Mental and physical health of international humanitarian aid workers on short-term assignments: Findings from a prospective cohort study

Research findings show humanitarian work impacts one's health. We conducted a prospective observational study among 618 international humanitarian aid workers (iHAWs)' recruited from 76 countries to investigate health changes and ill-health risk factors after mostly short-term (<1 year) medical emergency assignments. The aid workers were assigned to 27 countries. Data collected between 2017 and 2020. We also compared a gold-standard clinical interview with self-report questionnaires to assess whether self-report scores overestimate the prevalence of clinical anxiety, depression and PTSD. Analyses consisted of repeated measures ANOVAs and adjusted odds ratios, using pre-assignment (T1), post-assignment (T2) and two-month follow-up data (T3). Humanitarian workers experienced on average, 2.6 experienced and witnessed potential traumatic events, and 4.8 male and 5.6 female assignment-related stressors. Self-report health indicators demonstrated a significant increase in emotional exhaustion, loss of vitality, decreased social functioning and emotional well-being between T1 and T2, all of which improved between T2 and T3. PTSD, depression, experienced role limitations, physical functioning, pain, and general health - remained stable. Anxiety levels decreased significantly between T1 and T2. The presence of DSM-5 disorders anxiety (6.6 %), depression (1.3 %) and PTSD (0.3 %) was low compared to norm populations, except for alcohol-use disorder (13 %). None of the reported T2 risk factors was significant at T3. Compared to the clinical interview, self-report cut-off thresholds inflated the presence of a potential anxiety disorder (3×), PTSD (8×) and depression (25×). Humanitarian work is highly stressful but most iHAWs remained healthy. Looking into how iHAWs stay healthy may be a more useful way forward.