California’s health care employment sector is one of the state’s largest and fastest growing—at over 2.4 million in 2024 it represented more than 13% of total jobs. Several health-care occupations yield relatively high wages compared to others, yet do not require four-year degrees. The state’s community colleges are the primary public training provider for these pathways. At a recent event, PPIC senior fellow Shannon McConville shared findings from a new study exploring how various training pathways in this sector can promote economic mobility.
“The type of program, the length of training, and the pathway that they choose really [are] critical … in determining how much economic gain a person will be able to achieve through health training programs,” McConville said. Community college training providers interviewed for the report stressed that students were motivated by the certification—especially when training included clinical internships—because it gave them clarity about potential jobs and employers.
The top earning pathways are for careers in registered nursing, dental hygienist, respiratory therapy, and radiological tech. These occupations tend to pay over $60/hour, and qualified workers can more than double their prior income within six years. But these fields require an associate’s degree that can take several years to attain because of prerequisites, program availability (especially in the community colleges), and other factors. As McConville put it “the more intensive programs…yield very high returns, but they also are the more difficult to access and complete.”
Registered nursing programs are by far the most sought after at community colleges, but interviews revealed that “one of the most common themes was…limited capacity and long waiting lists.” The fact that more than 70% of students in these high-return programs are at least 25 years or older strongly suggests they have had to wait, and may have family and other obligations that slow them down. Community college career counselors reported that some students committed to earning a nursing degree at their local community colleges might have to wait years. During that time “life happens and then they’re not able to do that program.”
Private for-profit institutions confer the vast majority of sub-baccalaureate health-care credentials in the state. These institutions can cost many times more than a community college, and loan repayment may hinder economic mobility after graduation. Nevertheless, private for-profit training has some advantages: it is more widely available in some places, most students receive financial aid, and students can often complete programs more quickly.
Completing medium-return programs for jobs such as licensed vocational nurses and paramedics can also result in substantial wage gains—about 40% more. These often require a certificate that takes one to two years of full-time enrollment to complete. As with the high-yield training, this can be a difficult time commitment depending on students’ circumstances.
Short-term programs for jobs like medical assisting, certified nursing assistants and emergency medical technicians can often take just a few months to complete. But, McConville said, “we don’t find much of an economic boost” for those who complete the training. Although these short-term programs can be built on by coming back to school and completing additional training, only about one in five people return and successfully complete another health credential to move up the career ladder.
“We really do see several of these health training programs that offer post-secondary training for health care jobs can improve people’s economic trajectories,” McConville concluded. “But supporting people through various means—whether that’s financial, childcare, or other obligations—could help more workers advance, and perhaps return to complete additional training if they do start out in a shorter-term program.”
