Health care is one of the largest and fastest growing sectors in California’s economy due to a growing older adult population and health coverage expansions. Health careers can provide economic gains and security for workers without a four-year college degree—and meet essential needs for state residents. For both reasons, state leaders support developing training pathways for and broadening access to many health care jobs.

As the main publicly funded provider of job training, California’s community college system plays a central role given their wide range of program options, low tuition costs, and locations throughout the state. The largest community college health programs train people for jobs in nursing, dental care, behavioral health, and allied and technical fields. These represent the bulk of health care jobs (80%) that require some training beyond high school but less than a four-year degree. Workforce training organizations and private colleges also provide health training programs.

Most of these health occupations are projected to grow at higher rates than overall job growth in the state. They present job opportunities across all regions, and in most cases pay wages on par with median economy-wide levels and often well above. But not all training pathways yield the same results. And there are wide variations in who pursues different pathways across gender, age, and race/ethnicity.

How do health training pathways support economic mobility?

Different pathways have clear implications for future economic gains and career opportunities, affected by individual choices, program access, and broader workforce needs. Training providers highlight time commitments, financial needs, and family obligations as factors that affect the pathways Californians pursue.

Longer, more intensive programs that result in associate degrees afford high earnings returns—such as registered nursing, dental hygienist, and a few allied tech programs. They usually take several years to complete. Their earnings levels are well above average in all regions and can nearly double within six years of finishing a degree. Training providers articulate challenges to access due to prerequisite course requirements, capacity constraints, and high costs in some settings.

Mid-length programs lead to job opportunities with wages above average in most regions. These typically result in certificates that take between one and two years to complete—such as licensed vocational nursing (LVN) and psychiatric technicians. They often lead to better-paying jobs, but opportunities and wage levels vary across regions.

Shorter-term health programs take less than a year and often just a few months to complete. They most often lead to entry-level positions, such as nursing or medical assistants. Significant wage gains are unlikely unless people complete additional education to advance. Stacking credentials (i.e., using short training programs to enter the workforce, then return later for more training) can be effective at improving earnings trajectories. However, few individuals successfully complete higher-level credentials after finishing short-term programs.

Demand for these health jobs is expected to grow—but not uniformly. For example, some regions are projected to have shortages of registered nurses over the next decade. Others could have a more balanced supply. Some jobs—such as LVNs and respiratory therapists—may already have enough workers.

Women dominate community college health program enrollments. Health programs also enroll more students 25 and older compared to the community college student body overall. On average, men earning health credentials see smaller gains (about 60%) within six years than women (71%). Across racial/ethnic groups, white students’ gains are the largest—nearly 75 percent, followed by Latino (63%), Asian and Pacific Islander (58%), and Black students (55%).

How can policymakers and practitioners help?

Provide clear, accurate information early on. People pursuing health career pathways need accurate, actionable information about training requirements and job opportunities early. This will help to meet current and future workforce needs while improving economic security for workers.

Facilitate financial support and alleviate capacity constraints. Increasing flexibility in how, when, and where community colleges deliver training could help those with time and geographical constraints. It could also give students considering expensive for-profit private college health programs a more affordable option.

Provide reliable information about future hiring. Even in uncertain times, understanding broad trends can be useful for assessing the future. Statewide coordination to align industry needs and educational institutions—along with improved collaborations among stakeholders—could facilitate more reliable planning strategies.

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About the Authors

Shannon McConville is a senior fellow at the Public Policy Institute of California and a member of the PPIC Economic Policy Center. Her research interests include health care access, utilization, and outcomes among vulnerable populations and the impact of vocational training programs on economic mobility. Her current work focuses on examining safety net programs, assessing the effects of Medicaid coverage expansions on individuals involved with the criminal justice system, and analyzing the employment outcomes and economic returns of career technical education. Before joining PPIC, she was a research training fellow in the Health Services and Policy Analysis doctoral program at the University of California, Berkeley; a senior research associate at the Department of Health Research and Policy at Stanford University; and a project manager at the Lewis Center for Regional Policy Studies at the University of California, Los Angeles. She holds a master’s in public policy from the University of California, Los Angeles.

Daniel Payares-Montoya is a research associate at the Public Policy Institute of California. He is a member of the PPIC Economic Policy Center, and he also contributes to the PPIC Higher Education Center. His research focuses on expanding economic opportunity through the labor market, the relation between the labor market and higher education, income inequality, climate-related jobs, and economic development. Before joining PPIC, he worked as a consultant for the World Bank, concentrating on green growth and green finance in developing countries, and as a researcher at the Center for Latin American Studies, University of California Berkeley, focusing on the socio-economic impact of globalization and industrialization in the Americas. He has also conducted research on productivity, education, and labor markets for Fedesarrollo, the Private Council on Competitiveness, and Proantioquia Foundation in Colombia. He holds a master’s degree in public policy from Universidad de Chile and a master’s degree in development practice from the University of California, Berkeley.

Sarah Bohn is vice president and director of the PPIC Economic Policy Center and senior fellow at the Public Policy Institute of California, where she holds the John and Louise Bryson chair in policy research. She is also a member of the PPIC Higher Education Center. As the founding director of the PPIC Economic Policy Center, she leads research and engagement to inform California policymaking to support greater opportunity and upward mobility for workers, families, and businesses statewide. A labor economist, her research focuses on the job market, workforce skills, and the role of education and government programs in upward mobility. Her other areas of expertise include immigration policy, poverty measurement, income inequality, and career technical education. Her work has been published in major academic journals, including the American Economic Review, Demography, American Economic Journal: Economic Policy, and The Review of Economics and Statistics. Previously she served as vice president of research at PPIC. She holds a PhD in economics from the University of Maryland, College Park.

Chansonette Buck is the owner and executive editor of Appaloosa WordCraft, which provides research, writing, and editing for a wide range of organizational clients—including public policy think tanks and nonprofits. She is also an award-winning poet. She holds a PhD in English from the University of California, Berkeley.