Nurses Physicians Dentists and Other Health Care Practitioners - Increase In Health Care Employment

In 2002 almost thirteen million persons worked in the health care services, about three times the number employed in health services in 1970, when 4.2 million worked in the health field. (See Table 2.8.) Workers in health care professions accounted for 8.8% of all employed Americans (excluding military personnel). In 1970 only 5.5% of employed civilians worked in health care services.

Since 1970, the proportion of health care workers employed in hospitals has dropped dramatically. More than six in ten (63.4%) of health services personnel worked in hospitals in 1970. By 1990 that number had dropped to 49.6% employed in hospitals, and by 2002 that number fell again, to 42.2%. While hospitals still employ a larger proportion of health workers than any other service locations, more patients are now able to receive treatment in physicians' offices, clinics, and other outpatient settings. In addition, insurers are less willing to pay for lengthy hospitalizations than they were in the past.

Why Is Health Care Booming?

Three major factors appear to have influenced the escalation in health care employment: advances in technology, the increasing amounts of money spent on health care, and the aging of the U.S. population. In other sectors of the economy, technology often replaces humans in the labor force. But health care technology has increased the demand for highly trained specialists to operate the sophisticated equipment. Because of technological advances, patients are likely to undergo more tests and diagnostic procedures, take more drugs, see more specialists, and be subjected to more aggressive treatments than ever before.

The second factor in the increase in health care employment involves the amount of money the nation spends on keeping its citizens in good health. Americans spent more than $1.6 trillion on health care in 2004 and the Centers for Medicare & Medicaid Services project that national health expenditures will reach $3.4 trillion in 2013. For each year that the amount of money spent on health care continues to grow, employment in the field grows as well. Some health care industry observers believe

TABLE 2.8

Persons employed in health service sites, selected years 1970–2002
[Data are based on household interviews of a sample of the civilian noninstitutionalized population]
Site	1970	1980	1990	19951	1997	1998	1999	20002	2001	2002
1Data for years prior to 1995 are not strictly comparable with data from 1995 onwards due to a redesign of the Current Population Survey.
2Starting in 2000, 2000-based population estimates are used as survey controls.
3Data for 1980 are from the American Chiropractic Association; data for all other years are from the U.S. Bureau of Labor Statistics.
Notes: Employment is full- or part-time work. Totals exclude persons in health-related occupations who are working in nonhealth industries, as classified by the U.S. Bureau of the Census, such as pharmacists employed in drugstores, school nurses, and nurses working in private households. Totals include Federal, State, and county health workers. In 1970–82, employed persons were classified according to the industry groups used in the 1970 Census of Population. In 1983–91, persons were classified according to the system used in the 1980 Census of Population. Beginning in 1992 persons were classified according to the system used in the 1990 Census of Population.
SOURCE: "Table 98. Persons Employed in Health Service Sites: United States, Selected Years 1970–2002," in Health, United States, 2003, National Center for Health Statistics, 2003, http://www.cdc.gov/nchs/data/hus/tables/2003/03hus098.pdf (accessed June 2, 2004)
	Number of persons in thousands
All employed civilians	76,805	99,303	117,914	124,900	129,558	131,463	133,488	136,891	136,933	136,485
All health service sites	4,246	7,339	9,447	10,928	11,525	11,504	11,646	11,742	12,110	12,653
Offices and clinics of physicians	477	777	1,098	1,512	1,559	1,581	1,624	1,697	1,799	1,907
Offices and clinics of dentists	222	415	580	644	662	666	694	676	699	740
Offices and clinics of chiropractors3	19	40	90	99	118	127	142	124	117	138
Hospitals	2,690	4,036	4,690	4,961	5,130	5,116	5,117	5,092	5,270	5,340
Nursing and personal care facilities	509	1,199	1,543	1,718	1,755	1,801	1,786	1,737	1,771	1,942
Other health service sites	300	872	1,446	1,995	2,301	2,213	2,283	2,414	2,454	2,585
	Percent of employed civilians
All health service sites	5.5	7.4	8.0	8.7	8.9	8.8	8.7	8.6	8.8	9.3
	Percent distribution
All health service sites	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Offices and clinics of physicians	11.2	10.6	11.6	13.8	13.5	13.7	13.9	14.5	14.9	15.1
Offices and clinicsof dentists	5.2	5.7	6.1	5.9	5.7	5.8	6.0	5.8	5.8	5.8
Offices and clinics of chiropractors3	0.4	0.5	1.0	0.9	1.0	1.1	1.2	1.1	1.0	1.1
Hospitals	63.4	55.0	49.6	45.4	44.5	44.5	43.9	43.4	43.5	42.2
Nursing and personal care facilities	12.0	16.3	16.3	15.7	15.2	15.7	15.3	14.8	14.6	15.3
Other health service sites	7.8	11.9	15.3	18.3	20.0	19.2	19.6	20.6	20.3	20.4

that government and private financing for the health care industry, unlike most other fields, is virtually unlimited.

The third factor contributing to the rise in the number of health care workers is the aging of the nation's population. There are greater numbers of older adults in the United States than ever before, and they are living longer. According to the U.S. Bureau of the Census estimates, in 2005, 4.9 million Americans will be age eighty-five or older; and by 2030, 18.2 million people will be over the age of eighty-five.

The increase in the number of older people is expected to boost the demand for home health care services, assisted living, and nursing home care. Many nursing homes now offer special care for stroke patients, persons with Alzheimer's disease (progressive cognitive impairment), and persons who need a respirator to breathe. To care for such patients, nursing homes need more physical therapists, nurses' aides, and respiratory therapists—three of the fastest-growing occupations. The U.S. Bureau of Labor Statistics estimated that from 1996 to 2006 the number of physical therapists would increase 70.8%, to 196,000, and the number of respiratory therapists would grow 45.8%, to 119,000.