Impacts of Greater Use of Low Skilled, Low-wage Workers in Health Care Delivery


Objective: This study investigated the socioeconomic well-being of healthcare workers.
Data/Setting: We analyzed 2015 data from an ongoing monthly household survey called the Annual Social and Economic Supplement of the Current Population Survey (CPS). We restricted our analysis to employed respondents age 18 to 75 and used survey weights to generalize the results to the civilian non-institutionalized U.S. adult population.
Design/Methods: Using the BLS Occupational Outlook Handbook, we assigned individuals into one of five categories based on the minimum education requirement of the occupation in which they were employed at the time of the survey: 1) high school degree or equivalent or below; 2) post-secondary non-degree award, 3) associate degree, 4) bachelor’s degree, and 5) above bachelor’s degree.  Across these education categories and by healthcare setting, we compared socioeconomic well-being measures of these individuals, which include whether their hourly wage was under $15 per hour, whether they were at or below the poverty level, whether they lacked health insurance, and whether they relied on state/federal social assistance programs. We used unpaired two-sample t-tests to compare mean values between education requirement categories.
Results:  Almost two-thirds of healthcare occupations in this study required less than a bachelor’s degree for entry, consistent with statistics that the majority of healthcare occupations are low- to middle-skilled. Those working in occupations requiring a high school degree or below was the category with the highest percentage of people of color. There is a potential mismatch between skill and occupation; for example, over half of the individuals working in occupations requiring a high school degree or less attained more than a high school level of education. Despite working in healthcare settings, individuals across all education categories lacked health insurance ranging from 3.8% among those working in jobs requiring a bachelor’s degree to 15.6% among those working in jobs requiring a high school degree or below. Uninsured rates were significantly higher among part-time workers in ambulatory and long-term care settings. Among those in occupations requiring a high school degree or below, 26.3% relied on the Earned Income Tax Credit, 18.2% relied on Medicaid, and 18.7% relied on the Supplemental Nutrition Assistance Program. Long-term care settings have the highest proportion of individuals working in occupations requiring a high school degree or less, and 80% of these individuals relied on one or more social assistance programs.
Conclusions: Workforce planners and policymakers who advocate for healthcare as a promising industry with growing entry level job opportunities need to ensure that those entering these occupations have a viable career path. Employers wanting to reduce turnover for their workers in low-skilled occupations should find ways to address financial risks and worker’s reliance on state/federal assistance programs.
This study resulted in a full report and a 2-page policy brief that can be found in the publications section of our website.
Lead Researcher: Bianca K. Frogner, PhD
Contact Info:



HRSA: HWRC Allied Health






Authors Title Type Date Documents/Media
Frogner BK, Skillman SM, Patterson DG, Snyder CR Comparing the Socioeconomic Well-Being of Workers across Healthcare Occupations PUBLICATION 12-01-2016
Full Report
Policy Brief
Frogner BK Low Skilled, Low Wage Workers in Health Care PRESENTATION 06-26-2016 PowerPoint
Frogner BK Who is Entering/Exiting Health Care, and Why Do We Care? PRESENTATION 04-14-2016 PowerPoint
Frogner BK Financial Status of Low Skilled, Low Wage Workers in Health Care PRESENTATION 06-14-2016 PowerPoint
Frogner BK Low Skilled, Low Wage Workers in Health Care PRESENTATION 04-05-2016 PowerPoint
Frogner BK, Coe N Low Wage, Low-Skilled Workers in Health Care PRESENTATION 11-05-2015
Frogner BK, Stover B, Skillman SM Web Meeting: Low-Wage, Low-Skilled Health Care Workers PRESENTATION 11-16-2015