Introduction: Pediatric nursing has been a profession dominated by women, but patients benefit from representation of both men and women. We describe characteristics associated with male pediatric nurses and consider potential pathways to greater male pediatric nurse workforce participation. Method: We used data from the 2018 National Sample Survey of Registered Nurses, a nationally representative survey of nurses that estimates characteristics of the workforce. We present summary statistics to describe demographic, work setting and work environment characteristics of male and pediatric nurse workforces. Analyses accounted for complex survey design and weighting. Results: Only 7% (N = 108,752) of the pediatric registered nurse workforce and 3% (N = 779) of the pediatric nurse practitioner workforces were male. Notable demographic and educational difference exist among compared workforces. Discussion: Males are significantly underrepresented in pediatric nursing. Much effort and intention need to be directed towards increasing male representation in pediatric nursing.

The All of Us Research Program's Data and Research Center (DRC) was established to help acquire, curate, and provide access to one of the world's largest and most diverse datasets for precision med...

In June 2022, the United States (US) Supreme Court overturned both Planned Parenthood v. Casey (1992) and Roe v. Wade, the monumental 1973 case that granted the constitutional right to abortion, wi...

Women perform 77% of healthcare jobs in the US, but gender inequity within the healthcare sector harms women’s compensation and advancement in healthcare jobs. Using data from 2003 to 2021 of the Annual Social and Economic Supplement of the Current Population Survey (CPS), we measure women’s representation and the gender wage gap in healthcare jobs by education level and occupational category. We find descriptively that women’s representation in healthcare occupations has increased over time in occupations that require a master’s or doctoral/professional degree (e.g., physicians, therapists), while men’s representation has increased slightly in nursing occupations (e.g., registered nurses, LPNs/LVNs, aides and assistants). The adjusted wage gap between women and men is the largest among workers in high-education healthcare (e.g., physicians, advanced practitioners) but has decreased substantially over the last 20 years, while descriptively the gender wage gap has stagnated or grown larger in some lower education occupations. Our policy recommendations include gender equity reviews within healthcare organizations, prioritizing women managers, and realigning Medicare and Medicaid reimbursement policies to promote greater gender equity within and across healthcare occupations.

Purpose: Access to paid sick leave is critically important to promoting good health, caregiving, and stopping the spread of disease. In this study, we estimate whether access to paid sick leave among US full-time workers differs between rural and urban residents. Methods: We used data from the 2020 National Health Interview Survey and included adult respondents between the ages of 18 and 64 who were employed full-time (n = 12,086). We estimated bivariate differences in access to paid sick leave by rural/urban residence, and then calculated the predicted probability of access to paid sick leave, adjusting for sociodemographic and health characteristics, across different education levels. Findings: We find a nearly 10-percentage point difference in access to paid sick leave between rural and urban adults (68.1% vs 77.1%, P<.001). The difference in access to paid sick leave between rural and urban residents remained significant even after adjusting for sociodemographic and health characteristics. The fully adjusted predicted probability of paid sick leave for rural full-time workers was 69.8%, compared with 76.4% for urban full-time workers (P<.001). We also identified lower levels of paid leave for rural (vs urban) workers within each educational category. Conclusions: Full-time workers in rural areas have less access to paid sick leave than full-time workers in urban areas. Without access to paid sick leave, rural and urban residents may go to work while contagious or forego necessary health care. Left to individual employers or localities, rural inequities in access to paid sick leave will likely persist. K E Y W O R D S chronic conditions, COVID-19, employment, paid sick leave This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Objectives. The goal of this study was to measure unionization in the direct care workforce and the relationship between unionization and earnings, looking closely at differences across race/ethnicity and gender. Methods. Using data from the Current Population Survey from 2010 to 2020, we first used logit analyses to predict the probability of unionization among direct care workers across race/ethnicity and gender. We then measured the relationship between unionization and weekly earnings. Results. We found that male (12%) and Black (14%) direct care workers were most likely to be unionized, followed by Hispanic and other direct care workers of color. Unionized direct care workers earn wages that are about 7.8% higher than nonunionized workers, but unionized workers of color earn lower rewards for unionization compared with White direct care workers. Conclusions. Unions are a mechanism for improving job quality in direct care work, and protecting workers' rights to unionize and participate in collective bargaining equitably may be a way to stabilize and grow the direct care workforce. (Am J Public Health. 2022;112(11):1676-1684. https://doi.org/10.2105/AJPH.2022.307022).

