Part of the Solution: Pre-Baccalaureate Healthcare Workers in a Time of Health System Change

Source: Martha Ross, Nicole Prchal Svajlenka and Jane R. Williams, Brookings Institution, July 2014

From the summary:
Healthcare occupations account for a large and growing share of the workforce and span the education and earnings continuum. Although many discussions of the healthcare workforce focus on doctors and other occupations requiring advanced degrees, the healthcare system would not function without pre-baccalaureate workers—those with less than a bachelor’s degree. These workers perform a variety of clinical, assistive, and administrative tasks, and like all healthcare staff, should be working at their full level of competence in order to achieve the “triple aim” of improving the experience of care, improving health outcomes, and reducing per capita costs.

While individuals with less than a bachelor’s degree work in multiple healthcare occupations, they are overwhelmingly concentrated in a subset of occupations. This report identifies the 10 largest “pre-baccalaureate” healthcare occupations, those in which substantial shares of workers—ranging from 39 percent to 94 percent—have less than a bachelor’s degree, and focuses on those workers in the 10 occupations, unless otherwise noted. Using labor market and American Community Survey data from 2000 and 2009-2011, our analysis across the nation’s 100 largest metropolitan areas finds that:
∙ Workers with less than a bachelor’s degree in the 10 largest pre-baccalaureate healthcare occupations total 3.8 million, accounting for nearly half (49 percent) of the total healthcare workforce in the nation’s 100 largest metropolitan areas. …
∙ Educational attainment varies considerably among workers in pre-baccalaureate healthcare occupations, and earnings largely track education. …
∙ Pre-baccalaureate healthcare workers in the 10 largest pre-baccalaureate healthcare occupations are racially and ethnically diverse and overwhelmingly female. …
∙ The number of jobs held by pre-baccalaureate workers in the 10 largest pre-baccalaureate healthcare occupations increased at a faster rate than jobs held by similarly educated workers overall, but the largest growth was among lower-paying pre-baccalaureate healthcare occupations, and only registered nurses experienced real earnings growth between 2000 and 2009-11. …
∙ The size and nature of the pre-baccalaureate healthcare workforce varies by region, reflecting demographics and healthcare industry mix. …∙