Healthcare & Social Assistance in Rhode Island's Economy, part I

In a previous data story examining Rhode Island's economy, the RILDS Center found that healthcare and social assistance is both the largest employment sector in the state and that the sector is projected to add the most new jobs in the upcoming years. This data story explores the sector in more detail to better understand its role in our economy.

We start with the latest available wage data for all industries to see how this sector fits into Rhode Island's overall employment landscape. We then explore wages for healthcare and social assistance in detail, drilling down into individual job sectors to see where the wages actually go. Finally, we offer some comparative looks at healthcare wages in nearby states and at projected growth in different healthcare occupations nationally. Our analysis offers a detailed picture of the economic impact of this important job sector.

The first tab shows the distribution of annual wages per job for all Rhode Island jobs in 2013, including full-time and part-time positions. For most Rhode Island jobs, the annual wage was less than $25,000, far less than the Rhode Island average of $47,729. Remember that the average wage encompasses the lowest and highest-paying jobs, so it can be skewed by a small number of atypical wages.

The second tab visualizes the industries in which Rhode Island workers earned wages in 2013. By far the largest proportion of Rhode Island jobs were in the healthcare and social assistance sector.

The first graphic shows the distribution of annual wages for each job in the healthcare and social assistance sector in 2013. About 45% of Rhode Island healthcare jobs paid less than $25,000. However, about a third paid between $25,000 and $50,000, meaning that this sector provides a significant amount of middle-class jobs for Rhode Islanders.

The second graphic categorizes healthcare jobs by whether they provide a living wage. Using MIT's Living Wage Calculator for Rhode Island, we can see that 40.5% of these jobs do not provide a living wage for 1 adult. About 17.5% of Rhode Island healthcare jobs do provide a living wage for 1 adult, but not for a family (defined as 2 working adults with 2 children). About 42% of jobs in this sector do provide a family living wage or better.

Previously, we looked at the healthcare and social assistance sector as a whole. However, the sector is much more heterogenous than the previous analysis implies; it contains four subsectors, each of which contains multiple industry groups.

As the chart in the first tab shows, the subsector that provided the most jobs in 2013 was ambulatory healthcare services, with just over a third of all jobs. These are outpatient providers, doctors' office and the like.

The skills required in each of the subsectors varies, along with compensation level. The second chart displays average and median wages for each subsector. While the average wage gives us an overall picture of the wages paid, the median wage offers a picture of the "typical" wage per job. Jobs in the hospitals and ambulatory healthcare subsectors paid the highest average wages by far, but the typical wages were much lower. These sectors employs physicians and many less-skilled support staff. Wage disparities in the lower-paying nursing and social assistance subsectors were much smaller.

Next we delve into each subsector in more detail. In this set of charts we look at the largest, ambulatory healthcare services. The first chart shows, again, a skewed distribution of wages, with 42.4% of Rhode Island ambulatory healthcare jobs offering annual wages below $25,000. The second chart breaks out jobs by industry group to show which types of jobs are in highest demand right now. Offices of physicians employ the most Rhode Islander workers (33%).The graphs in the third tab show average wages by industry group. The highest wages are found in the largest group, offices of physicians, which employs a third of all ambulatory healthcare workers. The next-highest wages are earned in the smallest industry group, medical and diagnostic labs, which employs only 3% of workers in the sub-sector.

The hospitals subsector featured the highest average wage of all four subsectors in 2013. This is reflected in the wage distribution chart in the first tab; only 18.4% of hospitals jobs pay less than $25,000 a year. Average wages in hospitals are higher because the jobs generally pay better, not because a few top earners are skewing the figures.

The chart in the second tab shows that the vast majority of Rhode Island hospitals jobs are at general medical and surgical hospitals. However, as the third set of charts shows, average wages in 2013 were highest for those workers employed in specialty hospitals. These hospitals provide diagnostic and medical treatment to inpatients with a specific type of medical condition (except psychiatric or substance abuse).

Looking at nursing and residential care facilities, we see in the first chart that almost two-thirds of Rhode Island jobs in this subsector paid less than $25,000. Recall that this subsector provides one-quarter (24%) of the healthcare jobs in the state.

The majority of Rhode Island jobs in this subsector are in the skilled nursing facilities industry group. There is not a large difference in average wages across nursing industry groups. Skilled nursing would also be the only place to expect a family living wage; the other industry groups either pay too little on average or do not offer enough hours per job.

Finally, we look at the social assistance subsector. It is both the smallest and the one with the lowest average wages. These are the frontline workers. In the first chart, we see that almost three-quarters of Rhode Island social assistance jobs paid less than $25,000 in 2013. This pattern may reflect part-time work, by choice or otherwise. Either way, we might expect that many people employed in this subsector took on second jobs.

The largest industry group within social assistance is individual and family services, but it is the smallest industry group--community food and housing, and emergency and other relief services--that pays the highest wages.