PPIC Logo Independent, objective, nonpartisan research
Press Release · September 18, 2014

Growing Need for Allied Health Care Workers in Next Decade

190,000 New California Jobs Will Require Training But No Bachelor's Degree

SAN FRANCISCO, September 18, 2014—Over the next decade, California is expected to need nearly 450,000 new health care workers—due in part to expanded coverage under the Affordable Care Act but mainly to the growth and aging of the state’s population. About 190,000, or around 40 percent, of the new jobs are expected to require some college education but not a bachelor’s degree. To meet these workforce needs, California’s two-year educational institutions need to expand training opportunities for these positions, known as allied health care jobs.

These are among the key findings in a report released today by the Public Policy Institute of California (PPIC).

Allied health care jobs are technical—licensed vocational nurses, dental hygienists, and imaging technologists, for example—and support positions, such as certified nursing assistants, medical assistants, and dental assistants. They typically require an associate degree or post-secondary certificate that can often be completed in fewer than two years.

California’s community colleges have an important role to play in training the allied health care workforce. They are located throughout the state and serve a large and diverse student population. The PPIC report notes that this diversity is especially important in light of research showing that a culturally competent workforce is crucial to quality health care. The percentage of Californians age 65 and older is expected not only to grow nearly 50 percent by 2025 but to become more diverse as well: California’s Latino and Asian populations in this age group are projected to increase by 85 percent and 66 percent, respectively.

“Given the importance of associate degrees and postsecondary certificates in health care occupations—and the need for workers who can effectively serve California’s increasingly diverse population—the state needs to ensure that its institutions are meeting workforce demand and providing good job opportunities,” said Laurel Beck, PPIC research fellow and report co-author.

However, the number of associate degrees and postsecondary certificates in health programs awarded by the community colleges has increased only slightly in the past decade. Most of these additional degrees have been in nursing.

Private for-profit institutions have driven the recent growth in the number of associate degrees and postsecondary certificates in health programs. These institutions serve a large number of black and Latino students, but they do so at a considerably higher cost than community colleges. Tuition and fees for a licensed vocational nurse certificate program at a group of for-profit institutions ranged from $20,000 to $35,000. The total cost of the same program at community colleges is about $4,500.

For-profit schools are also more likely to offer programs in health care support fields, which tend to have lower wages. For example, nearly 40 percent of the health care certificates awarded by these schools go to medical assistants—one of relatively few health occupations with a projected surplus over the next several years. The report notes that this mismatch between training and future workforce demand is a cause for concern.

California can address the need for more allied health care workers in a number of ways. First, state and regional policymakers must have high-quality, integrated, and timely data to plan and make educational investments. Linking employment and wage information with educational opportunities is essential to ensuring that the state can train an adequate number of workers to meet future needs.

The community colleges can play a bigger training role by expanding access to health care programs, although this will be a challenge given the high cost of technical courses and college budgets that fluctuate from year to year. The colleges can strengthen outreach and mentoring for students from ethnic and racial groups underrepresented in health care professions. However, broadening access to training and diversifying the student populations in health programs are unlikely to meet workforce needs unless steps are also taken to ensure student success, an issue the colleges are now addressing.

The report points to the success of the state’s Nurse Education Initiative as evidence that strong state action—including financial investment—can help increase the supply of health workers in a relatively short time. Between 2005 and the end of 2009, when California faced a dramatic shortage of nurses, the number of students enrolled in nursing programs increased by more than 75 percent and 35 new nursing programs were established.

“The health care workforce is important to the state’s economy,” said Beck. “With careful planning and investment, the state can meet its health care needs and provide opportunities to Californians of all backgrounds for good jobs with good wages.”

The report is titled California’s Health Workforce Needs: Training Allied Workers. In addition to Beck, the co-authors are Shannon McConville, PPIC research associate, and Sarah Bohn, PPIC research fellow.


PPIC is dedicated to informing and improving public policy in California through independent, objective, nonpartisan research on major economic, social, and political issues. The institute was established in 1994 with an endowment from William R. Hewlett. PPIC does not take or support positions on any ballot measure or on any local, state, or federal legislation, nor does it endorse, support, or oppose any political parties or candidates for public office.