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Causes of Burnout and Associated Risk Factors

A panel on the causes of burnout and associated risk factors revolved around a commissioned paper developed by Youngjoo Cha (Indiana University) along with her collaborator Cassie Mead. She presented a high-level summary of the paper (see Appendix B for the full paper), followed by comments by planning committee member Lonnie Golden (Pennsylvania State University, Abington), discussant Rene Pana-Cryan (National Institute for Occupational Safety and Health [NIOSH]), and other attendees.

The purpose of the commissioned paper and this panel were to address the various factors at the root of high rates of burnout in the science, technology, engineering, mathematics, and medicine (STEMM) workforce and to understand how this might vary across diverse populations of workers, particularly along lines of race and gender. It additionally was developed to provide insight into how burnout relates to other demographic characteristics.

BURNOUT CAUSES AND FACTORS IN STEMM

As context about the prevalence of burnout, Cha began by pointing to the American Psychological Association’s 2023 Work in America Survey. Fifty-seven percent of workers said they experience emotional exhaustion and mental disengagement from work (APA, 2023). Cha said her review of the literature shows that burnout is a multilevel phenomenon caused by factors at the macro, meso, and micro levels. She elaborated on each of these levels.

At the macro level, Cha noted the impact of economic, cultural, and demographic shifts. Economic factors included globalization and union declines. These broad economic conditions pressure organizations to cut costs and to downsize. These changes lead to increased demands and lower job security for those who survive layoffs. She also noted the research on a “time divide,” in which high-skilled workers have seen an increase in hours and low-skilled workers a decrease (Jacobs and Gerson, 2004), as well as the rise of “gig” or contract work in STEMM fields, which can contribute to

stress and strain as well as insecurity at work and can affect burnout (Kunda et al., 2002; Wingfield, 2019).

Turning to macro-level cultural factors, Cha highlighted a few key challenges such as pressure to comply with the “ideal worker norm,” or the expectation that individuals must show complete dedication to their work, exemplified through long hours and undivided focus at all times, and intensified work-life conflict. Even when flexible policies are available, there is often a stigma to using them, so they go underutilized. Parenting norms have also intensified, which increases overall time demands and has gender implications because women still disproportionately provide care for children as well as other kin. “Both the family and the workplace have gotten greedier,” Cha commented. In STEMM fields, the strong ideal worker norm and flexibility stigma have led to higher turnover (Cech and Blair-Loy, 2014).

Finally turning to macro-level demographic changes, Cha pointed out that dual-earner households have increased, with a mean increase in work hours at the family level. Although an older example, heterosexual married couples’ joint weekly work hours increased from 52.5 hours in 1970 to 63.1 hours in 2000 (Jacobs and Gerson, 2004). Workers do not have the spousal support of the past, and time pressures can increase the likelihood that workers experience burnout.

At the meso or workplace level, job demands are increasing, Cha continued. These conditions include long and inflexible hours, “work-work conflicts”¹ when people have dual appointments or other multiple occupational roles that can conflict with each other and cause strain, an increase in “hidden work” such as service or mentorship efforts that more often go unnoticed and unrewarded, and the use of new communication technology that can mean workers are constantly logged in and basically “sleeping with their smartphones.” She noted that women and minoritized STEMM workers, including faculty, are particularly affected by work-work conflicts and hidden work phenomena. Resources that can mitigate these conditions include more control over schedules, creative and meaningful work, autonomy, and relationships. STEMM workers typically face higher job demands than those in other fields but also have more resources than

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¹ Work-work conflict refers to potential conflict between multiple organizational roles or activities an individual might hold or be engaged in that can produce stress and strain. For more, see Wynn et al., 2018.

workers in other fields. However, referring to her comments above, strong ideal worker norms often offset the benefit of these resources.

At the micro level, Cha looked at STEMM professionals’ identification with their work and perceptions of fit. Failing to attach meaning to their work in the face of job and family demands is a major factor of elite workers leaving their jobs. On the flip side, strong identification with the work shields some people from burnout when they feel they have a calling or passion project or when they receive organizational rewards or cultural appreciation. Perception of cultural fit affects burnout in STEMM jobs and, as with the intensification of parenting, has gendered implications. Cultural ideals of many STEMM fields are based on White male heterosexual values, and others often feel they must hide their lifestyles and bodily experiences. These ideals are communicated in many ways including through socialization in engineering education (Seron et al., 2016) and the language or images used in recruiting efforts (Wynn and Correll, 2018). Research shows that being a numerical minority is also a stressor (Jackson et al., 1995; Kanter, 1977; Taylor, 2016), Cha continued. Status beliefs and stereotypes can lead to a sense of underappreciation and inequality, which, in turn, lead to lower job satisfaction, higher turnover, and increased psychological distress for women and other minoritized STEMM workers (Beck et al., 2022; Hall et al., 2015, 2019; Pascoe and Richman, 2009; Wingfield and Chavez, 2020). Emotional labor and gendered and racialized “feeling rules,” or expectations that individuals perform certain emotions, such as expectations of being friendly or open, regardless of their own emotions, additionally create a double burden for women and other minoritized STEMM workers (Hochschild, 1983; Wingfield, 2019).

These macro, meso, and micro conditions affect gender and race disparities in STEMM and potential burnout, Cha concluded. This occurs both through seemingly gender- and race-neutral factors such as workplace resources. When these are combined with gender and race segregation in jobs, they produce gender- and race-specific outcomes in working conditions, job resources, and identification with work. They also have gender- and race-based implications due to implicit biases built into workplace culture, norms, practices, and interactions, Cha concluded.

