Strategies to Address Racial and Ethnic Disparities in Health and Health Care for Chronic Conditions : An Evidence Map of Research From 2017 to 2024.

Background: Racial and ethnic disparities in health and health care persist in the United States, adversely affecting outcomes in prevention and treatment of chronic conditions among adults.

Purpose: To map interventions aimed at reducing racial and ethnic disparities and improving health outcomes in the prevention and treatment of chronic conditions in adults.

Data Sources: Searches of MEDLINE, CINAHL, and Scopus from January 2017 to April 2024, supplemented with gray literature.

A Scoping Review of Health Equity Interventions in Governmental Public Health.

Context: Despite major efforts in research, practice, and policy, racial and ethnic disparities in health and health care persist in the United States. Interventions in collaboration with governmental public health may provide ways to address these persistent racial and ethnic health and health care disparities and improve health outcomes.

Objective: To conduct a comprehensive review of health equity interventions performed in collaboration with public health agencies.

The gender wage gap among health care workers across educational and occupational groups.

Women perform 77% of health care jobs in the United States, but gender inequity within the health care sector harms women's compensation and advancement in health care jobs. Using data from 2003 to 2021 of the Annual Social and Economic Supplement of the Current Population Survey (CPS), we measured women's representation and the gender wage gap in health care jobs by educational level and occupational category. We found, descriptively, that women's representation in health care occupations has increased over time in occupations that require a master's or doctoral/professional degree (eg, physicians, therapists), while men's representation has increased slightly in nursing occupations (eg, registered nurses, LPNs/LVNs, aides, and assistants).

Opportunities to Diversify the Pediatric Nursing Workforce: A Focus on Male Nurses.

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.

Retention of Community Health Workers in the Public Health Workforce: Public Health Workforce Interests and Needs Survey, 2017 and 2021.

To investigate the organizational factors contributing to the intent of community health workers (CHWs) to quit their jobs in local and state health departments in the United States. We used the 2017 (n = 844) and 2021 (n = 1014) Public Health Workforce Interests and Needs Survey data sets to predict CHWs' intent to leave with Stata 17 balanced repeated replication survey estimations. CHWs dissatisfied with organizational support, pay, or job security had high probabilities of reporting an intent to leave (50%,  < .

Describing the male registered nursing workforce toward increasing male representation in professional nursing.

Background: Men are significantly underrepresented in nursing and increasing their numbers should be a priority.

Purpose: To describe the male nursing workforce in terms of size, demographics, education, and work settings.

Methods: Using data from the 2018 National Sample Survey of Registered Nurses, we performed a secondary descriptive analysis.

Who Will Care for Rural Older Adults? Measuring the Direct Care Workforce in Rural Areas.

Using the 2021 Occupational Employment and Wage Statistics (OEWS) dataset, we calculate the ratio of direct care workers relative to the population of older adults (ages 65+) across rural and urban areas in the US. We find that there are, on average, 32.9 home health aides per 1000 older adults (age 65+) in rural areas and 50.

Retracted: Transactional and transformative diversity, equity, and inclusion activities in health services research departments.

The above article, published online on 08 January 2023 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal's Editor-in-Chief, Austin B. Frakt, the Health Research and Education Trust, and John Wiley & Sons Ltd.

Gender, Race/Ethnicity, and Unionization in Direct Care Occupations.

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. 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.

Tracking Turnover Among Health Care Workers During the COVID-19 Pandemic: A Cross-sectional Study.

Importance: The health care sector lost millions of workers during the COVID-19 pandemic and job recovery has been slow, particularly in long-term care.

Objective: To identify which health care workers were at highest risk of exiting the health care workforce during the COVID-19 pandemic.

Design Setting And Participants: This was an observational cross-sectional study conducted among individuals employed full-time in health care jobs from 2019 to 2021 in the US.

Rural/urban differences in access to paid sick leave among full-time workers.

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).

Professional certification and earnings of health care workers in low social closure occupations.

There has been rapid growth in professional certifications in the health care sector, but little is known about the rewards to workers for attaining professional certifications, especially in low social closure occupations where the barriers to entry (e.g., higher education, degrees, licensure) are relatively limited.

Taking the Long View: Understanding the Rate of Second Job Holding Among Long-Term Care Workers.

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 an LTC setting or in any industry at the first panel observation versus over a longer time period. We find that around 5% to 7% of LTC workers held a second job in another LTC setting in their first panel observation. However, we found that 20% to 30% of LTC workers held a second job in LTC during the survey period of 3 to 4 years, and 30% to 40% of LTC workers held a second job in any industry during the survey period.

Occupational Segregation And Hypertension Inequity: The Implication Of The Inverse Hazard Law Among Healthcare Workers.

Unlabelled: 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.

Structural Racism And Black Women's Employment In The US Health Care Sector.

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).

Career Ladders for Medical Assistants in Primary Care Clinics.

Background: 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.

Objective: Evaluate the effectiveness of career ladders in improving wages and career opportunity among MAs.

Federal requirements for nursing homes to include certified nursing assistants in resident care planning and interdisciplinary teams: A policy analysis.

Starting in 2016, Centers for Medicare and Medicaid Services implemented the first phase of a 3-year multi-phase plan revising the manner in which nursing homes are regulated. In this revision, attention was placed on the importance of certified nursing assistants (CNAs) to resident care and the need to empower these frontline workers. Phase II mandates that CNAs be included as members of the nursing home interdisciplinary team that develops care plans for the resident that are person-centered and comprehensive and reviews and revises these care plans after each resident assessment.

Unemployment and men's entrance into female-dominated jobs.

Despite the contraction of many male-dominated occupations, men have made limited progress in entering female-dominated jobs. Using monthly employment histories from the SIPP, we examine whether individual economic conditions-such as a period of unemployment-are associated with men subsequently pursuing female-dominated work. Specifically, we ask whether men are more likely to enter female-dominated jobs after unemployment, compared to men who take a new job directly from employment.

Is healthcare the new manufacturing?: Industry, gender, and "good jobs" for low- and middle-skill workers.

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.

Redesigning the Role of Medical Assistants in Primary Care: Challenges and Strategies During Implementation.

Efforts to reform primary care increasingly focus on redesigning care in ways that utilize nonprovider staff such as medical assistants (MAs), but the implementation of MA role redesign efforts remains understudied in the U.S. health care literature.

Motivation in caring labor: Implications for the well-being and employment outcomes of nurses.

For nurses and other caregivers there is a strong emphasis on prosocial forms of motivation, or doing the job because you want to help others, even in formal, institutionalized care settings. This emphasis is based in gendered assumptions that altruistic motivations are the "right" reasons for being a nurse and lead to the best outcomes for workers and patients. Other motivations for pursuing care work, particularly extrinsic motivation, depart from the prosocial model of care and may be indicative of substandard outcomes, but little research has examined variation in care workers' motivations for doing their jobs.

Healthcare organization-education partnerships and career ladder programs for health care workers.

Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers.

Frontline health care workers and perceived career mobility: do high-performance work practices make a difference?

Background: The use of high-performance work practices (HPWPs) related to career development (e.g., tuition remission, career ladders) is becoming more common in health care organizations, where skill shortages and concerns about quality of care have led to increasing investment in the frontline health care workforce.