Healthcare and Social Assistance: Program Description

doctor in operating room

Program Description

Over 21 million people are employed in private and public sector industries covered by the NIOSH Healthcare and Social Assistance (HCSA) program.1-2 These industries include ambulatory healthcare services, hospitals, nursing and residential care facilities and social assistance. These four industries are on a continuum starting with those establishments providing medical care exclusively, continuing with those providing healthcare and social assistance, and finally finishing with those providing only social assistance. Because of the many parallels between human healthcare and animal healthcare, the HCSA program also includes two veterinary medicine/animal care (VM/AC) industries — veterinary services and pet care except veterinary services — and industries that employ laboratory animal care workers such as zoos and botanical gardens, and academic institutions, pharmaceutical and biotechnology companies, and others. However, services provided by farmers, ranchers and other workers in animal production industries are not within the scope of the HCSA program.

Employment growth in the human healthcare industries is expected to account for nearly a third of the projected job growth for all industries from 2016 to 2026 – adding 4.0 million jobs during this period.2 Total employment is anticipated to reach 23 million (13.8% of U.S. workforce) by 2026.2 An estimated  544,000 people are employed in veterinary services, pet services, and zoos and botanical gardens. Veterinarians, veterinary technologists and technicians, and veterinary assistants and laboratory animal caretakers comprise the major occupations in these industries. Collectively, they are expected to grow more than 20% during 2016-2026.3

Healthcare support occupations (23%), and healthcare practitioners and technical occupations (15%) are projected to be among the fastest growing occupational groups during 2016-2026. These two broad occupational groups – which account for 14 of the 30 fastest growing occupations from 2016 to 2026 – are projected to contribute about one-fifth of all new jobs by 2026. The fastest growing healthcare support occupations between 2016 and 2026 include home health aides (47%) and personal care aides (39%). Healthcare practitioners and technical occupations with the fastest growth during this same period include physician assistants (37%), nurse practitioners (36%) and physical therapist assistants (31%).4 Factors such as the aging baby-boom population, longer life expectancies, and growing rates of chronic conditions will drive continued demand for healthcare services.2

Workers employed in industries covered by the HCSA program are at risk for injuries and illness because of lifting and repetitive tasks, long hours, changing shifts, violence (by patient or animal), stress, slippery or uneven walking surfaces, and exposure to infectious diseases and hazardous chemicals.

Research Areas

The HCSA Program works with partners in industry, labor, trade associations, professional organizations, and academia. The program focuses on these areas:

  • Reducing work-related injuries in priority areas, such as injuries caused by patients (human and animal), and among high risk populations, such as workers in home health care, nursing homes and veterinary medicine and animal care.
  • Reducing work-related illnesses and associated risk factors, including infectious, respiratory, dermal, and cardiovascular diseases, as well as cancer and adverse reproductive outcomes.

Research Activities

  • Disseminate useful prevention strategies for all affected workers. Reduce disparities through outreach to higher-risk, underserved and vulnerable worker populations.
  • Address knowledge gaps that are barriers to developing effective prevention strategies. Examples include determining risk factors for disease transmission and injury mechanisms.
  • Conduct surveillance for injuries, diseases, and risk factors. Provide findings to the research community, employers, workers, and other stakeholders to guide research and prevention efforts.
  • Develop and demonstrate effective methods of prevention. Make recommendations that can be used by professional healthcare organizations, employers, workers, and government agencies.


The HCSA Program collaborates and works closely with a broad spectrum of constituents representing this sector. Our stakeholders and customers represent industry, labor, academia, government agencies, non-governmental organizations, and professional organizations both domestic and international. These organizations may be research partners, users of our technology and scientific findings, peer reviewers, recipients of research grants and contracts, or sources of equipment, technology, or knowledge for advancing research in this sector.

For information about partnering with the NIOSH HCSA Program, contact the HCSA Program Coordinator. For general information about partnerships with NIOSH, contact the NIOSH Research to Practice Office (R2P).

Practical Solutions

The NIOSH program for the HCSA sector is committed to the development of practical solutions to the complex problems that cause occupational diseases, injuries, and fatalities among workers in this sector.

  • NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016 – NIOSH has updated its list of hazardous drugs. The 2016 update includes drugs reviewed from January 2012 to December 2013 and added 34 new drugs to the list. This document provides recommendations on personal protective equipment and engineering controls.
  • Workplace Violence Prevention Training for Nurses – This free, interactive course is designed to help healthcare workers better understand the scope and nature of violence in the workplace. Upon successful completion of the course, healthcare professionals can earn continuing education units.
  • Training for Nurses on Shift Work and Long Work Hours –The purpose of this online training program is to educate nurses and their managers about the health and safety risks associated with shift work, long work hours, and related workplace fatigue issues and relay strategies in the workplace and in the nurse’s personal life to reduce these risks.
  • Fast Facts: Home Healthcare Workers – Home healthcare workers allow patients to receive medical care in the comfort of their own homes, however, these workers are frequently exposed to a variety of potentially serious or even life-threatening hazards.
  • Health and Safety Practices Survey of Healthcare Workers  – Healthcare workers are potentially exposed to various hazardous chemicals. This survey evaluated how well best practices were followed for handling these chemicals and steps employers and employees can take to minimize exposure .
  • Health Hazard Evaluation (HHE) Program – NIOSH conducts HHEs at individual worksites to find out whether there are health hazards to employees caused by exposures or conditions in the workplace.


  1. BLS [2019] Current employment statistics – CES (National). Establishment data. Table B-1a. Employees on nonfarm payrolls by industry sector and selected industry detail, seasonally adjusted. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon
  2. BLS [2017]. Economic News Release Employment Projections: 2016-2026 Summary Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon.
  3. BLS [2018]. Occupational outlook handbook. Veterinarians, veterinary technologists and technicians, veterinary assistants, laboratory animal caretakers, and animal care and service workers. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon
  4. BLS [2018]. Occupational outlook handbook. Fastest growing occupations: 20 occupations with the highest percent change of employment between 2016-2026. Washington, DC: U.S. Department of Labor. Bureau of Labor Statistics. icon.
Page last reviewed: November 9, 2018