The healthcare sector has long been dominated by women — who currently perform 77% of healthcare jobs nationally — but gender wage gaps have remained a stubborn and persistent issue, potentially contributing to lower lifetime earnings for millions of women and deterring their professional advancement.

Although the problem is widespread, recent research on the healthcare wage gap has focused primarily on physicians and other workers with high levels of training and education. For example, we know that male physicians earn higher wages than women physicians across all medical specialties, and that medical specialties that are dominated by men pay significantly more compared with specialties where women predominate.

Few studies, however, have examined the gender wage gap comprehensively across the healthcare workforce, especially among healthcare workers with an associate’s degree or less. Furthermore, little research has been conducted on how the gender wage gap has changed over the last two decades relative to women’s representation in healthcare occupations.

A new study from the University of Minnesota School of Public Health (SPH) in collaboration with the Center for Health Workforce Studies (CHWS) at the University of Washington School of Medicine addresses this topic by examining data gathered between 2003 and 2021 to see how the gender wage gap within various healthcare fields has changed over the last two decades. The study, published in Health Affairs Scholar, found:

• Women’s representation increased in health care occupations that require a master’s or doctoral/professional degree. Women’s representation increased 8% in positions requiring a master’s degree and 42% in positions at the doctorate/professional level. At the bachelor’s degree level, growth was stagnant (0% change).
• Men’s representation increased slightly in nursing occupations like registered nurses and licensed practical nurses (LPNs).
• The adjusted wage gap between women and men is the largest among workers in high-education healthcare fields like physicians and other advanced practitioners.
• In 2021, the gender wage gap was the lowest among workers with a bachelor’s degree (88%), followed by those with an associate’s degree (82%), some college (77%), master’s degree (77%), high school degree (72%), less than high school (71%), and professional school/doctorate degree (61%).
• The gender wage gap has stagnated or grown larger in some lower-education occupations, where men’s percentage of the workforce has increased.

“Healthcare is a woman-dominated industry and should be a leading field in promoting gender equality in wages,” says Janette Dill, SPH associate professor and lead author. “The good news is that womens’ representation in health care occupations increased to a greater degree in high-education occupations like physicians and advanced practitioners,” she says. “However, though there have been improvements in recent years, we also found that the gender wage gap remains larger in high-education occupations as compared to lower-education healthcare occupations — meaning that women with several years of education and training are earning a fraction of what their male counterparts are making.”

“Health care organizations and government agencies should strive to implement policies and practices that directly address these long-standing gender disparities, Dill says.”

The paper includes a number of policy suggestions, including gender equity reviews within healthcare organizations, prioritizing female managers, and realigning Medicare and Medicaid reimbursement policies to promote greater gender equity within and across healthcare occupations.

This study was funded by a grant award to CHWS from the Health Resources and Services Administration

The paper was selected as an Editor’s Choice article by Health Affairs Scholar.