Category Archives: Workforce

The future of work in America: People and places, today and tomorrow

Source: Susan Lund, James Manyika, Liz Hilton Segel, André Dua, Bryan Hancock, Scott Rutherford, and Brent Macon, McKinsey Global Institute, July 2019

From the summary:

…..A new report from the McKinsey Global Institute, The future of work in America: People and places, today and tomorrow, analyzes more than 3,000 US counties and 315 cities and finds they are on sharply different paths. Automation is not happening in a vacuum, and the health of local economies today will affect their ability to adapt and thrive in the face of the changes that lie ahead.

The trends outlined in this report could widen existing disparities between high-growth cities and struggling rural areas, and between high-wage workers and everyone else. But this is not a foregone conclusion. The United States can improve outcomes nationwide by connecting displaced workers with new opportunities, equipping people with the skills they need to succeed, revitalizing distressed areas, and supporting workers in transition. Returning to more inclusive growth will require the combined energy and ingenuity of business leaders, policy makers, educators, and nonprofits across the country…..

Voices from an age of uncertain work – Americans miss stability and a shared sense of purpose in their jobs

Source: David L. Blustein, The Conversation, July 18, 2019

On the surface, the well-being of the American worker seems rosy.
Unemployment in the U.S. hovers near a 50-year low, and employers describe growing shortages of workers in a wide array of fields.

But looking beyond the numbers tells a different story. My new book, “The Importance of Work in an Age of Uncertainty,” reveals that some Americans are experiencing an erosion in the world of work that is hurting their well-being, relationships and hopes for the future.

We can’t simply blame the rise of the gig economy. It’s also a result of a growing impermanence in the U.S. economy, with more short-term jobs that lack security and decent benefits. At the same time, worker wages continue to stagnate, which underscores the breadth of the problem.

Rising Mortality Rates Among Working-Age Americans

Source: Emily Fazio, Regional Financial Review, Vol. 29 no. 9, May 2019
(subscription required)

Mortality in the U.S. is rising. As a result, life expectancy at birth has fallen every year since its peak in 2014. This paper discusses the rise in mortality and the influence of increased rates of suicide and fatal drug overdoses. It also looks at geographic differences in mortality. Third, this paper considers the impact of economic conditions on changes in mortality, suicide rates, and fatal drug overdoses.

State of the Union: Millennial Dilemma

Source: Stanford Center on Poverty and Inequality, May 2019

The annual Poverty and Inequality Report provides a unified analysis that brings together evidence across such issues as poverty, employment, income inequality, health inequality, economic mobility, and educational access to allow for a comprehensive assessment of where the country stands. In this year’s issue, the country’s leading experts provide the latest evidence on how millennials are faring.

Contents include:

Executive Summary
David B. Grusky, Marybeth Mattingly, Charles Varner, and Stephanie Garlow
With each new generation, there’s inevitably much angst and hand-wringing, but never have we worried as much as we worry about millennials. We review the evidence on whether all that worrying is warranted.

Racial and Gender Identities
Sasha Shen Johfre and Aliya Saperstein
The usual stereotypes have it that millennials are embracing a more diverse and unconventional set of racial and gender identities. Are those stereotypes on the mark?

Student Debt
Susan Dynarski
Often tagged the “student debt generation,” millennials took out more student loans, took out larger student loans, and defaulted more frequently. Here’s a step-by-step accounting of how we let this happen.

Employment
Harry J. Holzer
Labor force activity has declined especially rapidly among young workers. The good news: We know how to take on this problem.

Criminal Justice
Bruce Western and Jessica Simes
The imprisonment rate has fallen especially rapidly among black men. Does this much-vaunted trend conceal as much as it reveals?

Education
Florencia Torche and Amy L. Johnson
The payoff to a college degree is as high for millennials as it’s ever been. But it’s partly because millennials who don’t go to college are getting hammered in the labor market.

Income and Earnings
Christine Percheski
When millennials entered the labor market during the Great Recession and its aftermath, there were uniformly gloomy predictions about their fate. Does the evidence bear out such gloomy predictions?

Social Mobility
Michael Hout
Millennials have a mobility problem. And it’s partly because the economy is no longer delivering a steady increase in high-status jobs.

Occupational Segregation
Kim A. Weeden
Are millennial women and men working side by side in the new economy? Or are their occupations just as gender-segregated as ever?

Poverty and the Safety Net
Marybeth Mattingly, Christopher Wimer, Sophie Collyer and Luke Aylward
Millennial poverty rates at age 30 are no higher than those of Gen Xers at the same age. But this stability hides a problem: Millennials are replacing a falloff in earnings with large increases in government assistance programs.

