Food insecurity a significant problem among low-wage health care workers, study finds

Health care providers and policymakers regard access to adequate and nutritional food as one of the major factors affecting an individual’s health. But a new study finds troubling rates of limited or uncertain access to food—food insecurity—within the health care industry itself, especially among low-skill, low-wage employees.

The study looked at food insecurity among 5,500 people working in a variety of health care settings from 2013 to 2018. Subjects were grouped into three occupational categories: health diagnosing and treating practitioners, health technologists and technicians, and health care support workers. It found that while the overall rate of food insecurity was less than for the country as a whole (6.6% versus 10.5% in 2019), among health care support workers—a category that includes about one in five of all those employed in the industry—the rate was nearly 20%. For support workers in nursing and residential care facilities, the rate was close to 23%.

The authors attribute the differing rates of food insecurity among health care providers to income disparities in the industry, with doctors and nurses earning much more than health care support workers.

In addition, they say, wages in hospital settings generally are higher than in nursing or home residential settings. They cite the 2020 median annual wage for nursing assistants, which was $32,160 in hospitals compared with $30,120 in a skilled nursing facility.

The authors note that many characteristics of low-wage health care workers are similar to those of people at greatest risk for food insecurity among the general population. Women, who make up 76.4% of the health care workforce, are significantly overrepresented, and Black, Latina and Native American women are more likely than white women to work in low-wage positions.

Moreover, workers in low-wage positions are also more likely to work irregular hours or be in per-diem or contract positions, which may put them at additional risk for food insecurity.

The fact that a significant number of those employed in health care support positions experience food insecurity has important policy implications, the authors point out. The health care industry is the largest employer in the U.S., and the long-term care sector of the industry is expected to grow rapidly as the population ages and policies and financial incentives promoting community-based care are implemented. Without adequate nourishment, they say, health care employees could have difficulty providing high-quality care.

That is especially the case for people in support positions, given that their responsibilities often are both physically demanding—helping patients with tasks such as using the toilet, bathing and walking—and psychologically stressful.

To reduce food insecurity among this cohort, the authors recommend implementing a $15 minimum wage and/or adopting more equitable human resource policies, such as benefit packages that maximize take-home pay and a sliding scale for health insurance coverage.

The study, “Food Insecurity Among Health Care Workers in the US,” appears in the September issue of Health Affairs.