Health Care Jobs in a Pandemic: Indispensable or in Trouble?

by Henry Fields

March 8, 2021

Early in 2020, many people were puzzled to see health care employment decline during a global health crisis. Like any number of other puzzling experiences we’ve had, it seemed to undermine the one point of certainty – if health care jobs are exposed during a health crisis, what isn’t? 

The truth is that health care (and related social assistance) is a broad sector with components that have fared differently in the past year. Although health care has been more exposed overall than some might expect, some of the impacts have also been relatively temporary.

The most recent estimates put Lane County health care jobs 7% below the same time the year before. Looking at the components of the sector tells us more about where the pain is felt most acutely.

For the private health care and social assistance industry in Lane County, I looked at employment since January in three major sectors: ambulatory health care (primarily outpatient services and doctors’ offices); nursing and residential care facilities; and social assistance (which includes services to the elderly and people with disabilities, addiction counseling, and day care services, among other things).
Ambulatory health care services, which include many medical visits that can be postponed, saw the largest immediate impact of the pandemic, shedding 20% of jobs through April. This makes sense: perhaps in your own life you put off a non-essential procedure or your annual dentist visit early on in the year. In the time since, the sector made a strong recovery and is now down only 3% from the beginning of the year.

Nursing and residential care facilities saw a slow decline in employment over the year, and in September had around 6% fewer jobs. Just as in medical care, customers may be delaying decisions that seem too risky to make right now, and it may take a bit longer to reverse that pain in the case of staffing a long-term care facility. There are signs in recent months that the sector is making progress. In statewide estimates, nursing and residential care facilities had 2.6% more jobs in December 2020 than in December 2019.

Social assistance has shed more employment than the sector average and is down about 12% through September. Here too there is probably meaningful variation – child day cares, job counseling programs, and addiction treatment programs are each under different pressures and subject to different regulations – but the sector as a whole suffered early in the year and only made partial progress back through the fall. Social assistance employers are feeling their clients’ uncertainty of what the future holds. In some cases those customers may make a totally different decision than they would have otherwise – for example, staying home with children rather than putting them in day care to brave an uncertain job market.

Another major element of health care employment is at hospitals. Private hospital employment is confidential in Lane County, but at the state level hospitals were not impacted as much as other parts of health care. Relative to January, Oregon employment at private hospitals was down 2% in September. The deepest impact was in May, when employment dipped 3% compared with January.

The questions moving forward are of concern to all of us. How quickly can these services resume their previous levels? Will the sector take new approaches that require fewer workers, or more? Which of these impacts will be permanent?

It seems that in outpatient settings providers made it through an initial period of adjustment that caused temporary disruption, but with time to adjust their procedures and safety protocols were able to reverse much of the damage. It’s a little early to say, but possible that nursing homes and social assistance providers may permanently change how they provide services, with possible employment impacts.

Much of the pain is temporary, but health care jobs haven’t recovered yet. Widespread vaccine distribution is the first step on the path to normalcy for the sector, but no one can say for certain that health care will look the same as it did pre-COVID five years from now.


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