The objective of this study was to describe how structural racism and sexism shape the employment trajectories of Black women in the US health care system. Using data from the American Community Survey, we found that Black women are more overrepresented than any other demographic group in health care and are heavily concentrated in some of its lowest-wage and most hazardous jobs. More than one in five Black women in the labor force (23 percent) are employed in the health care sector, and among this group, Black women have the highest probability of working in the long-term-care sector (37 percent) and in licensed practical nurse or aide occupations (42 percent). Our findings link Black women's position in the labor force to the historical legacies of sexism and racism, dating back to the division of care work in slavery and domestic service. Our policy recommendations include raising wages across the low-wage end of the sector, providing accessible career ladders to allow workers in low-wage health care to advance, and addressing racism in the pipeline of health care professions. T he COVID-19 pandemic has brought heightened attention to racial disparities in health outcomes as infections, hospitalizations, and deaths have had a disproportionate impact on Black populations, Indigenous populations , and populations of people of color. 1 In this article we focus on an aspect of racism and health that has gotten somewhat less attention: the role of racism in the stratification of the health care workforce. Specifically, we build on the insights of interdisciplinary scholarship about the gendered and racialized division of care to examine the unique role of Black women in health care.We argue that structural racism in the labor market, linked to historical legacies of slavery and domestic service, has had a strong impact on shaping the health care workforce. The stratification of the health care workforce and the concentration of women who are Black, Indigenous, and people of color in low-wage health care jobs is well established. 2-5 Scholars have also found that women of color in caregiv-ing jobs often experience discriminatory treatment and racist abuse from both employers and care recipients. 6,7 Our goal here is to broaden the focus beyond individual exposure to racism and discrimination to explore the role of racism at a macro level. Structural racism is defined as struc-turing opportunity and assigning value based on race, unfairly disadvantaging some individuals and communities and advantaging others. 8,9 Structural racism can only be understood by reference to historical processes, and we look to the history of care to understand contemporary patterns. Scholars of care define care broadly to include the paid and unpaid labor of caring for people who are young, old, ill, or disabled.

In the United States (US), Black—particularly Black female—healthcare workers are more likely to hold occupations with high job demand, low job control with limited support from supervisors or coworkers and are more vulnerable to job loss than their white counterparts. These work-related factors increase the risk of hypertension. This study examines the extent to which occupational segregation explains the persistent racial inequity in hypertension in the healthcare workforce and the potential health impact of workforce desegregation policies. We simulated a US healthcare workforce with four occupational classes: health diagnosing professionals (i.e., highest status), health treating professionals, healthcare technicians, and healthcare aides (i.e., lowest status). We simulated occupational segregation by allocating 25-year-old workers to occupational classes with the race- and gender-specific probabilities estimated from the American Community Survey data. Our model used occupational class attributes and workers’ health behaviors to predict hypertension over a 40-year career. We tracked the hypertension prevalence and the Black–white prevalence gap among the simulated workers under the staus quo condition (occupational segregation) and the experimental conditions in which occupational segregation was eliminated. We found that the Black–white hypertension prevalence gap became approximately one percentage point smaller in the experimental than in the status quo conditions. These findings suggest that&nbsp;policies designed to desegregate the healthcare workforce may reduce racial health inequities in this population. Our microsimulation may be used in future research to compare various desegregation policies as they may affect workers’ health differently.

