Can Addressing SDHs Predict “Joy in Work” and “Burnout”?

Although the topics of “Joy in Work” and “Burnout” have been common research topics for many years, a recent study conducted by MHVC and Einstein College of Medicine has found a connection between those topics and how an organization addresses social determinants of health (SDH).

“Addressing Social Determinants of Health: Predictors of Healthcare Staff Resilience and Burnout,” by Kathleen McAuliff, PhD, and Bruce Rapkin, PhD, Einstein College of Medicine; and Dr. Damara Gutnick, MHVC Medical Director, confirms the connection between SDHs, Joy, Burnout, and an organization’s approach to change management. The research poster can be seen here, and a summary PowerPoint presentation viewed here.

The survey, guided by MHVC’s Cultural Competency and Health Literacy Workgroup, included 46 organizations, with 1930 individual respondents (ranging from 1 to 242 respondents per organization). Data were collected from February to April, 2018. The survey domains included cultural competency, SDHs, and burnout and job turnover. Research questions included:
1. Do SDHs predict burnout, or job turnover (i.e., leaving a job?)
2. If so, which SDH?
3. Do change management concepts predict burnout or job turnover? (i.e., leaving a job?)
4. If so, which concepts?

The top three SDHs that identified as the most challenging to address with patients/clients are (1) money/finances, (2) housing, and (3) physical health including activities of daily living and dependence on assistance. “Many of the results regarding ‘joy’ and ‘burnout’ were expected, almost intuitive,” said McAuliff, “but it is crucial to have sound data and documented results in order to effect change.” Comparing Joy in Work and Burnout across job roles, the study found that peers — people with a lot of ‘lived’ experience — had the highest level of Joy. Case managers and social workers had the highest rate of Burnout; senior administrators had the least.

The significant part of the study was connecting organizational readiness to address a patient’s SDHs as a predictor of Joy and Burnout. McAuliff continued, “SDHs are a principal source of stressors for staff. Are organizations providing resources, linkages, information, and support? Are they prepared to screen clients and give them access to meet needs?”

MHVC will incorporate the survey results into its efforts in Cultural Competency and Health Literacy, according to Dr. Gutnick. “We are preparing reports that partners can cite, and other resources, to provide support around cultural competency and health literacy, which are critical initiatives for MHVC and DSRIP. The most important is the readiness to address SDHs and linkage — know who to go to, show support, and train.”

Each participating site will be given a summary report with resources tailored for their results. McAuliff said the next step will be to put together a handbook of resources that will also be available on the MHVC website. For more information about the survey or results, contact Katie McAuliff at

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