported concerns related to employment, finances, accommodation, transportation, and likelihood of receiving medical attention for COVID-19 were the main factors that resulted in moderate-to-severe psychological distress (p<0.05). [Proc Singap Healthc 2023;doi:10.1177/20101058231192784]

Specifically, stress from isolation and fear of COVID-19 infection caused the greatest psychosocial burden among essential workers.

Respondents reported that their employers and social circles were the ones that provided them with much-needed support. They also mentioned their enhanced individual ability to cope and that additional financial aid from their employers and the government would be of great help.

“Financial and accommodation-related stressors reflect structural factors that exacerbated the psychosocial burdens faced by nonmedical hospital workers,” the researchers said. “Most respondents tended to individualize their coping strategies, which point towards the need for stronger social protections and mental health provisions for hospital essential services workers.”

Recommendations

Based on these findings, several recommendations were made. First, acknowledging that all classes of essential workers face challenging conditions is essential. Therefore, more expansive social protections must be put in place for low-wage essential workers. [Glob Soc Welf 2021;8:107-116; Econ Lab Relat Rev 2018;29:308-327]

“However, social protection in Singapore remains dependent on regular employment, highly targeted and differentiated by class and nationality, and limited in scope and duration to disincentivize reliance on social welfare,” the researchers said. [ASEAN Econ Bull 2012;29:218]

“[T]here is an urgent imperative to pre-empt such health inequalities from becoming entrenched, and exacerbating already-existing inequalities that perpetuate poverty traps for members of the lower socioeconomic strata,” they added.

Second, greater awareness and normalization of mental health support at the organizational level, particularly for contract workers, are necessary. The respondents’ tendency to individualize coping strategies, which could create potential unhealthy self-expectation, is a common trend among studies of healthcare workers. [Psychiatr Res 2020;293:113441]

“Although these workers are not directly employed by the hospital, given the important role they play in supporting clinical services, there needs to be greater scrutiny of the contractual standards for these workers,” the researchers said. “National manpower policies and regulations also need to be improved and enforced appropriately to ensure that the needs of these essential workers are not neglected.”