REFLECTIONS ON COMMISSIONED PAPER

Golden commented on Cha’s presentation as a labor economist. Overwork is not new, he pointed out; Adam Smith wrote about it in 1776.

Future research questions may include whether there is a tipping point beyond which burnout risk cannot be reduced, and whether workers choose to leave a particular job, the entire field, or the labor force entirely. Burnout has multiple causes and should be viewed with multiple frameworks: the economics of labor supply and demand economics, time use/allocation between work and nonwork time, individual and organizational psychology, health risk, and salutogenesis,² or what supports or creates health and well-being rather than just looking at negative or unhealthy factors.

A salutogenic approach applied to burnout has at its core a sense of coherence with three dimensions: (1) comprehensibility (the degree to which a person perceives work, job, and life as structured and predictable); (2) manageability (the extent to which a person feels they have the resources to cope with multiple demands); and (3) meaningfulness (how much a person feels their workplace challenges are worthy of investing time and emotional energy). Reflecting on Cha’s literature review and presentation, Golden said burnout is a culmination of a variety of factors that can build up at the macro, meso, and micro levels. He offered three questions: How do we disentangle the three levels, what is the role of the ideal work norm, and can they be addressed?

Discussant Pana-Cryan briefly introduced NIOSH, which is within the Centers for Disease Control and Prevention. In her remarks, she specifically highlighted the Healthy Work Design and Well-Being (HWD) Program.³ While acknowledging the importance of macro and micro factors as described by Cha, she explained HWD’s focus on the meso, or organizational, level. Proximal outcomes are related to burnout, fatigue, and stress, but the program also recognizes economic and evaluative outcomes to rate quality of life now and in the future.

HWD complements the observations from previous presenters, she noted, such as spillover effects and feedback loops across macro, meso, and micro levels. HWD has delineated “healthy work design elements” that encompass flexibility, workload, and other topics. HWD is also looking at the differential effects between direct employment and contract work, as well as availability and use of paid leave policies.

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² Salutogenesis was developed by sociologist Aaron Antonovsky to argue for a move away from focusing on the “pathogenesis” of disease but instead consider what advances and maintains health. For more on salutogenesis, see https://pmc.ncbi.nlm.nih.gov/articles/PMC7014834/.

³ For more information, see https://www.cdc.gov/niosh/research-programs/portfolio/hwd.html.

OPEN DISCUSSION

Following the moderated discussion, the floor was opened to general questions. When asked by Golden about how to disentangle the levels and tackle norms and stigmas, Cha recognized the levels are a useful analytical framework, but real life offers a more complex picture. Interventions at the workplace level seem the most fruitful. She agreed that the root causes are important, and changing laws and culture should be considered but it takes a long time. For example, the norm in most workplaces is that a household has a single breadwinner, which contributes to policies that often produce more strain for families with multiple working members as is increasingly more often the reality of today’s workforce.

At the micro level, she expressed skepticism about the fix to “give employees a spa day.” Other individual interventions are more effective, such as confronting day-to-day discrimination and stereotypes that are chronic stressors. These micro-level dynamics must be recognized, and interventions to address them may originate at the meso level. Regarding combatting the ideal worker norm, she noted that a root cause to address is that currently most people are rewarded when their job demands increase. She is undertaking a study on flexible work policies and has found how they are implemented makes a difference. A differentiator is whether the policies are up to the discretion of managers versus policies for everyone to use in a gender-neutral way. She echoed the value of starting with “small wins,” and normative changes might eventually follow. Elaborating on the impact of globalization, Cha said an increase in competition and participation in the global economy brings a faster pace and greater pressure to reduce labor costs.

Golden then gathered a series of questions from attendees, and Cha responded to the series in totality. A participant asked about the balance between expanding accommodations broadly to avoid stigma while faced with finite resources. Another participant asked how the different levels can talk with each other. Questions about identification with work and building the evidence base were also raised.

Framing policies is important, Cha stressed. When a policy is framed as a gender issue, it may be more stigmatized and therefore not be used as frequently. Instead, flexible policies should be seen as a legal entitlement, not an accommodation. She noted that in Germany, workers are entitled to 4 weeks of vacation, and they take it. Cha noted that the mindset toward vacation is very different when seen as an entitlement versus an accommodation. In the United States, vacation is not seen as a legal entitlement. As a result, people may be required to ask co-workers to fill in and feel that

taking vacation is an imposition on their team, resulting in taking less vacation time. In dealing with how to distribute work when it is seen as a zero-sum game, Cha said the response must come from the organization. Stigma is enhanced when others must pick up the extra work, she noted. She discussed the importance of considering each level when designing policies. At the macro level, why are we having this problem? At the meso level, how can we mitigate individual factors, such as through different hiring practices, mentoring and networking, or sending out signals related to cultural fit? A participant urged engaging the individuals affected in the design of meso and macro policies. Pana-Cryan underscored the need for workers’ voice. She referred participants to NIOSH’s Worker Well-Being Questionnaire as a resource.⁴ It provides free, de-identified data to use in designing policies, learning from each other, or serving as a benchmark. She also noted that mental health is part of what NIOSH considers as worker health.

When asked about making the business case for childcare, Cha noted that many studies have shown how flexible work improves the bottom line. They have not been effective in convincing most employers. This might be a situation in which political will is needed and not just the business case. Pana-Cryan added that a business case must be tailored for each environment. As a future research question, a participant raised generational shifts in the workplace and tailoring interventions to respond to rapid changes.

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⁴ To access the questionnaire, see https://www.cdc.gov/niosh/twh/php/wellbq/index.html.

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