<h3>Importance</h3><p>The health care sector lost millions of workers during the COVID-19 pandemic and job recovery has been slow, particularly in long-term care.</p><h3>Objective</h3><p>To identify which health care workers were at highest risk of exiting the health care workforce during the COVID-19 pandemic.</p><h3>Design, Setting, and Participants</h3><p>This was an observational cross-sectional study conducted among individuals employed full-time in health care jobs from 2019 to 2021 in the US. Using the data from the Current Population Survey (CPS), we compared turnover rates before the pandemic (preperiod, January 2019-March 2020; 71 843 observations from CPS) with the first 9 months (postperiod 1, April 2020-December 2020; 38 556 observations) and latter 8 months of the pandemic (postperiod 2, January 2021-October 2021; 44 389 observations).</p><h3>Main Outcomes and Measures</h3><p>Health care workforce exits (also referred to as turnover) defined as a health care worker's response to the CPS as being unemployed or out of the labor force in a month subsequent to a month when they reported being actively employed in the health care workforce. The probability of exiting the health care workforce was estimated using a logistic regression model controlling for health care occupation, health care setting, being female, having a child younger than 5 years old in the household, race and ethnicity, age and age squared, citizenship status, being married, having less than a bachelor’s degree, living in a metropolitan area, identifier for those reporting employment status at the first peak of COVID-19, and select interaction terms with time periods (postperiods 1 and 2). Data analyses were conducted from March 1, 2021, to January 31, 2022.</p><h3>Results</h3><p>The study population comprised 125 717 unique health care workers with a mean (SD) age of 42.3 (12.1) years; 96 802 (77.0%) were women; 84 733 (67.4%) were White individuals. Estimated health care turnover rates peaked in postperiod 1, but largely recovered by postperiod 2, except for among long-term care workers and physicians. We found a 4-fold difference in turnover rates between physicians and health aides or assistants. Rates were also higher for health workers with young children (&lt;5 years), for both sexes and highest among women. By race and ethnicity, persistently higher turnover rates were found among American Indian/Alaska Native/Pacific Islander workers; White workers had persistently lower rates; and Black and Latino workers experienced the slowest job recovery rates.</p><h3>Conclusions and Relevance</h3><p>The findings of this observational cross-sectional study suggest that although much of the health care workforce is on track to recover to prepandemic turnover rates, these rates have been persistently high and slow to recover among long-term care workers, health aides and assistants, workers of minoritized racial and ethnic groups, and women with young children. Given the high demand for long-term care workers, targeted attention is needed to recruit job-seeking health care workers and to retain those currently in these jobs to lessen turnover.</p>

We analyze the 2004, 2008, and 2014 longitudinal panels of the Survey of Income and Program Participation (SIPP) to compare the percentage of long-term care (LTC) workers who held a second job in a...

This study examines the effects of local and nationwide COVID-19 disease control measures on the health and economy of China's rural population. We conducted phone surveys with 726 randomly selected village informants across seven rural Chinese provinces in February 2020. Four villages (0.55%) reported infections, and none reported deaths. Disease control measures had been universally implemented in all sample villages. About 74% of informants reported that villagers with wage-earning jobs outside the village had stopped working due to workplace closures. A higher percentage of rural individuals could not work due to transportation, housing, and other constraints. Local governments had taken measures to reduce the impact of COVID-19. Although schools in all surveyed villages were closed, 71% of village informants reported that students were attending classes online. Overall, measures to control COVID-19 appear to have been successful in limiting disease transmission in rural communities outside the main epidemic area. Rural Chinese citizens, however, have experienced significant economic consequences from the disease control measures.

The purpose of this article is to explore two research questions: In what ways do Black mothers experience workplace oppression? and How can anti-oppressive practices informed by contemplative prac...

In recent decades, many male-dominated jobs have contracted, while many female-dominated jobs have increased. Scholars have tied these changes to men’s declining employment rates; yet, little attention has been paid to unemployed men’s consideration of work associated with women. Based on a sample of 441 unemployed men, we used an experimental survey design to examine the likelihood that unemployed men pass up applying to a job based on the job’s gender composition, masculine/feminine-typed skills, and pay. We also examined their perceptions about how other unemployed men would respond to such jobs. We supplement these findings with content analyses of qualitative responses for why unemployed men would or would not work in a female-dominated job. Our findings suggest that unemployed men were willing to work in jobs with a higher proportion of women, but resisted jobs requiring them to perform feminine-typed skills, even if it meant being unemployed longer. Notably, respondents believed other men would be more likely to pass applying to both female-dominated jobs and jobs that required feminine-typed skills. Broadly, this study sheds important light on how unemployed men perceive non-traditional work and identifies key factors that contribute to men’s persistent low representation in jobs associated with women.

