How the Health Care Sector Can Prepare for the Aging of Its Workforce

The health care sector is already challenged to recruit and retain workers at all levels of skill. Demand for staff to provide services can only grow as the swell in population represented by the Baby Boom moves into old age. Recognizing the needs and interests of older workers—as well as the needs of the multigenerational workforce as a whole—may help health care-sector employers face big staffing challenges that are just on the horizon.

First, the numbers. According to the United States Bureau of Labor Statistics (BLS), 14.3 million people were employed in the health care sector as of 2008. Opportunities are expected to expand far faster—by 22.5 percent from 2008 to 2018— in this sector of the economy than in any other. At that rate health care will create more than 3.2 million new jobs by 2018. While some jobs will require high-level skills and technical expertise (for example, doctors and nurses), most will require less than a four-year college education (for example, receptionists and maintenance workers).

Given current and anticipated labor needs, one would expect most employers in this sector to be paying close attention to their long-term workforce requirements, but this does not seem to be the case. A study conducted in 2009 by the Sloan Center on Aging & Work shows that fewer than one in four employers (23 percent) in the health care sector had projected their retirement rates and that only one in two employers (50 percent) had gauged supervisors’ ability to anticipate and plan for staffing needs.

The aging of the society is going to increase demand for health care services, as well as exacerbate challenges in attracting and keeping workers. These challenges will vary with employment setting (for example, hospitals versus home care) and geographic locale (such as rural, suburban and urban areas). Many workers will need both “hard” (technical) skills and “soft” (people) skills.

To avoid large-scale losses over a short period, employers will have to replace older members of their existing workforce who choose to retire, as well as find ways to retain at least some of their existing employees. In many respects, older workers are an ideal match to serve the aging population, not only because of the skills they have honed from years on the job but also because of the cultural and generational experiences they share with older patients.

One strategy to attract and retain workers is compensation. Jobs in the upper tier of the health care sector can pay quite handsomely; for example, according to the BLS, as of 2008, the average wage earned by registered nurses in hospitals was $30.71 an hour. But not all jobs pay as well. For example the average wage of hospital housekeeping staff was only $10.28 an hour. Rising costs to deliver health care may make it difficult to substantially improve pay levels for lower-tier workers, unless the efficiency of service delivery is improved or current wage standards across industries are changed.

Wages are just part of the story, however—especially for those in upper-tier jobs, where improvements in the design of jobs and careers can matter to some employees as much as satisfaction with compensation. One indicator of concern surfaced in the 2009 Sloan Center study, which found that conflicts between the demands of work and family are much more common among health care workers than among those laboring in other sectors of the economy. Health care-sector employees are also considerably more likely than workers in other sectors to rate flexible work hours as an important or very important job incentive. This is understandable, given that four in five health care workers (79 percent) are women. So long as workers in this sector continue to run out of time before they are able to get their work done (45 percent) or come home from work too tired to do their chores (48 percent), the push to exit work may be stronger than the pull to keep working, especially when they have a choice, such as the option to retire.

Evidence indicates that the opportunities and challenges that an aging workforce will present are going to catch many employers in the health care sector flat-footed. Health care employers by and large do not know the risks that demographic changes pose for their organizations, and they continue to structure work in ways that employees disfavor. Many older workers and women across age groups are attracted to part-time jobs. An increasing percentage of men across age groups are, too. One effective way that health care employers can solve their current and future staffing needs is to notice this trend and reconsider how they manage and array schedules.