NSECE Snapshot: Mental Health and Well-being of Center-based Child Care Workers from 2019 during the COVID-19 Pandemic: Key Findings by Race and Ethnicity

This snapshot reports on the mental health and well-being of the center-based CCEE workforce from 2019, by race and ethnicity, as collected in longitudinal data from 2019, 2021, and 2022 in the National Survey of Early Care and Education (NSECE).

• The percentage of the center-based CCEE workforce from 2019 at risk of depression increased between 2019 and 2021 and remained higher in 2022 compared to 2019.  
• Risk of depression was higher in 2021 than in 2019 among members of the 2019 center-based CCEE workforce for all four racial/ethnic groups (Hispanic, non-Hispanic White, non-Hispanic Black, Other Race/Ethnicity) examined.  

In 2022, the percentage of the center-based CCEE workforce at risk of depression remained higher compared to 2019. This was observed consistently in each racial/ethnic group examined. 

This snapshot draws from data collected in NSECE Workforce Surveys in 2019 (March 2019 — July 2019) and in the COVID-19 Longitudinal Follow-up Wave 1 (January 2021-March 2021) and Wave 2 (November 2021 — February 2022). The nationally representative sample in 2019 was comprised of one or two classroom-assigned instructional staff members from each center-based provider that completed a center-based provider interview in the 2019 NSECE. One classroom serving children birth through age 5 (not yet in kindergarten) was selected at random from one of the age groups the center-based program reported serving. Workforce respondents were selected at random from a list of classroom staff. All workers in the 2019 NSECE were asked to participate in the NSECE COVID-19 Longitudinal Follow-up, whether or not they were still working in CCEE. The 2019 NSECE Center-based Workforce Survey indicated that there were 1.36 million teachers, assistant teachers, and aides in center-based CCEE classrooms in 2019. The analytic sample in this snapshot, known as the snapshot sample, includes respondents from the NSECE Workforce Surveys in 2019 and COVID-19 Longitudinal Follow-up Surveys who represent 825,000 members of the center-based CCEE workforce from 2019, which is about 60% of the full 2019 center-based workforce. 

A seven-item short form of the 20-item Epidemiologic Studies Depression Scale (CES-D), which is widely used to screen for risk of depression in U.S. community studies. The CES-D short form (CES-D-SF) includes questions about the frequency of seven depressive symptoms over the last week. Respondents are asked to indicate how often they felt in the following ways during the prior week using four categories, which are assigned a numeric value (0-3) for scale construction: Rarely or none of the time (less than 1 day) is assigned 0, Some or a little of the time (1-2 days) is assigned 1, Occasionally or moderate amount of time (3-4 days) is assigned 2, and All of the time (5-7 days) is assigned 3. Responses to each of the below 7 items are summed to generate a total score ranging from 0 to 21, where a higher score means more signs of being depressed. 

1. I did not feel like eating; my appetite was poor.
2. I had trouble keeping my mind on what I was doing. 
3. I felt depressed. 
4. I felt that everything I did was an effort. 
5. My sleep was restless. 
6. I was sad. 
7. I could not get going. 

The CES-D cutoff of 16 has been widely used for identifying depressive symptoms (Weissman et al.,1977), although there has been no diagnostic validation of major clinical depression on the CES-D.  In the original development of the short-form measure (CES-D-SF), Levine (2013) found that, using a methodological approach (classification accuracy analysis), there was alignment between scores of 8 or more on the short form (CES-D-SF) and scores of 16 or more on the original form (CES-D). Following this approach (Levine, 2013) respondents on the CES-D-SF with a score above this cutoff (scores of 8-21) are described as “at-risk” of depression in this snapshot. Recent research has similarly implemented this approach of using a cutoff of 8 or higher in studying depression among CCEE workers (Markowitz and Bassok, 2022). 

Park, Ji Eun and AR Datta (2023).  NSECE Snapshot: Mental Health and Well-being of Center-based Child Care Workers from 2019 during the COVID-19 Pandemic: Key Findings by Race and Ethnicity. OPRE Report #2023-252, Washington DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services