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— Want to find robust good health? Go to a doctor's office or a hospital. The patients may be sick, but health-care employment is doing very, very well. According to a study by Business Week magazine, in the last five years, health-care jobs in the nation have soared while the rest of the private sector has gone nowhere. That's not true in San Diego: health care did moderately well over the same period, but so did the rest of the private sector.

Business Week found that since 2001, the health-care sector nationally added 1.7 million jobs. Construction and real estate added 940,000, but the rest of the private sector lost 1.2 million, as computer, electronic, and telecom employers shed jobs. Without health care, "the nation's labor market would be in a deep coma," says the magazine.

At my request, Cheryl Mason of San Diego Association of Governments got comparable information for San Diego: annual average employment from July 2001 to July 2006 in health care and all other private-sector categories. Health-care jobs rose 6.2 percent to almost 150,000, providing 10 percent of overall employment growth. Health-care categories include bioscience, testing labs, social assistance, and health and medical insurance.

Not surprisingly, the big winner was construction and real estate, with a whopping 21.1 percent rise to 164,600 jobs. It provided a stunning 35 percent of job growth during that period. The number of construction workers zoomed 36.6 percent, while loan brokers soared 114.3 percent. But the construction/real estate sector is going to recede, probably sharply, as housing sales and prices come down -- leaving San Diego double-domes to ponder how to replace an economic juggernaut that has been providing more than one-third of job growth.

Where San Diego differed from the rest of the country in 2001 to 2006 was in the category of non-health-care private-sector employment. Unlike in the United States overall, non-health-care jobs rose moderately, rising 5.9 percent to 781,000, providing 53 percent of growth in the last five years.

San Diego had some non-health-care strengths that the nation didn't enjoy. One was tourism jobs: up 17.2 percent in the five years to 153,800 jobs. Another was retail, up 10.7 percent to 114,500 jobs. Wholesale was up 10.9 percent to 44,900. However, Alan Gin, economist at the University of San Diego, says that retail slowed in the last two years.

San Diego suffered tech/telecom job losses, as the nation did, although not as severely because dot-com employment was never as giddily high in San Diego as in some places such as Silicon Valley. Computer and electronics employment dropped 20.3 percent in the last five years. Infotech employment was down 7.7 percent and telecom down 3.5 percent.

In the health-care sector, there were only two losers: biomed manufacturing (such as certain health-care equipment), down 21.8 percent, and biotech, which despite all the ballyhoo and the stock market excitement, dropped 8.9 percent to only 4100 jobs. Even with some closures, problems such as at Alvarado, and declining profitability, hospital employment grew 9.4 percent to 24,500. Ambulatory health-care services gained 8.4 percent to 44,100 jobs, the largest employer in the health-care segment. (This category includes ambulance services. It's little wonder, then, that in the non-health-care sector, legal services were up 10.2 percent. This statistical correlation suggests that lawyers indeed deserve to be called ambulance chasers.)

Economic and demographic factors favor continued growth in the health-care sector. "The demographics are absolutely on the side of continued growth in health-care jobs," says Ross Starr, economist at the University of California, San Diego. "In the next four to five years, the first wave of baby boomers qualifies for Medicare. There will be embarrassments of running out of Medicare trust funds; you can expect Congress and the Treasury to have to deal with that." It's true that financially strapped corporations are cutting back health benefits. Medical technology is advancing rapidly, and patients spend much less time in hospitals. But overall, "You can expect more health-care employment. It would take a revolution in medical technology or medical finance to reverse that." And with great strides being made at medical centers such as at his own university, San Diego should capture much of that employment growth.

Gin expects health-care employment to rise as the population ages, life expectancy increases, and more older people retire to San Diego. Over the short-term, non-health-care employment will slow. "Construction and real estate jobs will decline," says Gin. Tourism job growth will slow as the nation's economy weakens and fewer people travel here. Long-term, tourism will recover. Retail will pick up again, but it won't be fired by folly -- that is, people living the California lifestyle by borrowing on the artificial increase in their homes' values.

The good news for job seekers is that labor shortages are worsening in the health-care sector, according to a study this year by the San Diego Workforce Partnership. In coming years, the shortages will intensify for registered nurses, dental hygienists, dental assistants, licensed practical and vocational nurses, cardiovascular technologists and technicians, home health aides, radiologic technologists and technicians, and speech-language pathologists.

Happily, the laws of supply and demand seem to be working. The local study points out that the San Diego region has only one program for training dental hygienists, and such training costs a bundle. That's one reason there is a shortage of them. In 2004, the median wage of all those in health-care occupations was just under $38,000. But dental hygienists were making $87,445 a year, tops among the categories. Registered nurses, also in short supply, were making $60,521. Speech-language pathologists were bringing in $64,665.

It pays to be in an undersupplied occupation. But does it pay enough? In San Diego these days, $60,000 a year won't bring you an aristocrat's perquisites.

But San Diego's high cost of living -- 50 percent above the nation's -- isn't the only cause of the shortage. "The people in our school of nursing and health science say there is a shortage nationwide, not just in high-cost places like San Diego," says Gin. "They just can't recruit sufficient faculty to teach the nurses."

And nurses are in such a demanding profession that burnout is rife and turnover high.

All in all, health-care jobs look poised to expand as a bigger and bigger piece of San Diego employment. The question is whether there will be the trained people to fill the jobs.

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