Impacts of Covid-19 on rural health care workers in Manitoba

By Kyrra Rauch, Margaret de Jager, Doug Ramsey, Rachel Herron, Breanna Lawrence, Candice Waddell, and Nancy Newall
March 2021
Print Version

What you need to know

This pilot study examines the mental health impacts of COVID-19 on frontline health care workers during the initial stages of the pandemic response in rural Manitoba, Canada. It is one stage of a larger project examining the impacts of COVID-19 on rural people and places. The research is undertaken through the Centre for Critical Studies of Rural Mental Health at Brandon University.

Why this research is important

COVID-19 is a global pandemic and its impacts are far reaching. This research is important as it examines the impacts of the pandemic on the mental health of frontline health care workers that are doing all they can to protect society from COVID-19. Focusing on rural health care workers is also important as rural areas are often underserviced.

How this research was conducted

Data was collected using an online survey over a one-month period from May to June 2020 (n= 137). Primarily nurses (including psychiatric, licensed, and practical) responded to the survey that included questions assessing symptoms of anxiety as well as strategies and barriers to addressing mental health concerns. The questionnaire also employed the Generalized Anxiety Disorder (GAD-7) scale to assess anxiety. Developed and validated in primary care by Spitzer et al., the Generalized Anxiety Disorder 7-item Scale is an efficient, self-report scale that has been shown to be a reliable and valid measure of clinical symptoms of anxiety.

What the researchers found

The initial stages of the COVID-19 pandemic in Manitoba had negative effects on the mental wellbeing of rural frontline health care workers. In communities of less than 10,000 people, analysis showed that nearly ¼ of health care workers that responded to the survey reported moderate to severe levels of anxiety. Health care workers mostly accessed informal supports, such as family and friends, and they reported numerous barriers to accessing formal mental health support. Frequent barriers reported included fatigue, not having time to seek support, and fear of judgement. As the number of barriers experienced trying to access resources increased, GAD-7 scores also significantly increased.

Health care workers identified a wide array of coping strategies they used to support their mental health and well-being during the initial stages of the pandemic. Common coping strategies included eating regularly, having a good sleep routine, and exercising. It is also important to address potentially negative strategies reported such as increased consumption of substances such as alcohol, tobacco, and cannabis through the provision of other complementary supports. Importantly, those who reported using more coping strategies displayed lower GAD-7 scores. This finding speaks of the importance of providing and supporting positive coping strategies in the workplace, community, and at home.

How this research can be used

This research provides a baseline for future research on the impacts of COVID-19 on frontline health care and other workers. People are resilient in the face of adversity, however, there are limits. The researchers hope that these and other findings reported elsewhere, will be used by government agencies and governing bodies to improve workplaces and thereby increasing safety, quality of life, and service delivery.


Funding for the research was provided through the Canada Research Chair Program. The researchers thank the frontline health care workers for their participation in this research, and more importantly, their dedication to service.

About the Researchers

Kyrra Rauch

Kyrra Rauch, B.A. (Hons)

Kyrra Rauch is a recent graduate, B.A. (Hons) in Psychology, and research assistant for the CCSRMH.

Margaret de Jager

Margaret de Jager, B.A.

Margaret de Jager, B.A. (Psychology), is a student in the Department of Psychiatric Nursing and research assistant.

Doug Ramsey

Doug Ramsey, Ph.D.

Doug Ramsey is a professor in the Department of Rural Development

Rachel Herron

Rachel Herron, Ph.D.

Rachel Herron is an associate professor in the Department of Geography and Environment.

Breanna Lawrence

Breanna Lawrence, Ph.D.

Breanna Lawrence is an assistant professor in the Department of Educational Psychology and Student Services.

Candice Waddell

Candice Waddell, Ph.D. (c)

Candice Waddell is an assistant professor in the Department of Psychiatric Nursing.

Nancy Newall

Nancy Newall, Ph.D.

Nancy Newall is an associate professor in the Department of Psychology.


  • health care workers
  • mental health
  • nursing
  • pandemic
  • rural

Publications Based on the Research

Ramsey, D., Lawrence, B., Rauch, K., Herron, R., Waddell, C., Newall, N., & de Jager, M. (2021). COVID-19 and mental health: Impacts of a pandemic on rural healthcare workers in Manitoba. Manuscript submitted for publication.

Waddell, C., de Jager, M., Herron, R., Ramsey, D., Rauch, K., Lawrence, B., & Newall, N. (2021). Examining rural healthcare workers’ needs and experiences during COVID-19. Manuscript submitted for publication.

Editor: Christiane Ramsey

Research at Brandon University follows comprehensive policies designed to safeguard ethics, to ensure academic integrity, to protect human and animal welfare and to prevent conflicts of interest.