Labor unionization confers benefits for health care workers
Health care workers who were unionized in 2009 to 2021 earned better pay and benefits than those who were not, according to researchers. Despite this, rates of labor unionization were low.
There has been a recent resurge in labor unionization efforts in the United States, “with the National Labor Relations Board receiving a 57% increase in union election petitions in the first half of 2022,” Ahmed M. Ahmed, MPP, MSc, an MD candidate at Harvard Medical School, and colleagues wrote in JAMA.
“Workers in multiple industries, including those in health care, are unionizing to bargain for better pay, better noncash benefits, and safer work conditions,” they wrote. “For health care workers, the toll of the COVID-19 pandemic — including struggles obtaining personal protective equipment, inconsistent testing and notification of COVID-19-positive exposures, and inadequate pay with increased work hours — against the backdrop of increasing burnout prior to the pandemic has amplified calls for labor unionization to improve working conditions in the U.S. health care system.”
There is limited research on the prevalence and benefits of labor unionization among U.S. health care workers, according to Ahmed and colleagues. They conducted a cross-sectional study to better understand how health care unionization has changed over the years and the benefits that workers gain from unionizing.
The researchers analyzed data from 14,298 respondents — 81.5% of whom were women and 70.4% of whom were white with a mean age of 41.6 years — including 6,350 technicians and support staff, 4,931 nurses, 1,072 physicians and dentists, 981 advanced practitioners and 964 therapists.
After weighting, the researchers found that 13.2% (95% CI, 12.5-13.8) of respondents were involved in a union. There were no significant trends in unionization from 2009 through 2021.
Compared with white people, those who are part of underrepresented racial or ethnic groups were more likely to report being part of a union. People who resided in a metropolitan area were also more likely to report being part of a union.
The researchers found that unionization was linked to significantly higher weekly wages — $1,165 vs. $1,042 (95% CI, 88-157). It was also associated with a higher likelihood of having retirement benefits like pensions at work (57.9% vs. 43.4%; RR = 1.33; 95% CI, 1.26-1.41) and having full premium-covered, employer-sponsored health insurance (22.2% vs. 16.5%; RR = 1.35; 95% CI, 1.17-1.53).
Ahmed and colleagues also noted that union members reported slightly more work hours — 37.4 vs. 36.3, with a mean difference of 1.11 (95% CI, 0.46-1.75) per week.
Among nonunionized workers, the researchers noticed disparities. White people had significantly higher mean weekly wages than people of underrepresented racial and ethnic groups — $1,066 vs $1,001, with a mean difference of $65 (95% CI, 40-91).
However, among unionized workers, there was no significant difference between the two groups — $1,157 vs. $1,170, with a mean difference of $13 (95% CI, 78 to 52).
“The associated benefits of unionization are striking but not surprising,” Ahmed said in a press release. “Unions collectively bargain for their members, which appears to improve both employee compensation and pay gaps between workers.”
Xiaojuan Li, PhD, senior author and instructor in the department of population medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute, said in the release that future causal analysis of the relationships is needed.
“Given the toll of the COVID-19 pandemic on the health care workforce, investigating whether unionizing could help mitigate burnout will be important,” Li said in the release.
References:
- Ahmed AM, et al. JAMA. 2022;10.1001/jama.2022.22790.
- New study finds unionized health care workers earned better pay and benefits. https://www.eurekalert.org/news-releases/975191. Published Dec. 27, 2022. Accessed Jan. 4, 2023.