Housing
Darrick Hamilton and Christopher Famighetti
Housing reforms during the civil rights era helped to narrow the white-black homeownership gap. But those gains have now been completely lost … and the racial gap in young-adult homeownership is larger for millennials than for any generation in the past century.

Social Networks
Mario L. Small and Maleah Fekete
Millennials are not replacing face-to-face networks with online ones. Rather, they’re a generation that’s found a way to do it all, forging new online ties while also maintaining the usual face-to-face ones.

Health
Mark Duggan and Jackie Li
It might be thought that, for all their labor market woes, at least millennials now have health care and better health. How does this story fall short?

Policy
Sheldon Danziger
A comprehensive policy agenda that could help millennials … and other generations too.

Work of the Past, Work of the Future

Source: David Autor, NBER Working Paper No. 25588, February 2019
(subscription required)

From the abstract:
Labor markets in U.S. cities today are vastly more educated and skill-intensive than they were five decades ago. Yet, urban non-college workers perform substantially less skilled work than decades earlier. This deskilling reflects the joint effects of automation and international trade, which have eliminated the bulk of non-college production, administrative support, and clerical jobs, yielding a disproportionate polarization of urban labor markets. The unwinding of the urban non-college occupational skill gradient has, I argue, abetted a secular fall in real non-college wages by: (1) shunting non-college workers out of specialized middle-skill occupations into low-wage occupations that require only generic skills; (2) diminishing the set of non-college workers that hold middle-skill jobs in high-wage cities; and (3) attenuating, to a startling degree, the steep urban wage premium for non-college workers that prevailed in earlier decades. Changes in the nature of work—many of which are technological in origin—have been more disruptive and less beneficial for non-college than college workers.

Meeting the Demand for Health: Final Report of the California Future Health Workforce Commission

Source: California Future Health Workforce Commission, February 2019

From the summary:

California’s health system is facing a crisis, with rising costs and millions of Californians struggling to access the care they need. This growing challenge has many causes and will require bold action by the new governor, legislators, and a broad spectrum of stakeholders in the public and private sectors. At the core of this challenge is the simple fact that California does not have enough of the right types of health workers in the right places to meet the needs of its growing, aging, and increasingly diverse population.The California Future Health Workforce Commission has spent nearly two years focused on meeting this challenge, issuing a new report with recommendations for closing California’s growing workforce gaps by 2030…..

…..The Commission’s final report includes a set of 27 detailed recommendations within three key strategies that will be necessary for: (1) increasing opportunities for all Californians to advance in the health professions, (2) aligning and expanding education and training, and (3) strengthening the capacity, retention, and effectiveness of health workers. Throughout its deliberations, the Commission has focused on the need to increase the diversity of the state’s health workforce, enable the workforce to better address health disparities, and incorporate new and emerging technologies.

While advancing all 27 recommendations over the next decade will be important, the Commission has high-lighted 10 priority actions that its members have agreed would be among the most urgent and most impactful first step toward building the health workforce that California needs.

To make these proposals a reality, the Commission also recommended establishing statewide infrastructure, starting in 2019, to implement the recommendations in partnership with stakeholders, to monitor progress, and to make adjustments as needs and resources change. This statewide effort will need to be paired with strong regional partnerships to advance local workforce and education solutions.

The Commission’s 10 priorities for immediate action and implementation are:
1. Expand and scale pipeline programs to recruit and prepare students from underrepresented and low-income backgrounds for health careers….
2. Recruit and support college students, including community college students, from underrepresented regions and backgrounds to pursue health careers….
3. Support scholarships for qualified students who pursue priority health professions and serve in underserved communities….
4. Sustain and expand the Programs in Medical Education (PRIME) program across UC campuses….
5. Expand the number of primary care physician and psychiatry residency positions….
6. Recruit and train students from rural areas and other underresourced communities to practice in community health centers in their home regions….
7. Maximize the role of nurse practitioners as part of the care team to help fill gaps in primary care….
8. Establish and scale a universal home care worker family of jobs with career ladders and associated training….
9. Develop a psychiatric nurse practitioner program that recruits from and trains providers to serve in underserved rural and urban communities….
10. Scale the engagement of community health workers, promotores, and peer providers through certification, training, and reimbursement….

Together, the Commission’s prioritized recommendations will:
● Grow, support, and sustain California’s health work-force pipeline by reaching over 60,000 students and cultivating careers in the health professions.
● Increase the number of health workers by over47,000.
● Improve diversity in the health professions, producing approximately 30,000 workers from under-represented communities.
● Increase the supply of health professionals who come from and train in rural and other underserved communities.
● Train over 14,500 providers (physicians, nurse practitioners, and physician assistants), including over 3,000 underrepresented minority providers.
● Eliminate the shortage of primary care providers and nearly eliminate the shortage of psychiatrists.
● Train more frontline health workers who provide care where people live…..

