Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Social Work


Social Work

First Advisor

Dr. David Royse


Child welfare workers respond to human tragedy and the job stresses associated with their positions that may result in their own trauma, secondary traumatic stress, compassion fatigue, emotional exhaustion, and burnout. Workers continue to leave their positions at alarming rates, influencing service quality and the ability to meet the needs of vulnerable populations. Decades of research have attempted to solve this national crisis by identifying salient factors found to influence the child welfare worker's experience and intention to leave their position. However, the problem prevails.

Addressing a major gap in the literature, this mixed methods study took a unique approach by exploring how the stress of working in public child welfare affects workers’ personal health. Using secondary data analysis from a statewide sample of public child welfare workers, qualitative thematic content analysis and binary logistic regression were used to explore what child welfare workers identified as unhealthy habits they have developed as a result of stress from their positions. Findings from this study provide clear evidence that the demands associated with working in this capacity negatively impact the health of the child welfare worker.

Qualitatively, five self-reported themes emerged when workers were asked to describe the health consequences of their work. Workers described their affinity for unhealthy consumption (e.g., food, alcohol, tobacco) and the development of a number of unhealthy behaviors (e.g., disturbed sleep, lack of exercise, angry outbursts) as a result of the stress of their positions. Workers also provided descriptions of the physical and mental health implications of working, compounded by the poor work-life balances reported.

Quantitatively, significant differences were found across all subscales of the Child Welfare Employee Feedback Scale (CWEFS) when examined by the current health status of the workforce. Workers reporting poorer health had worked at the agency longer and reported a greater intention to leave the agency in the next 12 months. Finally, a binary logistic regression identified Workload and Job Impact as factors predicting lower worker health outcomes. Although “marginally” significant, working outside of one’s home county and working in an urban area were factors contributing to the stress-induced health impact associated with respondents’ positions.

The profession must recognize the health implications associated with working in public child welfare and organizational efforts to allow these employees to self-care seems to be an absolute necessity. Future research should integrate the use of biometric screening and multidisciplinary collaboration to investigate organizational, supervisory, and individual level efforts to improve the situation.

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Social Work Commons