For years, the US has been talking about The Great Teacher Resignation. “The education crisis was very much here way before Covid,” says Anna Sutter, former teacher and director of school counselling in an opinion video by Agnes Walton and Nic Pollock, published by the New York Times. “I was spinning 100 plates, and I only had the capacity to spin 25 plates.” OECD data shows that even in 2016 – years before the Covid pandemic hit – sizable proportions of teaching staff were quitting their jobs. Germany, on the other hand, still considers itself shielded from the phenomenon. German teachers are well paid, right? Most of them are in tenured positions, civil servants even. What’s not to love?

Yet, just like other countries the world over, Germany is facing shortages of teaching staff. Some federal states have come up with a solution: Part-time options – frequently chosen by teachers to reduce the mental load and physical burden that comes with the profession – have been restricted. This will cost us dearly, because teacher burnout is related to physical illness, as a metastudy by Daniel J. Madigan, Lisa E. Kim, Hanna L. Glandorf and Owen Kavanagh of York St John University and the University of York, UK, shows.

Teacher burnout affects countries across the world

Burnout is a condition which develops when a person experiences chronic work-related stress. They will feel emotionally exhausted, they might become cynical as a response, and the passion which they once felt for teaching may wane. They feel less competent than they used to do. As a result, they get the impression that they get less work done.

To investigate how burnout is related to physical illness in teachers, Madigan and his colleagues reviewed 21 studies involving a total of more than 5,000 teachers. Teachers in the studies came from Brazil, Canada, China, Germany, Luxemburg, Poland, South Africa, Slovakia, Spain, Ukraine and the USA. Almost 60 percent of them were female. On average, they were 43.3 years old and had been teaching for 14.4 years. In some of the studies, burnout was treated as a categorical variable, which means that teachers were sorted into two groups according to whether they were experiencing a high or low level of burnout symptoms. In others, burnout was represented as a continuum. To measure burnout symptoms, most of the studies used the Maslach Burnout Inventory, which covers three dimensions:

  • Emotional exhaustion (feelings of emotional overextension caused by the workplace)
  • Depersonalization (an impersonal and seemingly unfeeling response to one’s profession and students)
  • Personal accomplishment (feelings of competence and achievement).

Burnout is associated with a variety of physical health conditions

As is the case for other professions, teacher burnout is related to myriad physical health conditions. Teachers with a high level of burnout symptoms suffer from headaches in general, and migraines in particular. They experience back pain, skin rash, and disorders of the digestive system, which may be as specific as gastroenteritis, an inflammation of the stomach and/or intestine. One of the more teacher-specific physical health problems concerns their voice. Some teachers may, for instance, experience a complete loss of voice. Teachers have also been shown to suffer from temporomandibular joint dysfunction, a condition which affects the muscles that move the jaw, and which can cause difficulties in speaking and eating, pain, tinnitus and dizziness.

Cardiovascular disorders, which concern the heart and blood vessels, have also been shown to be related to teacher burnout. Amongst the heart function indices used in the studies which were reviewed, burnout was positively associated with sympathetic activity. The sympathetic nervous system is responsible for increasing heart rate when responding to stressful situations. A positive association therefore means that teachers with burnout symptoms were displaying increased heart rates. On the other hand, burnout was negatively related with parasympathetic activity, which is responsible for controlling heart rate during times of rest. A negative association means that rest and recovery do not work well in teachers with burnout symptoms.

Physical health conditions in teachers with strong burnout symptoms
Physical health conditions in teachers with strong burnout symptoms

Teacher burnout affects their cortisol levels. Cortisol is a hormone which, in healthy people, regulates a person’s response to stress, their blood pressure, blood sugar and metabolism, which is the process that converts food into energy. Chronic stress has a two-fold impact on cortisol levels. Initially, cortisol levels will be raised as the body is struggling to regulate its responses. The longer this is required though, the less cortisol the body will produce, and cortisol levels will fall below what is the norm in healthy people. It is therefore unsurprising that teacher burnout was found to be associated with both above- and below-the-norm cortisol levels.

Burnout also affects cytokines. Cytokines are proteins which may be viewed as messengers between cells of the immune system. They are responsible for the body’s response to infection, inflammation and cancer. Teachers with a high level of burnout symptoms displayed lower anti-inflammatory responses and higher pro-inflammatory responses. In other words, their body fights disease less well and even contributes to the development of new inflammatory diseases.

Pathways to physical illness: Immune system, stress response, unhealthy behaviour

The researchers suggest three different pathways which might lead to the association between teacher burnout and physical health problems. As has been shown above, stress can lead to a person’s immune system being compromised. In addition, chronic stress may cause the body to become less effective in responding to stress in adequate ways. Last but not least, chronic stress may lead a person to engage in unhealthy behaviour more that they would normally do. For instance, they may smoke more and drink more alcohol, which, in turn, causes health problems.

Unsurprisingly, burnout and its associated physical health problems affect teachers’ personal lives in a variety of ways. They will influence their mood, general life satisfaction and mental health, creating long-term physical and mental health conditions. Interpersonal consequences include conflict, irritability and a reduced capacity for communication. The latter in particular will impact the quality of teaching and the wellbeing of students.

Ignoring teacher burnout will cost us dearly

The researchers emphasize that there is a need for more awareness of the consequences of teacher burnout. As burnout interventions, they cite mindfulness, cognitive-behavioural, social and emotional learning-based programmes. They do, however, add, that changes will have to take place at the organizational level as well: “[G]iven the potential cost of burnout for physical health and associated problems, it is likely intervention benefits will be significant, and possibly exceed outlay costs.”

Nevertheless, few countries seem to seriously consider this approach. “We rely on teachers to not give a *** about themselves,” says Anna Sutter. “We rely on teachers to not care about themselves. We rely on teachers to not know their worth and to not know what they deserve.” This ignorance will cost us dearly.

Madigan, D. J., L. E. Kim, H. L. Glandorf & O. Kavanagh (2023). Teacher burnout and physical health: A systematic review. International Journal of Educational Research, 119, 102173.