Gender wage gap in healthcare is complicated

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The gap in wages between genders has been a pervasive issue in healthcare and many other industries, but the wage gap between men and women is becoming more complicated in the sector, with the gap decreasing in some health-centric occupations, but not in others.

The gender wage gap decreased over the last two decades in many healthcare occupations, and notably among those where women's representation increased substantially, according to a new Health Affairs study. For example, among advanced practitioners, the gender wage gap decreased from women's earnings being about 50% of men's earnings to approximately 65% of men's earnings.

There was a similar pattern among male and female physicians over the last couple of decades, although the gender wage gap among physicians remains much higher than the general population. In general, women with higher levels of education – professional degrees, master's degrees or bachelor's degrees – made substantial gains in terms of wage equity relative to men in the healthcare sector.

But for women with lower levels of education, the gender wage gap story is more complicated. The gender wage gap for RNs, technicians, LPNs/LVNs, and aides/assistants is, in general, smaller as compared with occupations that require higher levels of education. For example, female RNs made approximately 82% of male RNs' salaries, as compared with female physicians, who made approximately 70% of male physicians' salaries.

However, in many lower-education, heavily women-dominated healthcare occupations, the gender wage gap widened over the last 20 years. For example, among aides/assistants, women earned approximately 85% of men in 2003, but this dropped to below 80% in 2021. Similarly, the gender wage gap for LPNs/LVNs and RNs remained basically stagnant or widened slightly over the last 20 years.

In these lower-wage jobs with high female representation, the gender wage gap is similar to what is seen nationally, but unlike national trends towards closing of the pay gap, it is widening or stagnant in these occupations over time, according to the study.

WHAT'S THE IMPACT?

Past research on the so-called "glass escalator" theory has shown that men in women-dominated occupations have higher wages and are more likely to be promoted compared with their female peers. 

The new research posits that the worsening gender wage gap is likely because men are being offered higher wages than their women counterparts, are advancing into supervisory positions and are concentrated in specialties that have higher compensation.

The gender wage gap may be a function of both gender representation and education, authors said. There has been an improvement in the gender wage gap among those with a college degree and higher, while there has not been a closing of the gender wage gap among those with less than a college degree.

The research offered additional alternative explanations for the trends. For instance, as the gender wage gap goes up, women may decide to leave an occupation, or relatively high-earning women may be more likely to leave in search of better paying jobs than low-earning women.

Marital status has also been associated with gender wage gaps. For example, a recent study of female physicians married to male physicians found that these women worked fewer hours than women who were not married to physicians. 

"Testing these explanations is beyond the scope of our paper but is an important area for future research in gender inequity across the health professions," authors wrote.

THE LARGER TREND

A March 2023 Doximity report – which includes self-reported compensation data from over 190,000 U.S. doctors over six years, and more than 31,000 full-time physicians in 2022 – also highlights the substantial gender pay gap among physicians, with men earning nearly $110,000 more than their women counterparts in 2022.

This represents a 26% gender pay gap, even when salaries were controlled for specialty, location and years of experience. This disparity may be contributing to an even higher burnout rate among women physicians, with nearly 92% of women physicians surveyed reporting overwork, compared to 83% of men.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com