This study examines the use of career ladders for medical assistants (MAs) in primary care practices as a mechanism for increasing wages and career opportunity for MAs. A growing body of research on primary care suggests that successful expansion of support staff roles such as MAs may have positive organizational and quality of care outcomes, but little is known about worker outcomes. Evaluate the effectiveness of career ladders in improving wages and career opportunity among MAs. We use a mixed-methods design to evaluate the impact of career ladders on MA job quality. We draw on interview data collected from 115 key informants at four large health systems (ranging from 24 to 29 clinics each), and we analyze wage and employment data for MAs from primary care clinics in the four health systems in the sample. We describe the MA career ladder context and infrastructure within primary care clinics and evaluate the rewards to MAs for participation in the career ladder programs. The expanded roles within career ladders for MAs focused on the following four clinical and educational areas: panel management and care coordination, EHR documentation support, supporting delivery of person-centered care, and supervision and training. The three primary components of the career ladder infrastructure were training and education for MAs and providers, credentialing and certification for MAs, and differentiated job levels for MAs. The use of career ladders in the four large health systems in our case study sample resulted in yearly income increases ranging from $3000 to $10,000 annually. Investing in career ladders in primary care clinics can improve MA job quality while also potentially addressing issues of equity, efficiency, and quality in the health care sector.

Using the 2004 and 2008 panels of the Survey for Income and Program Participation (SIPP), we examine whether the heavily feminized health care industry produces “good jobs” for workers without a college degree as compared to other major industries. For women, we find that jobs in the health care industry are significantly more likely than the food service and retail industries to provide wages above $15 per hour, health benefits, fulltime hours, and job security. Jobs in the health care industry are not “good jobs” for low- and middle-skill men in terms of wages, relative to the industries of construction and manufacturing, but health care jobs can provide men with greater job security, and in comparison to construction, a higher probability of employer-based health insurance. That said, the findings emphasize that because men and women are differentially distributed across industries, access to different forms of job quality is also gendered across industries, with important implications for gender dynamics and economic strain within working class families.

We use the Location Affordability Index (LAI) and the newly developed Child Opportunity Index (COI) to assess, for the first time, the tradeoff between neighborhood opportunity and housing/transportation affordability facing low-income renter families in the 100 largest metropolitan areas. In addition to describing the opportunity/affordability relationship, we explore the level of balance between neighborhoods’ relative cost burden and their corresponding opportunity levels to determine whether children of different racial/ethnic groups are more (or less) likely to experience cost-opportunity imbalance. Our multilevel analyses show that housing affordability is largely accounted for by the neighborhood opportunity structure within each metropolitan area. The metropolitan characteristics examined account for only a small proportion of the between-metro variance in the opportunity/affordability gradient for housing, presumably because the neighborhood opportunity structure already reflects metro area factors such as fragmentation and segregation. On the other hand, transportation affordability shows a weaker association with neighborhood opportunity. The COI/LAI association is much weaker for transportation than for housing, and a large part of the variation in the transportation gradient occurs at the metropolitan area level, not the neighborhood level. Sprawl is particularly associated with transportation affordability, with lower sprawl areas having lower transportation-cost burden. We discuss the implications of the empirical findings for defining affordability in housing assistance programs. We recommend that housing policy for low-income renter families adopt an expanded notion of affordability (housing, transportation, and opportunity) and explicitly consider equity (e.g. cost-opportunity imbalance) in the implementation of this expanded affordability definition.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Context: National efforts are underway to classify a minimum set of public health services that all jurisdictions throughout the United States should provide regardless of location. Such a set of basic programs would be supported by crosscutting services, known as the "foundational capabilities" (FCs). These FCs are assessment services, preparedness and disaster response, policy development, communications, community partnership, and organizational support activities. Objective: To ascertain familiarity with the term and concept of FCs and gather related perspectives from state and local public health practitioners. Design: In fall 2013, we interviewed 50 leaders from state and local health departments. We asked about familiarity with the term "foundational capabilities," as well as the broader concept of FCs. We attempted to triangulate the utility of the FC concept by asking respondents about priority programs and services, about perceived unique contributions made by public health, and about prevalence and funding for the FCs. Setting: Telephonebased interviews. Participants: Fifty leaders of state and local health departments. Main Outcome Measures: Practitioner familiarity with and perspectives on the FCs, information about current funding streams for public health, and the likelihood of creating nationwide FCs that would be recognized and accepted by all jurisdictions. Results: Slightly more than half of the leaders interviewed said that they were familiar with the concept of FCs. In most cases, health departments had all of the capabilities to some degree, although operationalization varied. Few indicated that current funding levels were sufficient to support implementing a minimum level of FCs nationally. Conclusions: Respondents were not able to articulate the current or optimal levels of services for the various capabilities, nor the costs associated with them. Further research is needed to understand the role of FCs as part of the foundational public health services.