Community health worker pay gap: Women and people of color earn less than their male and white counterparts
A new study by PJ Maddox and Tammie Jones also found that salaries for community health workers are higher in states with certification programs.
The ability of community health workers (CHWs) to address the social determinants of health and support access to primary and preventive health programs has made them an increasingly crucial part of public health, resulting in increased employment for CHWs. The US Bureau of Labor Statistics has projected a 21% increase in CHW jobs (about 13,500) by 2030, a growth rate much faster than the average for all US occupations. Given the rise in employment, Mason researchers set out to determine how wages had changed due to certification, labor turnover, and funding policies that may influence wages or rotation.
A recent study by Tammie Jones, assistant professor in the Department of Health Administration and Policy (HAP), and PJ Maddox, chair of the HAP department, found that there are salary gaps between white and non-white CHWs and between male and female CHWs. Additionally, salaries are higher in states with certification programs.
“Our study found that after adding certification standards, hourly wages increased among white workers, men, and part-timers, and increases for men were four times greater than increases for white workers. women,” Jones said. “While an increase in hourly wages is a positive thing for the field, the majority of community health workers are people of color and women who should be compensated fairly.”
Hourly wages for people who identify as white were $2.72 higher and $5.16 higher for men. According to a Health Resources and Services Administration study, 54.5% of CHWs identify as Hispanic or Black and 82% identify as female.
CSA salaries increased $2.42 more per hour in states with certification programs than in states without programs, and in states with early certification programs, salaries increased by $14.46 . The researchers did not find a statistically significant effect on job turnover in certified states. Medicaid reimbursement was found to have no significant effect on salaries or turnover.
“Federal, state, and employer-based strategies are needed to establish and sustain effective CHW programs to meet the needs of populations with health disparities and disproportionate barriers to accessing care and services while providing fair wages that compensate CHWs for their worth,” says Maddox, the lead researcher.
CHW is a general term for frontline public health workers with in-depth knowledge and understanding of the community they serve. They are widely recognized as uniquely capable of identifying issues contributing to health disparities, improving access to health services, and connecting people to needed social services.
“Community Health Worker Hourly Wages and Turnover by U.S. State Certification Policy and Medicaid Reimbursement, 2010-2021was published online in the American Journal of Public Health in August 2022. In addition to Maddox and Jones, other authors include Alex Schulte and Charlotte M. Lewis of the Mason’s Center for Health Workforce; and Chanup Jeung, a Mason Ph.D. health services alumnus now at the University of Massachusetts at Amherst.
The research was partially funded by the Claude Moore Charitable Foundation. A scaled difference-in-differences design was used to compare CHW salaries and turnover in states with and without CHW certification or CHW health insurance reimbursement policies. The data comes from the Current Population Survey from 2010 to 2021 in the United States.
Maddox and Jones have previously studied CHWs and found that state regulations are associated with greater adoption of occupational standards. Learn more about their research here.