Report on Pharmacist Working Conditions and Public Health Implications

An Examination in the Context of Sustainable Development Goals

A recent investigation into a series of pharmacist suicides in Pennsylvania has brought critical attention to the demanding working conditions within the pharmacy profession. These events highlight significant challenges to achieving key United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 8 (Decent Work and Economic Growth).

SDG 3: Good Health and Well-being at Risk

The well-being of healthcare professionals is intrinsically linked to the health and safety of the public. The current crisis in the pharmacy sector threatens both, undermining the core principles of SDG 3.

Mental Health Crisis Among Pharmacists

• A recent study in the Journal of the American Pharmacists Association found the suicide rate among pharmacists is nearly 20 per 100,000, significantly higher than the rate of 12 per 100,000 in the general population.
• In Pennsylvania, a recent cluster of deaths has underscored this crisis, with two CVS pharmacists in Lancaster dying by suicide in June, and another pharmacist in Montgomery County dying by suicide in April.
• These incidents reflect a broader pattern of high stress, burnout, and mental health struggles within the profession, directly contravening the SDG 3 target of promoting mental health and well-being.

Impact on Patient Safety

• Advocates, including retired professor Dan Hussar, have filed formal complaints with the Pennsylvania Board of Pharmacy, noting that excessive stress and demanding workloads increase the risk of prescription errors.
• This potential for error poses a direct threat to public health and safety, compromising the goal of ensuring access to safe, effective, and quality medicines for all.

SDG 8: The Challenge of Ensuring Decent Work

The conditions reported by pharmacists, especially in large retail chains, raise serious questions about the industry’s alignment with SDG 8, which calls for decent work and safe and secure working environments for all workers.

Workload and Staffing Analysis

1. The 2024 National Pharmacist Workforce Study revealed that 73% of full-time pharmacists rated their workload as “high” or “excessively high.”
2. This figure rises to 91% for pharmacists employed by chain or mass merchandiser pharmacies.
3. Testimonies from former pharmacists cite unmanageable performance metrics, inadequate staffing, and a lack of institutional support as primary drivers of burnout.

Calls for Regulatory and Corporate Accountability

• The Pennsylvania Pharmacists Association acknowledges that demanding workloads and administrative burdens contribute to high levels of stress.
• A formal complaint has called for the Pennsylvania Board of Pharmacy to investigate staffing and workload conditions, highlighting a potential gap in institutional oversight as the state currently has no mandated staffing ratio requirements. This points to a need for stronger institutions (SDG 16) to protect labor rights and public safety.

Industry Response and Future Considerations

Corporate Actions and Commitments

• In response to the incidents, CVS Health issued a statement expressing condolences and confirming that counseling and support services are being offered to colleagues.
• The company states it is committed to ensuring appropriate staffing levels and has reduced the number of performance metrics used in recent years.
• To manage an increased workload from acquiring Rite Aid prescription files, CVS reports hiring over 1,500 pharmacy team members in Pennsylvania this year.

Relevant Sustainable Development Goals (SDGs)

The article highlights issues that are directly connected to two primary Sustainable Development Goals:

• SDG 3: Good Health and Well-being

  This goal is central to the article, which focuses on the mental health crisis among pharmacists, evidenced by a high suicide rate, and the subsequent impact on public health and patient safety. The article explicitly discusses the “suicide rate among pharmacists is higher than general population” and mentions that difficult working conditions could lead to an “increased risk of prescription errors,” which is a matter of “public safety.”

• SDG 8: Decent Work and Economic Growth

  This goal is addressed through the article’s detailed examination of the working conditions faced by pharmacists. The text points to systemic issues such as excessive workloads, high stress, and lack of support, which undermine the principle of decent work. The “2024 National Pharmacist Workforce Study” is cited, stating that “73 percent of pharmacists working full-time rated their workload as ‘high’ or ‘excessively high’,” directly linking the health crisis to poor labor conditions.

Specific Targets Identified

Based on the article’s content, the following specific targets under the identified SDGs are relevant:

1. Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

   The article’s core subject is the alarming rate of suicide among pharmacists, which is a form of premature mortality directly linked to mental health. The discussion of depression, stress, burnout, and the provision of “counseling and support services” by employers like CVS directly relates to the promotion of mental health and well-being as a preventative measure.

2. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

   The concern that pharmacist stress and overwork could lead to an “increased risk of prescription errors” directly threatens the “safe” and “quality” aspects of essential health-care services. The article frames this as a “matter of public safety,” emphasizing that the well-being of pharmacists is integral to the safe delivery of medicines to the public.

3. Target 8.8: Protect labour rights and promote safe and secure working environments for all workers…

   The article extensively details the unsafe and insecure working environments for pharmacists. It describes “demanding workloads, increasing administrative burdens,” “unmanageable metrics,” and a “lack of support for the staff.” The fact that “91 percent of pharmacists” in chain stores rated their workload as high or excessively high illustrates a systemic failure to provide a safe working environment, which this target aims to rectify.

Indicators for Measuring Progress

The article mentions or implies several indicators that can be used to measure progress towards the identified targets:

• Indicator 3.4.2: Suicide mortality rate.

  This indicator is explicitly mentioned and quantified in the article. It states that “the suicide rate among pharmacists is almost 20 for every one hundred thousand, compared to 12 for every one hundred thousand in the general population.” This data provides a clear baseline for measuring progress in reducing premature mortality within this profession.

• Implied Indicator for Target 3.8: Rate of medication or prescription errors.

  While the article does not provide a specific number, it strongly implies that this is a key metric for patient safety. Dan Hussar’s complaint notes that “difficult working conditions for pharmacy staff in retail chains could lead to an increased risk of prescription errors.” Tracking the frequency of such errors would be a direct way to measure the impact of pharmacist working conditions on public health and safety.

• Implied Indicator for Target 8.8: Percentage of workers reporting high levels of work-related stress or excessive workload.

  The article provides specific data for this indicator from the “2024 National Pharmacist Workforce Study,” which found that “73 percent of pharmacists working full-time rated their workload as ‘high’ or ‘excessively high’.” This percentage serves as a direct measure of the quality of the working environment and can be tracked over time to assess the effectiveness of interventions like increased staffing and reduced performance metrics.

Summary of Findings

Source: wgal.com