Wage Discrimination within Health care Professions: An Intersectional Analysis
Authors: Karbeah J.M. 
Published: August 2020

Research ObjectiveThe goal of this project was to analyze the degree to which gender discrimination and black‐white racial wage discrimination exist within the US health care workforce. Additionally, this project utilizes a critical race theoretical framework to explore how individuals with intersectional identities, specifically black women, are impacted by these wage differences.Study DesignOur project uses the 2010‐2018 pooled samples of the American Community Survey, a household survey conducted by the US Census Bureau and extracted using the Integrated Public Use Microdata (IPUMS) data tool. This study uses Blinder‐Oaxaca wage decomposition to analyze gender and race wage differentials. To analyze wage differentials, we used the Blinder‐Oaxaca decomposition method. To capture intersectionality, we conduct a series of specific decompositions to capture the reality of black women within the health care workforce. First, we ran a decomposition analysis to identify and quantify the degree to which individual endowments contribute to gender wage differentials at each earning level. Next, we ran a similar analysis to identify the cause of racial wage differentials. Next, we ran two analyses that compared (1) white men and black women and (2) black men with white women. Each decomposition took into account wage differences at each earning level. A series of robustness checks were also conducted to check the validity of our decomposition results.Population StudiedThis sample of over 1.5 million individuals includes all individuals who reported being employed within the health care industry. This sample excludes managers and those in administrative position but does include individuals from a broad range of earning levels and includes technicians as well as specialists and surgeons.Principal FindingsGender and racial wage differences do exist within the health care workforce. Our results show that only 67% of the differences in wages between white men and black women can be attributed to skill‐based differences. This finding suggests that 33% of this difference is unexplained and may be attributable to wage discrimination. However, we find that compared to white women, black men may be experiencing some forms of positive discrimination as skill‐based differences fail to account for the observed wage differentials. Overall, we see that black women have the lowest wages at all earning levels within our sample.ConclusionsThe analytic findings of this study confirm existing racial and gender wage disparities within the health care workforce. Our intersectional analyses suggest that black women are uniquely disadvantaged within the health care workforce. In order to achieve critical racism theoretical practice, it is important for the health care industry to not replicate the system disadvantage that people of color, and specifically black women experience in other aspects of our society.Implications for Policy or PracticeDiversifying the health care workforce is a stated priority for AHRQ and a necessary step in providing adequate care for our increasingly diverse patient populations. Attracting a retaining a diverse workforce requires the elimination of both gender and racial wage discrimination.Primary Funding SourceUniversity of Minnesota Interdisciplinary Predoctoral Fellowship.