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COVID-19 and the Health Workforce

COVID Q&A with Professor McHenry

Millions of workers provide services in the healthcare industry. We spoke with William & Mary labor economist Peter McHenry, Tang Distinguished Term Associate Professor of Economics and Public Policy, to hear about how the COVID-19 pandemic is affecting the health workforce. While the pandemic increases the demand for some healthcare workers, others have experienced unemployment and dramatic reductions in work hours like workers in other sectors such as retail and restaurants.

Q.  Tell me a little about the health workforce.

A.  It’s a very diverse group of workers. Some like surgeons have lots of education and very high earnings. Others like nurse aides and medical technicians earn very low wages. Almost 90 percent of registered nurses are women. But then pharmacist has been called the most egalitarian occupation (by economists Claudia Goldin and Larry Katz). Healthcare workers deliver services that yield benefits to everyone in the society.

Q.  So COVID means the health workforce is in high demand, right?

A.  Some healthcare workers have been working very hard under very difficult conditions. But the COVID recession has taken job opportunities away from a lot of healthcare workers. One of the most conspicuous places is the dentist’s office. They all shut down for weeks. My regular cleaning appointment got pushed far into the future. Dentists are working again now, but in April they lost a lot of business in a similar way to restaurants and hair salons. Elective surgeries and check-ups have been postponed, and many healthcare workers have been furloughed and laid-off. Hopefully much of that is temporary, but it’s had real consequences for a lot of families.

Q.  So even work in healthcare isn’t pandemic-proof. How do you measure that?

A.  There are a variety of ways, but one of the best is to go to the Current Population Survey, which the U.S. Bureau of Labor Statistics and Census Bureau facilitate jointly. Each month on Jobs Friday we learn the official unemployment rate, which is calculated with the CPS. But the survey includes a lot – a lot – of other great information, and we can use all that to learn specific things about the health workforce. A great institution called IPUMS based at the University of Minnesota puts the CPS in a pretty user-friendly format.

I recently looked into the monthly CPS surveys for January through April 2020. I focused on people with healthcare occupations (for example, audiologists, dental assistants, paramedics, registered nurses). In January and February, 94 percent of them were at work, but by April only 83 percent of them were at work. About 7.5 percent had been laid off and another 7 percent were absent from work for some other reason. Almost all of those were COVID-related.

Those averages hide a lot of variety, though. Only half of the dentists and 14 percent of dental hygienists in the sample were at work in April. I found work reductions among surgical technicians, medical records specialists, opticians, physical therapists and their aides, and some nursing occupations like nursing assistants. I didn’t see any reduction in work among emergency medical technicians, though. Some registered nurses clearly experienced reduced hours, but those weren’t as widespread as among other occupations.

Q.  What could be the next steps for an analysis of COVID and the health workforce?

A.  The full CPS for May will be available soon, so we’ll be able to see whether trends continued. The May Jobs Friday report showed that employment rose since April. We’re still deep in a hole employment-wise, but it seems that the expected recovery started a bit earlier than we anticipated. Did that happen for the health workforce in the same way? We can get past the headline numbers to dig into the survey and figure that out.

Another great feature of the CPS is that it includes a lot of information about each respondent to the survey. We know each respondent’s age, sex, race, ethnicity, marital status, presence of kids at home, education level, and plenty of other traits. So we could measure how employment trends influenced people in different groups. We could also look at earnings as well as employment status. The CPS includes geographic information, so we could look separately at employment in rural and urban areas, or across regions. We could calculate the correlation between COVID cases and employment, or between state distancing policies and employment.

 Additional resources:

Current Population Survey Data for Social, Economic and Health Research

Center for Health Workforce Studies

IPUMS CPS: Sarah Flood, Miriam King, Renae Rodgers, Steven Ruggles and J. Robert Warren. Integrated Public Use Microdata Series, Current Population Survey: Version 7.0 [dataset]. Minneapolis, MN: IPUMS, 2020.  

Unequal Employment Impacts of COVID-19

U.S. Bureau of Labor Statistics