Research by Daniel Enemark, PhD, Senior Economist
The San Diego Workforce Partnership is creating a strategy for helping workers—especially women, people of color and those without a college degree—find a pathway to the middle class in the healthcare sector. To inform this strategy, we’ve studied the regional healthcare sector and are releasing a report based on our results. Below is a summary of our findings.
Overview of San Diego County’s healthcare sector
The healthcare sector employs 186,000 workers in San Diego County—5% of the population and 13% of overall employment. One of the reasons it’s such a large portion of overall employment is because of San Diego’s advanced medical research and biotechnology industries, which work together with local hospitals to provide cutting-edge treatment. San Diego ranks #1 in the U.S. for genomic patents and is home to more than 80 research institutions and 30 hospitals. Healthcare is San Diego’s second biggest employer, and many of San Diego County’s top employers are in the healthcare sector.
Figure 1: The below graph shows sectors by number of jobs in San Diego County. Light grey lines represent the national average for number of jobs for a region of our population.
Figure 2: Largest individual employers in San Diego County, with healthcare employers highlighted in orange (note that UC San Diego has a health system employing approximately 8,000 workers).
Most common healthcare jobs
Figure 3 shows the 20 most common healthcare occupations, and Figure 4 shows the 20 most common healthcare occupations with median wages over $60 an hour, or about $125,000 a year. The 20 most common healthcare occupations supply about 2,000 jobs or more each. By contrast, the very-high-wage occupations are small—with one exception, they supply fewer than 800 jobs each. Nearly all the highest-paying jobs in healthcare require advanced education. The 20 high-pay jobs listed in Figure 4 account for about 7,600 jobs in San Diego, and only 3% of those jobs (those in nuclear medicine technology and radiation therapy) are accessible with an Associate Degree.
Figure 3: The 20 most common occupations in San Diego’s healthcare sector
Figure 4: The 20 most common occupations with median hourly wages of $60+
Entry-level options in healthcare
The San Diego Workforce Partnership does not have any programs designed to put clients through more than two years of education, so we’re currently interested in helping clients begin careers that require an Associate Degree or less. We also believe it is important to place clients in jobs with self-sufficient entry-level wages. The University of Washington Center for Women’s Welfare estimates the basic needs of a San Diego County resident (a single adult with no dependents) to be $3,058.72 per month, requiring full-time employment at $17.65 an hour. Removing all occupations that require a four-year degree or pay less than $17.65 at the entry level leaves the occupations listed in Table 1, ordered by training requirements and then by number of jobs. These are some of the jobs we’ll be working to help clients secure.
Table 1: Jobs with self-sufficient entry-level wages not requiring a four-year degree
The pathway from licensed practical/vocational nurse (LVN) to registered nurse (RN)
One of the most promising career pathways among the 11 jobs in Table 1 is LVN to RN. Not only are there far more LVNs in San Diego than PTAs and OTAs combined, there are multiple local LVN to RN bridge programs. There are four compelling reasons to pursue an LVN to RN program. First and foremost, for individuals with a high school education interested in a nursing career, LVN is a much, much faster process than becoming an RN. The average LVN program lasts one year, but some programs are as brief as seven months. For clients who want to start working in the healthcare sector and need employment in months rather than years, LVN is a good first step. In addition, many local nursing programs view an LVN certificate as a major advantage when evaluating applications, which means that students who might ordinarily struggle to gain admittance into a BSN program can improve their odds by starting as an LVN.
Second, there are 6,700 LVNs in San Diego County, and widening the pathway from LVN to RN improves job quality for LVNs. Third, moving LVNs to RNs creates new openings to backfill in the LVN field, helping more workers get a start in the healthcare sector. Finally, the LVN workforce is much more diverse than the RN workforce, so helping more LVNs advance has the potential to create a RN workforce that better matches the local patient population. Given the scientific literature showing that white medical professionals provide a lower quality of care to BIPOC patients, this would likely improve the experiences of patients of color.
Identifying high-paying employers of medical assistants
An essential complement to public data is direct communication with employers, and we did this through our talent-pipeline-management research along with San Diego’s Regional Economic Development Corporation. This section previews some of the findings from that work, which will be described in greater depth in a separate report. Surveying our employer working group, we found that the occupation in greatest need was Medical Assistant—a professional who performs both administrative and routine clinical tasks in a medical setting. While our broad-based labor market analysis rejected this role as a career pathway because of its low earnings, reported entry-level wages among our employer working group were high enough to justify treating this occupation as a potential entry point to healthcare careers.
Table 2 shows the current workforce, total demand our employers expected over the next three years, expected growth in employment, average entry-level wages and talent-sourcing difficulty for 10 jobs that meet the following four criteria: higher-than-average projected job growth, key role within both hospital and community healthcare settings, offers $19 an hour with benefits, and does not require a degree but does require some formal education or training.
Table 2. Data on key middle-skill healthcare jobs from our talent-pipeline management research
Our talent-pipeline-management work leads us to believe that building relationships with the right employers may allow us to help clients obtain jobs with self-sufficiency wages in occupations that typically pay lower wages at the entry level. It also suggests we may be able to create new pathways to high-paying jobs that require an associate degree. Working together with employers and training providers could allow us to significantly widen access to high-paying healthcare jobs for clients without a bachelor’s degree—especially those from the Black, Hispanic and Native American communities underrepresented in the sector. The pilot work we are undertaking with the support of JP Morgan Chase will help us assess the viability of these strategies moving forward.
Want to learn more about the healthcare sector in San Diego? Find the full report here.
Interested in supporting San Diegans enter the healthcare sector or filling open healthcare positions? Email Karen Connolly at KarenConnolly@workforce.org.
Thank you to JP Morgan Chase for providing funding for this report and for two pilot programs that are shaped by this analysis.