Is community Health workers mental health affected by community violence? A study in a brazilian metropolis
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Fundação Oswaldo Cruz e Unichristus, Brazil
Universidade Estadual do Ceará, Brazil
Prefeitura Municipal de Fortaleza, Brazil
Harvard T. H. Chan School of Public Health, United States
Unifanor, Brazil
Escola de Saúde Pública do Ceará, Brazil
Unichristus, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1240
The Family Health Strategy (FHS) is the main primary health care system in Brazil. FHS is organized through a multidisciplinary team that include Community Health Wokers (CHWs), which play a critical role, by strengthening the bond between families and FHS teams. However, they are also exposed to adverse factors such as violence in the territories served. Violence is a major social problem in Brazil with serious repercussions on the health care sector. In this study, we analyzed the relationships between adverse working conditions and dimensions of violence in the territory on the prevalence of common mental health disorders (CMHD) among CHWs in Fortaleza, a Northeastern Brazil capital. Information was collected with a self-report questionnaire containing items on sociodemographics, job-related violence, psychoemotional signs and symptoms (Self-Reporting Questionnaire-20), mental health care, and absence from work due to general or mental health issues. The prevalence of CMHD among CHWs in Fortaleza was shown to be influenced by high levels of violence in the territory and on the job. Based on the responses of 1,437 CHWs, the prevalence of CMHD (32.75%) was shown to be associated with violence perceived, witnessed or suffered in the work territory. In the hierarchical analysis, CHMD was associated with age, sex, religious identity, years of experience as a CHW with the FHS, activites in the community, considering the absence of bond with families as an obstacle, having suffered domestic violence, use of medication for emotional dysregulation, identifying the neighborhood as violent, considering violence a physical or mental health determinant, and identifying impunity as a cause of violence. Thus, the work and mental health of CHWs were significantly impacted by dimensions of violence. Our findings are relevant to the adoption of strategies to mitigate the effect of violence on the work and mental health of CHWs., 2013).
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