Share of Unionized Healthcare Workers Remained Low for 12 Years

Over the last 12 years, the share of unionized healthcare workers remained stable at 13.2 percent, with nurses, older workers, and those working full-time more likely to report being unionized, according to a JAMA study.

The COVID-19 pandemic kickstarted a resurgence of labor unionization efforts, especially among healthcare professionals. Workers have started to unionize more frequently in 2022, calling for better pay, safer work conditions, and better noncash benefits.

Specifically, healthcare workers have faced challenges with personal protective equipment shortages, inconsistent testing and notification of COVID-19 exposures, inadequate pay for increased hours, and physician burnout during the pandemic.

Researchers used data from the US Census Bureau’s Current Population Survey (CPS) and Annual Social and Economic Supplement (ASEC) to determine the prevalence of labor unionization among healthcare workers between 2009 and 2021 and its impact on employee pay, benefits, and work hours.

The sample included 14,298 healthcare workers, comprised of physicians, dentists, advanced practitioners, nurses, therapists, technicians, and support staff.

Overall, 1,787 healthcare workers (12.5 percent) reported being unionized. The majority (88.2 percent) reported being labor union members, while 11.8 percent were covered by a labor union but were not members.

After survey weighting, 13.2 percent of healthcare workers reported being unionized, with the reported prevalence remaining unchanged across the study period.

Certain factors impacted the likelihood of unionization among healthcare workers, the study found.

Older workers were more likely to report being unionized compared to younger workers. For example, the share of unionized healthcare workers was 8.9 percent among workers between 15 and 29, compared to 14 percent among those aged 30 to 44, 15.2 percent among those aged 45 to 59, and 14.5 percent among those aged 60 years or older.

Racial and ethnic minorities were also more likely to be unionized than non-Hispanic White workers, with 21.7 percent of Asian workers, 14.8 percent of non-Hispanic Black workers, and 13.9 percent of Hispanic workers reporting being in a union.

Unionization was more common among healthcare workers living in the Northeast, the West, and metropolitan areas, compared to workers in the South, the Midwest, and rural areas.

Among the different healthcare occupations, nurses had the highest prevalence of unionization, with 17.5 percent reporting being unionized. In contrast, 9.8 percent of physicians and dentists and 9.9 percent of technicians and support staff reported being unionized.

Full-time healthcare workers (14.1 percent) and those working in the public sector (33.5 percent) were also more likely to report being unionized than part-time workers (10.3 percent) and workers in the private sector (10.6 percent).

Unionization was associated with better pay and benefits, researchers found. For example, unionized healthcare workers ($1,165) reported significantly higher mean weekly earnings than nonunion workers ($1,042).

Unionized workers were also more likely to report having a pension or other retirement benefits than nonunion workers (57.9 percent versus 43.4 percent). In addition, 22 percent of unionized workers reported having a health insurance plan their employer paid for, compared to 16.5 percent of nonunion workers.

However, healthcare workers in a union (37.4 hours) reported more weekly work hours than nonunion workers (36.3 hours).

While healthcare worker unionization remained low between 2009 and 2021, unionization efforts rebounded in 2022.

In June, the Central Oregon Providers Network (COPN) filed for union representation amid a financial crisis stemming from poor choices made before and during the pandemic. Around 300 healthcare workers at St. Charles Medical Group, represented by COPN, were seeking union representation to increase provider input in managerial decision-making.