Second Job Holding and Extended Working Hours Among Hospital Workers: Implications for Mental Health

Background and Purpose: While the healthcare profession has recognized the relationship between job demands and the prevalence of depression and anxiety among healthcare workers, one aspect of their work that has received limited attention and remains under-researched is the phenomenon of second job or multiple job holding. Limited research has delved into the connection between second job holding and mental health, particularly among healthcare workers. To enhance our ability to provide effective support for the mental well-being of these workers, it is crucial to gain insights into the prevalence of second job holding among them, identify those who engage in multiple job holding, and understand how this practice relates to the mental health of healthcare workers. Therefore, the primary objectives of this study are to investigate the characteristics of healthcare workers holding multiple jobs and to explore the relationships between multiple job holding and mental health outcomes, such as depression and anxiety.

Methods: The cross-sectional study involved 1,467 registered nurses and service/technical workers in Allegheny County, Pennsylvania, utilizing a survey administered through Qualtrics in March 2022. Second job holding status, demographic information (i.e., gender, age, marital status, parental status, race/ethnicity, education, yearly household income), work-related attributes (i.e., occupations, hourly wage, regular work hours, overtime work hours, second job hours), and mental health screens were collected. Mental health screens included the Patient Health Questionnaire-2 for depression and the Generalized Anxiety Disorder-7 scale for anxiety. The data were analyzed using descriptive statistics and multivariate logistic regression, adjusting for demographic and work-related variables.

Results: Approximately 25% of participants reported engaging in a second job, despite 90% being classified as full-time employees. Furthermore, the study identified the link between multiple job holding and mental health outcomes. The first logit model, controlling solely for demographic factors, revealed a higher likelihood of depression among second job holders. A second logit model, adjusting for both demographic and work-related variables, emphasized the role of total weekly hours, encompassing regular work, overtime, and second job hours, in relation to depression and anxiety. Therefore, hospital workers, particularly those with second jobs leading to longer work hours, were more likely to report symptoms of depression and anxiety.

Conclusions and Implications: This study unveils the prevalence of second job holding among healthcare workers in hospital settings and its association with mental health outcomes. The findings carry implications for infection control practices, as healthcare workers with multiple jobs may pose challenges in effectively managing Covid-19 infections. Additionally, the impact on mental health has broader consequences for patient care, necessitating attention to structural conditions contributing to workers seeking secondary employment. Addressing issues such as low wages and inadequate hours in primary jobs is crucial for improving the well-being of healthcare workers and, in turn, enhancing patient care. Efforts to support mental health should consider the consequences of extended work hours and the potential ripple effects on both healthcare workers and the quality of patient care they provide.