Perspective: The Health Care Jobs Recovery Stagnates for Women in 2021

In January, we published a research brief that examined the drop in health care employment in 2020 due to the COVID-19 pandemic and the impact on women’s health care jobs compared to men’s jobs. While the extent of the health care job loss by itself was unusual (historically, even in recessionary periods, health care employment is typically stable or even continues to grow), the divergence in trends between health care jobs held by women versus men was a significant finding. We observed that by October 2020, only 62% of women’s health care jobs lost had returned, resulting in 530,000 fewer jobs compared to pre-pandemic levels, whereas 79% of men’s jobs had already returned.

At the time of that prior work, it was unclear if the gap in job recovery between women and men in health care would continue, or if it would slowly close as the economic and health care spending recovery progressed this year. In this blog, we update the prior work with Bureau of Labor Statistics data through May 2021 and find that health care job growth for women in 2021 has completely stagnated and actually turned negative, with 27,000 fewer women employed in health care in May 2021 compared to last December. Compared to January 2020, women’s employment in health care is still down 3.6%, or 470,000 jobs, while men’s employment has continued to recover in 2021 and is down only 0.7%, or 24,000 jobs. (Figure 1).

Figure 1: Percentage change in health care jobs since January 2020, by sex

When assessed by health care setting, we see that the loss in women’s health care jobs is primarily driven by job losses among nursing care facilities and home health care, with employment in these settings as of May 2021 lower by 14% and 3.8% respectively when compared to January 2020 (Figure 2). The job loss among nursing home workers is likely driven by lasting effects of the pandemic on the number of individuals receiving care in nursing homes during 2021, a utilization trend that has yet to show signs of abating.

Other major health care settings where women’s employment is below the pre-pandemic levels, although to a much lesser extent, include hospitals, outpatient care centers, and offices of physicians. Employment levels for women in these settings as of May 2021 are somewhere between 1% and 3% lower than in January 2020. The two remaining settings, dental offices and other ambulatory settings, are employing a slightly greater number of women as of May, with each surpassing the number of pre-pandemic jobs by around 1%. The trend in dental offices is particularly surprising, as they were among the hardest hit of all the health care services early in the pandemic and spending on dental care remains 12.3% below pre-pandemic levels.

Figure 2: Changes in women’s employment compared to January 2020, by major health care setting

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Comparing job recovery data by setting, we find that the number of jobs left to be regained to return to pre-pandemic levels is higher for women than for men across every single major health care setting (Figure 3). While some of this is driven by the fact that women are the majority of the health care workforce, it is notable that men’s jobs in health care have almost completely recovered as of May 2021.

For men, health jobs in ambulatory services, physician offices, outpatient care centers, and home health care services have completely returned to pre-pandemic levels. In these same settings, a significant number of women’s jobs are still lagging, including 110,000 jobs in ambulatory settings and 56,000 in home health care. In nursing home settings, a whopping 187,000 women’s health care jobs have yet to be regained to reach pre-pandemic levels, despite only 20,000 of men’s jobs still outstanding. A similar story exists for hospitals, where the gap between May 2021 and pre-pandemic for men’s jobs is only 8,000, while sitting at nearly 90,000 for women.

Figure 3: Number of jobs left to be regained as of May 2021, by sex and sector

When looking at broader macroeconomic trends, we see that the lasting disproportionate impact on women’s jobs is not unique to the health care sector. However, among industry “supersectors,” the largest magnitude difference in the job recovery between the sexes is in Health Care, tied with Trade, Transportation and Utilities (Figure 4). Among the other economic sectors, a greater relative percentage of jobs for women have returned in Education and Professional and Business Services; yet a majority of the other remaining supersectors show a greater impact on women’s jobs.

Figure 4: Difference in percentage of jobs lost for women and men, by supersector 
Negative values indicate women’s job losses are more severe

As a whole, including both men and women, the health care sector still lags over 500,000 jobs behind the employment level seen pre-pandemic. While the pandemic and associated recession has upended many of the health sector treatment norms, disrupted patterns in utilization for both discretionary and non-discretionary care, and potentially permanently impacted spending growth trends in some health care categories, the continued impact on health care employment (and specifically employment among women) remains notable. At a time when many employers across the U.S. are looking to hire more workers, the gap in employment for health care in 2021 is likely due both due to a change in the need for health care jobs, but also a decreased supply of available workers. The extent to which workers come back into the workforce and health care employment levels (particularly for women and in nursing home settings) return to pre-pandemic levels remains to be seen; however, the data through May 2021 show that some net job declines relative to the time before COVID-19 are likely to continue given the pace of current trends.