State and Federal Legislators’ Responses on Social Media to the Mental Health and Burnout of Health Care Workers Throughout the COVID-19 Pandemic: Natural Language Processing and Sentiment Analysis

Matthew P. Abrams, Arthur P. Pelullo, Zachary F. Meisel, Raina M. Merchant, Jonathan Purtle, Anish K. Agarwal

Research output: Contribution to journalArticlepeer-review


Background: Burnout and the mental health burden of the COVID-19 pandemic have disproportionately impacted health care workers. The links between state policies, federal regulations, COVID-19 case counts, strains on health care systems, and the mental health of health care workers continue to evolve. The language used by state and federal legislators in public-facing venues such as social media is important, as it impacts public opinion and behavior, and it also reflects current policy-leader opinions and planned legislation. Objective: The objective of this study was to examine legislators’ social media content on Twitter and Facebook throughout the COVID-19 pandemic to thematically characterize policy makers’ attitudes and perspectives related to mental health and burnout in the health care workforce. Methods: Legislators’ social media posts about mental health and burnout in the health care workforce were collected from January 2020 to November 2021 using Quorum, a digital database of policy-related documents. The total number of relevant social media posts per state legislator per calendar month was calculated and compared with COVID-19 case volume. Differences between themes expressed in Democratic and Republican posts were estimated using the Pearson chi-square test. Words within social media posts most associated with each political party were determined. Machine-learning was used to evaluate naturally occurring themes in the burnout- and mental health–related social media posts. Results: A total of 4165 social media posts (1400 tweets and 2765 Facebook posts) were generated by 2047 unique state and federal legislators and 38 government entities. The majority of posts (n=2319, 55.68%) were generated by Democrats, followed by Republicans (n=1600, 40.34%). Among both parties, the volume of burnout-related posts was greatest during the initial COVID-19 surge. However, there was significant variation in the themes expressed by the 2 major political parties. Themes most correlated with Democratic posts were (1) frontline care and burnout, (2) vaccines, (3) COVID-19 outbreaks, and (4) mental health services. Themes most correlated with Republican social media posts were (1) legislation, (2) call for local action, (3) government support, and (4) health care worker testing and mental health. Conclusions: State and federal legislators use social media to share opinions and thoughts on key topics, including burnout and mental health strain among health care workers. Variations in the volume of posts indicated that a focus on burnout and the mental health of the health care workforce existed early in the pandemic but has waned. Significant differences emerged in the content posted by the 2 major US political parties, underscoring how each prioritized different aspects of the crisis.

Original languageEnglish (US)
Article numbere38676
JournalJMIR Infodemiology
StatePublished - 2023


  • COVID-19
  • Twitter
  • burnout
  • content analysis
  • health care workforce
  • healthcare worker
  • healthcare workforce
  • infodemiology
  • legislator
  • mental health
  • mental well-being
  • policy
  • policy maker
  • psychological distress
  • social media
  • thematic analysis
  • wellness

ASJC Scopus subject areas

  • Health Information Management
  • Health Policy
  • Health Informatics
  • Computer Science Applications


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