University Times

More than one of every 10 working people in the Pittsburgh region is employed in health care. But the advent of managed care and certain advances in medical practice have changed the health care industry and slowed the employment boom that characterized it in the 1980s, according to a report issued by the Health Policy Institute (HPI) at the Graduate School of Public Health.

HPI, established in 1980, conducts analyses and studies to help inform and shape policies and decisions that influence health care in the region. The report, authored by Jeanne Black, associate director of HPI, found that between 1994 and 1996 more jobs were lost in hospitals than were created in other health care settings such as nursing homes, physicians' offices and in-home care. "Policy makers in Pittsburgh are faced with the pressure to spur economic development and create jobs for this region," commented Black. "One of their strategies in doing that is to reduce health care costs faced by employers. However, they also need to understand the impact on health care employment.

"Although some health care opportunities are shifting out of urban hospitals and into other health care settings in the region, in Allegheny County there are not enough new jobs being created to compensate," she continued. "This shift also impacts the wages and benefits of health care workers." Most positions in a nonhospital setting pay lower wages and offer fewer benefits than those in a hospital. For instance, aides in nursing homes made $3.75 per hour less than their in-hospital counterparts, according to a national study cited in the report. "The greatest impact is felt for lower-income workers and minorities," Black stated.

Nationally, one of every 10 employed African American women is a health care aide, housekeeper or food service worker. Nonhospital settings require fewer support staff. Health care aides and nurses who do not have access to reliable or convenient transportation to suburban areas may not be able to obtain new employment in home care or physicians' offices. Also, there is no indication that the shifting of jobs from urban hospitals to nonhospital settings will cease anytime soon, according to Black. The region already has too many hospital beds and high health care expenditures, both exceeding the national average. In fact, data collected by Black through 1997, but not published in the report, show that 2,000 more hospital jobs were eliminated in Allegheny County, bringing the total reduction since 1994 to 6,500.

"If a corporation or manufacturing firm announced a layoff of thousands of workers, state and federal funds would be mobilized to provide retraining and placement programs," remarked Black. "We have more than 6,500 displaced health care workers in Allegheny County, and we need to determine what can be done to help them." The HPI report is the first to analyze health care employment data for each county in the Pittsburgh region. To obtain a copy of the report, call Linda Kalcevic at 624-6104.