Healthcare and Social Assistance
Input: Economic Factors
Across the Sector
Terrorism, Natural Disaster, and New and Emerging Health Threats
The demand for services is increased exponentially when a disaster, such as a hurricane, flood, tornado, or a terrorist event occurs. The existing workforce may be overextended during a prolonged period, which may result in higher numbers of injuries and illnesses.
Financing
A unique feature of the HCSA sector is the important role of public financing through Medicare and Medicaid and the imperative to provide charity care to those without other means of support. Under-reimbursement results in cost shifting to other payers, but this mechanism for recovering costs is limited. Tight funding is an important consideration for health care and social services providers.
Healthcare Subsector
The healthcare subsector (NAICS 621, 622, 623) consists of the following industries: hospitals, nursing and residential care facilities, offices of other health practitioners, outpatient care centers, other ambulatory health care services (blood and organ banks), medical and diagnostic laboratories. Ambulance services (NAICS 62191), in the ambulatory healthcare services subsector (NAICS 621),is covered by the NORA Public Safety sector which developed goals specifically addressing this industry.
In 2010, the Healthcare subsector had the largest employment of any NAICS two-digit industrial sector and had 10 of the top 20 fastest growing occupations. The industry is rapidly changing due to pressure to contain costs as well as the introduction of technological and clinical advances for the diagnosis and treatment of illnesses and injuries.
Labor Force Issues
- Difficulties in recruiting and retaining qualified workers, coupled with an increasing demand for services, place additional occupational safety and health risks on workers.
- Inadequate staffing and chronic understaffing are exerting additional mental and physical stress on the existing providers.
- The average age of employed nurses is 45.5 years and is increasing at more than twice the rate of all other occupations in the U.S. workforce. This aging workforce, employed in a physically and psychologically demanding environment, may result in more injury and illness incidents with longer recovery periods, resulting in increased workers' compensation payments and lost productivity.
- Shift work and long work hours (including mandatory overtime) may have an impact on the safety and health of the worker, as well as the quality of care for the patient.
- Reductions in hospital stays have resulted in greater than average patient acuity and increased complexity of care, placing increased demands on workers.
- The importation of health care providers, particularly nurses, creates language and cultural differences which may impede training efforts and basic understanding of occupational safety and health requirements.
Industry Structure
- The healthcare subsector varies substantially in size of establishment, organizational structure, and staffing patterns.
- A large proportion of the healthcare subsector is composed of very small establishments that may not be able to take advantage of safer technologies, which may require high start-up and operating costs.
Social Assistance Subsector
The social assistance subsector (NAICS 624) consists of the following industries: individual and family services, community food and housing, emergency and other relief services, vocational rehabilitation services, and child day care services. Child daycare services employs over half of the workers in social assistance.
Some of the fastest growing occupations in the nation (e.g., home care aides, child care workers) are concentrated in the social assistance subsector. A large number of the jobs in social assistance are part-time and low-paying service jobs.
- High job turnover, part-time workers, and the projected rapid employment growth in this subsector impacts the ability of the organization to provide sufficient and appropriate safety and health training to workers.
- A substantial amount of the worker's time is spent in local travel, increasing the risk of motor vehicle incidents.
- Workers in this subsector provide services to populations at risk-mentally ill, physically disabled, and families in crisis-which may contribute to additional mental stress and physical demands on the worker.
- As in the healthcare subsector, social assistance workers are somewhat older than workers in other industries.
- Non-traditional worksites (homes as opposed to institutions) may not provide adequate safety and health protection.
- Non-traditional work schedules, such as 24-hour-long operation, evening, weekend and holiday work requirements, may contribute to higher injury and illness incidents.
Veterinary Services
The focus on hazards in the veterinary services industry (NAICS 54194) relates to the work of veterinary medicine and animal care personnel. Veterinary medicine and animal care services include medical, surgical and preventive health services for non-farm animals as well as workers that care for non-farm animals in a variety of settings ranging from zoos to pet stores to research laboratories. Not included in the NORA HCSA sector grouping are services provided by farmers, ranchers and others involved in care, treatment or harvesting of farm or commodity animals or fish; these are covered by the NORA Agriculture, Forestry and Fishing industry sector program. In 2010, over 287,000 people were employed in veterinary services (NAICS 54194). However, 2010 employment estimates for the following relevant occupational groups across all industries including veterinarians, veterinary technicians, nonfarm animal caretakers and animal control workers exceed 462,000 persons. Salient characteristics of these occupations include
- About 80% of veterinarians work in private practice and may not be able to take advantage of safer technologies
- By 2018, the number of veterinarians is projected to increase 33% and currently ranks18th among fastest growing occupations.
- About 90% of veterinary technologists/ technicians are in veterinary services (NAICS 54194)
- By 2018, the number of veterinary technologists/technicians is projected to increase 36% and currently ranks13th among fastest growing occupations.
- By 2018, the numbers of animal care and service workers (e.g., animal trainers, non-farm animal caretakers, pet sitters, groomers, kennel attendants) is projected to increase 21%.
- Nearly 4 out of 5 animal care and service workers are employed as nonfarm animal caretakers; the rest worked as animal trainers of which about 50% were self-employed
Resources:
Bureau of Labor Statistics: Industry at a Glance: NAICS 61 & 62: Education and Health and Social Services
External link: http://www.bls.gov/iag/eduhealth.htm
American Association of Colleges of Nursing: Hallmarks of the Professional Nursing Practice Environment
External link: http://www.aacn.nche.edu/Publications/positions/hallmarks.htm
Career Guide to Industries: Healthcare
External Link: http://www.bls.gov/oco/cg/cgs035.htm
Career Guide to Industries: Social Assistance, Except Child Day Care
External Link: http://www.bls.gov/oco/cg/cgs040.htm
Career Guide to Industries: Child Day Care Services
External Link: http://www.bls.gov/oco/cg/cgs032.htm
Occupational Outlook Handbook, 2010-2011
External Link: http://www.bls.gov/oco
