1. Low-Skilled, Low-Wage Workers in Health Care
Bianca K. Frogner, PhD, Associate Professor, Department of Family Medicine & Director, Center for Health Workforce Studies, University of Washington
Setting the Stage
Selected Findings
Conclusions
Greater need for supply of health care workers as demand for health services increases due to:
Expanding needs for aging population with multiple chronic conditions
Expansion of health insurance (e.g., Medicaid)
Shift towards greater use of primary care
Health care has been and projected to be fastest growing employment sector
In 2013, health care was 12% of total labor force in US
Occupation by Health Care Setting
Jobs with entry requirements with high school degree or less tend to be at higher financial risk
Workers in ambulatory care settings tend to be at higher financial risk compared to workers in hospitals
Not shown: Long-term care workers also tend to be at much higher financial risk than hospital workers
Concern is that health care labor has a weak financial foundation that may result in high turnover and low supply especially as health reform leads to:
Team-based care with greater reliance on lower skilled workers
Task shifting towards low skilled workers to achieve lower costs
Are compensated appropriately for higher skilled tasks?
Reliance on Federal Assistance
Poverty Rates
Background
Among top 20 fastest growing health care occupations over next decade:1
Top two fastest jobs (personal care aides and home health aides) are expected to grow over 70%, which is two to three times as fast as any other occupation
Over 25% of these jobs require less than a high school degree
Long-term care job leavers:2
Half leave unemployed or exit the labor force
Have higher disability and poverty rates than entrants or stayers
Age by Occupation
References
Frogner B and Spetz J. (2013) “Affordable Care Act of 2010: Creating Job Opportunities for Racially and Ethnically Diverse Populations.” Report and presentation prepared for and published by Joint Center for Political and Economic Studies Report
Frogner BK and Spetz J (2015). “Entry and Exit of Workers in Long-Term Care,” UCSF Health Workforce Research Center Report. Available at:
Insurance Status
Study Design
Funding
Other Selected Demographics
Research Question:
In which health care jobs are workers at highest financial risk?
To what extent are workers relying on federal support?
Data and Methods:
Data: Current Population Survey, Annual Social and Economic Supplement (“March Supplement”) [ ]
Annual cross-sectional survey of approximately 100,000 households (200,000 individuals) weighted for national representation
Sample: individuals employed in 10 allied health jobs, years old
Less than Bachelor’s level education entry requirements
Excluded self-employed workers
Health care jobs defined using 2009 Standard Occupation Classification System
Minority
Single
Child under 18
Part-time
All employed
20.1
44.9
43.6
18.8
Less than high school
Personal and home care aides
32.6
60.6
47.2
43.5
Nursing, psychiatric and home health aides
43.7
61.1
50.4
30.9
High school
Pharmacy aides
18.1
64.2
30.2
36.1
Medical assistants
21.8
52.4
52.2
21.0
Post-secondary
Emergency medical technicians and paramedics
8.3
46.5
45.7
10.4
Massage therapiasts
15.3
58.6
42.7
57.6
Dental assistants
17.6
38.5
52.9
34.8
Medical records and health information technicians
45.2
49.8
13.3
Phlebotomists
32.8
44.7
56.1
18.9
Licensed practice and vocational nurses
33.7
45.4
55.9
17.8
This study was supported by the National Center for Health Workforce Analysis (NCHWA), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS) under cooperative agreement # U81HP The information, conclusions and opinions expressed in this presentation are those of the authors and no endorsement by NCHWA, HRSA or HHS is intended or should be inferred.
For more information
Bianca K. Frogner, PhD
Associate Professor, Department of Family Medicine
Director, Center for Health Workforce Studies
University of Washington