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New study from PJ Maddox and Tammie Jones also found that community health worker wages are higher in states with certification programs.
Community health workers' (CHW) ability to address social determinants of health and support access to primary and preventive health programs have made them an increasingly crucial part of public health, which has led to increased employment for CHW. The U.S. Bureau of Labor Statistics has projected a 21% increase in CHW jobs (approximately 13,500) by 2030, a rate of growth much faster than the average for all U.S. occupations. Given the increase in employment, Mason researchers sought to determine how wages have changed due to certification, labor turnover, and funding policies that might influence wages or turnover.
A recent study from Tammie Jones, assistant professor in the Department of Health Administration and Policy (HAP), and P.J. Maddox, chair of the HAP Department, found that wage gaps exist between White and non-White CHW and between men and women CHW. Additionally, wages are higher in states with certification programs.
“Our study found that after adding certification standards hourly wages increase among white workers, men, and part-time workers, and increases for men were four times more than increases for women,” said Jones. “Though 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 equitably.”
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 CHW identify as Hispanic or Black and 82% identify as female.
CHW wages increased by $2.42 more per hour in states with certification programs than in states without programs, and in the states with the first certification programs, wages increased by $14.46. Researchers did not find a statistically significant effect on occupational turnover in states with certification. Medicaid reimbursement was not found to have a significant effect on wages 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 equitable wages that compensate CHWs according to their value,” says Maddox, the principal investigator.
CHW is a general term for frontline public health workers with deep knowledge and understanding of the community they serve. They are generally recognized as uniquely able to identify problems contributing to health disparities, improve access to health services, and connect people to needed social services.
“Hourly Wages and Turnover of Community Health Workers According to US State Certification Policy and Medicaid Reimbursement, 2010–2021” was 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 from Mason’s Center for Health Workforce; and Chanup Jeung, a Mason Ph.D. in Health Services alumnus now at the University of Massachusetts Amherst.
The research was partially funded by the Claude Moore Charitable Foundation. A staggered difference-in-differences design was used to compare wages and turnover of CHWs in states with and without CHW certification or CHW Medicaid reimbursement policies. Data were derived from the 2010 to 2021 Current Population Survey in the United States.
Maddox and Jones have previously studied CHW and found that state regulations are associated with greater adoption of occupational standards. Learn more about their research here.