Community health worker pay gap: Women and people of color earn less than their male and white counterparts

The new study by PJ Maddox and Tammie Jones also found that community health worker salaries are higher in states with certification programs.

The ability of community health workers (CHWs) to address the social determinants of health and support access to primary and preventive health programs has made them an increasingly important part of public health, which has led to increased employment for CHW. The US Bureau of Labor Statistics has projected a 21% increase in CHW jobs (approximately 13,500) by 2030, a much faster growth rate than the average for all US occupations. Given the increase in employment, the Mason researchers sought to determine how wages have changed due to certification, job turnover, and funding policies that may affect wages or turnover.

A recent study by Tammie Jones, assistant professor in the Department of Health Administration and Policy (HAP), and PJ Maddox, chair of the HAP Department, found that wage gaps exist between white and non-white CHWs and between men and CHW women. Additionally, wages are higher in states with certification programs.

“Our study found that after the addition of certification standards, hourly wages increased among white workers, men, and part-time workers, and increases for men were four times greater than increases for women,” Jones said. “While an increase in hourly wages is a positive thing for this field, the majority of community health workers are people of color and women who should be compensated equally.”

Hourly wages for people who identify as white were $2.72 higher and $5.16 higher for men. According to a study by the Health Resources and Services Administration, 54.5% of CHWs 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 states with early certification programs, wages increased by $14.46. The researchers did not find a statistically significant effect on occupational turnover in certification states. 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 support 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 CHW- according to their value,” he says. Maddox, the lead investigator.

CHW is an umbrella term for frontline public health workers with deep knowledge and understanding of the community they serve. They are generally recognized as uniquely capable of identifying problems that contribute to health disparities, improving access to health services, and connecting people with needed social services.

“Hourly Wages and Turnover of Community Health Workers by US State Certification and Medicaid Reimbursement Policy, 2010–2021” was published online at American Journal of Public Health in August 2022. In addition to Maddox and Jones, other authors include Alex Schulte and Charlotte M. Lewis of Mason’s Center for Health Workforce; and Chanup Jeung, a Mason Ph.D. in Health Services degree now at the University of Massachusetts Amherst.

The research was funded in part by the Claude Moore Charitable Foundation. A difference-in-differences nested design was used to compare wages and turnover of CHWs in states with and without CHW certification or CHW Medicaid reimbursement policies. The data is drawn from the 2010-2021 United States Current Population Survey.

Maddox and Jones have previously studied CHWs and found that state regulations are associated with greater adoption of professional standards. Learn more about their research here.

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