The unfortunate truth about most health care jobs

For Americans seeking career advice, experts often point to health care as an occupation ripe with opportunities. If only the pay were better.

Employment data do, in fact, show the health care industry to be the fastest growing sector in the U.S. A recent analysis by the National Employment Law Project estimates that the number of jobs, mostly tied to hospitals, will rise 21 percent in the decade ending 2024. That contrasts with a projected 7 percent decline in manufacturing.

About 1.4 million manufacturing jobs evaporated during a 16-year period, while health care added 1.3 million, according to the analysis, which focused on 11 industrial states. By 2016, health care had a net 780,000 more workers versus manufacturing in the region, concluded NELP, a labor rights advocacy group. The figures are based on U.S. Labor Department data from its quarterly census of employment and wages.

"There's been a lot of focus on the industrial Midwest in general because there is so much anxiety," said Rajesh Nayak, NELP's director of research and author of the analysis, in an interview. "Contrast that with the growing health care industry, and you start to see opportunities for folks."

Yet for every higher-paying job held by workers like nurses and doctors, more than six workers such as orderlies, phlebotomists and cooks make less than $15 an hour. Nationwide, 70 percent of hospital service workers make less than $15 an hour, NELP found. In the Midwest, it's 71 percent.

The NELP study defined Midwest industrial states as Minnesota, Indiana, Missouri, Illinois, Wisconsin, Michigan, Indiana, Ohio, Kentucky, West Virginia and Pennsylvania.

By contrast, unionized hospital workers in Seattle, New York and Oakland had wages higher than $15. Higher wages can help with quality of care, the group said, citing collective bargaining agreement data.

"We can take some of the lessons from factories -- folks had decent labor standards. They had a collective bargaining agreement, or just more of a voice in general," Nayak said. By raising wages, "You start to get to a place where people can pay for a family that looks like the kind of wages that folks were getting in the factory jobs."

It's not just hospitals that pay lower hourly wages, a study released this week by the Center for Economic Policy and Research shows hourly wages in outpatient centers either fell or stayed stagnant in the decade ending in 2015. Median hourly wages after inflation is factored in rose 75 cents over the decade, from $23.79 to $24.54, the think tank found. That amounts to a rise of only 3.2 percent over 10 years. 

"A hospital's workforce is its most vital asset," said Marie Watteau, vice president of media relations with the American Hospital Association, in an e-mailed statement. "From the clinicians to environmental services professionals, all play a role in ensuring that patients receive high quality care."

The top three fastest-growing health care occupations from 2014 to 2024 are personal care aides, registered nurses and home health aides, according to projections from the Bureau of Labor Statistics. Health care will drive all five of the five fastest growing industries, the NELP analysis found.

In 2015, spending tied to health care made up 17.8 percent of U.S. gross domestic product, a figure that is projected to rise to 19.9 percent by 2025, according to the Centers for Medicare and Medicaid Services.

Women made up 68 percent of hospital workers in Midwest industrial metro areas, while 49 percent were non-white, the NELP analysis found.

On Monday, thousands workers rallied in Chicago, including hospital support workers, focusing on issues including raising the minimum wage to $15 an hour by 2022 from the current $8.25. Illinois Gov. Bruce Rauner vetoed such an increase last month, contending the cost may be too high for some employers.  

Even as some cities like Seattle require higher wages, some states, like Missouri, are rolling them back as employers generally complain they can't afford to pay. Conflicting studies earlier this year differed on how well Seattle's shift to a higher minimum wage affected the city's economy.

Most counties in the U.S. have a cost of living across industries that isn't covered by minimum wage incomes, according to a recent blog post from Amy Glasmeier, a professor and co-chair at the Massachusetts Institute of Technology's economic geography and regional planning Ph. D program. 

For instance, in Chicago, a single parent of one child needs to earn $24.67 an hour to meet a definition of living wage, while a person living alone there needs at least $12.33, based on a living-wage calculator  developed by Glasmeier in conjunction with MIT.