California’s Behavioral Health Services Workforce Is Inadequate for Older Adults

Source: Janet C. Frank, Kathryn G. Kietzman, and Alina Palimaru, UCLA Center for Health Policy Research, Health Policy Brief, January 2019

The Workforce Education and Training component of California’s Mental Health Services Act, which passed in 2004, has infused funding into the public mental health system. However, funding has not kept pace with an existing behavioral health workforce shortage crisis, the rapid growth of an aging population, and the historical lack of geriatric training in higher education for the helping professions. This policy brief draws on recent study findings, state planning documents, and a review of the literature to describe gaps and deficiencies in the behavioral health workforce that serves older adults in California. The brief offers recommendations to the following specific audiences for improving workforce preparation and distribution: state policymakers and administrators; educational institutions, accrediting bodies, and licensing boards; and county mental health/behavioral health departments and their contracted providers…..

Home Health Care For Children With Medical Complexity: Workforce Gaps, Policy, And Future Directions

Source: Carolyn C. Foster, Rishi K. Agrawal, and Matthew M. Davis, Health Affairs, Vol. 38, No. 6, June 2019

From the abstract:
With the medical and surgical advances of recent decades, a growing proportion of children rely on home-based care for daily health monitoring and care tasks. However, a dearth of available home health care providers with pediatric training to serve children and youth with medical complexity markedly limits the current capacity of home health care to meet the needs of patients and their families. In this article we analyze the workforce gaps, payment models, and policy challenges unique to home health care for children and youth with medical complexity, including legal challenges brought by families because of home nursing shortages. We propose a portfolio of solutions to address the current failures, including payment reform, improved coordination of services and pediatric home health training through partnerships with child-focused health systems, telehealth-enabled opportunities to bridge current workforce gaps, and the better alignment of pediatric care with the needs of adult-focused long-term services and supports.

Care For America’s Elderly And Disabled People Relies On Immigrant Labor

Source: Leah Zallman, Karen E. Finnegan, David U. Himmelstein, Sharon Touw, and Steffie Woolhandler, Health Affairs, Vol. 38, No. 6, June 2019

From the abstract:
As the US wrestles with immigration policy and caring for an aging population, data on immigrants’ role as health care and long-term care workers can inform both debates. Previous studies have examined immigrants’ role as health care and direct care workers (nursing, home health, and personal care aides) but not that of immigrants hired by private households or nonmedical facilities such as senior housing to assist elderly and disabled people or unauthorized immigrants’ role in providing these services. Using nationally representative data, we found that in 2017 immigrants accounted for 18.2 percent of health care workers and 23.5 percent of formal and nonformal long-term care sector workers. More than one-quarter (27.5 percent) of direct care workers and 30.3 percent of nursing home housekeeping and maintenance workers were immigrants. Although legal noncitizen immigrants accounted for 5.2 percent of the US population, they made up 9.0 percent of direct care workers. Naturalized citizens, 6.8 percent of the US population, accounted for 13.9 percent of direct care workers. In light of the current and projected shortage of health care and direct care workers, our finding that immigrants fill a disproportionate share of such jobs suggests that policies curtailing immigration will likely compromise the availability of care for elderly and disabled Americans.

2019 State of the Workforce Report: Pay, Promotions and Retention

Source: Ahu Yildirmaz, Christopher Ryan, Jeff Nezaj, ADP Research Institute, June 2019

All employers face the fundamental challenge of structuring, rewarding and motivating their organization’s workforce for optimal productivity and overall business performance. Unfortunately, there is no magic formula for success that works in all situations. Each employer faces its own unique circumstances — mission, market demand, competitive differentiation, labor availability and cost structure, among other things — that drive continuous change. Existing literature suggests that an organization’s ability to adapt to these changes is fundamental to the organization’s survival.

…. As a comprehensive, up-to-date source of organizational data, the findings in the report provide a solid basis for firms to understand their own organizational dynamics and improve performance.

Key observations from this inaugural study illustrate some of the ways employers can use this data:
– On average, employers will promote 8.9 percent of their employees annually, and those employees will receive an average wage increase of 17.4 percent
– Firms are more likely to promote internal employees for management positions
– Promotions within a team are associated with higher turnover among other team members
– Employee turnover varies significantly with demographic factors
– Males and females show significant disparities across pay and organizational hierarchies