In this report, we examine how racial and gender groups are represented in health care and investigate wage disparities within occupations. We use occupational crowding theory and methodology to examine the distribution of workers in health care occupations, taking into account educational level requirements and educational attainment. We also examine wages within health care occupations. Through this analysis and interviews with a handful of experts, we identify a set of strategies that policymakers, higher education institutions, and health care employers can adopt to ensure more equal access to high-paying jobs and address wage disparities while meeting hiring needs for a diverse and well-trained workforce.

Why This Matters

Health care workers are an essential part of the US economy, providing needed services and patient care in their communities. Demand for health care workers is high and is projected to grow. Overall, the sector offers the prospect of quality jobs, but opportunities are not distributed equitably across racial and gender groups. It is important to address these disparities, not only because all workers should have equal access to opportunity and economic well-being, but also because a more diverse health care workforce improves patient outcomes.

What We Found

Key takeaways include the following:

• Asian men, Black women, Black men, Latinx women, Latinx men, and white women are crowded in to lower-paying occupations, while the reverse is dramatically true for white men.
• Wage disparities exist across groups when compared with white men; in particular, for Black and Latinx women.
• Wage disparities are smaller for women of color when compared with white women than they are when compared with white men.

Primary reasons for these disparities likely include employer discrimination in hiring and compensation. Additional contributors could be an oversupply of college graduates and not enough workers with industry-aligned credentials, and a lack of information and support for students and job seekers in making career decisions. To address these problems:

• Employers can address issues with bias in hiring and unequal pay by auditing their practices, training staff, and implementing transparent pay policies.
• Policymakers at all levels can enforce antidiscrimination laws, create policies that support pay equity and transparency, and implement new legislation to respond to emerging challenges.
• States, localities, and community colleges systems can use labor market data to calibrate postsecondary program size and offerings so that higher education is not producing more graduates than the job market can absorb.
• Educational institutions can put in place new structures for career support and guidance that help align college and career decisionmaking with industry demand, identify “high road” employers, and support employer partners in adopting more equitable hiring and compensation practices.

How We Did It

We use Barbara Bergmann’s (1971) occupational crowding theory to examine the educational requirements of health care-related occupations and the educational attainment of eight different racial and gender groups—Asian women, Asian men, Black women, Black men, Latinx women, Latinx men, white women, and white men. We then assess how workers with the required education are distributed across occupations. We also look at average and median wages in occupations that groups are crowded in to and out of to determine the extent to which crowding may impact the economic well-being of health care workers who provide vital services to communities. We also spoke with experts from organizations working to identify challenges in the health care workforce and support the implementation of solutions.