Oregon needs to improve the supply and distribution of health care providers, enhance the resiliency and well-being of health care workers and increase diversity among the health care workforce to provide more culturally and linguistically responsive care, a new report by Oregon State University public health researchers found.
The report was developed by OSU for the Oregon Health Policy Board as part of a contract with the Oregon Health Authority, fulfilling a 2017 law that requires biennial assessment of the state’s health care workforce for the purpose of informing the state Legislature.
It includes recommendations for how state agencies and legislators can address the most pressing problems.
A dire picture of health care
Though the findings were not surprising, they did paint a dire picture, says lead author Tao Li, an assistant professor in OSU’s College of Public Health and Human Sciences.
“We all understood that burnout among health care providers would be high, especially during the pandemic,” says Tao, who also holds a medical degree.
“When we really dug into the report and compiled the existing data from different areas, we noted that wow, there is a severe health care crisis. Health care workers really need support, because the burnout level is just higher than I expected.”
Co-authors on the report were OSU associate professors Jeff Luck and Veronica Irvin, health policy doctoral student Collin Peterson and research analyst Alex Kaiser.
Good health care starts with the health care workforce
The 111-page report discusses how the health care sector saw significant job losses during the first two years of the pandemic, which have been largely regained over the past year, and how employment trends varied within the health care sector.
However, Tao says, researchers do not yet have enough data to analyze the long-term physical and emotional impacts the pandemic has had on providers.
“If we want to make sure that everyone in Oregon can get good health care, we definitely need to invest in the strong foundation of the health care workforce,” he says.
“When they don’t get enough support and they get burned out, it will have many negative consequences — it will cost us money and quality of care. We need to address this problem, both nationally and in Oregon.”
Recommendations to reduce health inequities
The report’s recommendations are grouped into seven main categories. Along with calls to improve the supply, distribution, diversity and resiliency of health care workers, researchers highlight the need to expand and clarify career pathways and training for many segments of the workforce.
They also recommend expanding telehealth and integrated care models and increasing the use of community-based care providers like health interpreters and peer wellness specialists to connect on a more personal level with their local communities.
“We believe all health care professionals need more support around resiliency and well-being, and many professionals with unclear career pathways need clearer pathways. And some professionals will need increased compensation,” Tao says. “These are the three things we would like to prioritize.”
These priorities align with the overall goal of the biennial health care workforce report, which is to eliminate health inequities altogether, Tao said.
Structural change is needed
The well-being of all health care providers is interconnected, such that negative experiences for one type of provider have a domino effect on other providers, he says. For instance, if a physician quits, all their responsibilities and heavy lifting shift to the nurses.
Health care workers need greater structural supports like more flexibility in scheduling, more available and affordable child care and a reduction in administrative paperwork, the report found.
Less tangible workplace supports such as showing providers that their work is valued were also important.
Larger socioeconomic forces compound the pressures health care workers are facing, such as housing affordability, availability of quality education for workers’ children and employment opportunities for workers’ partners and spouses, Tao says.
“To address the health care workforce crisis, it’s not something one sector can do,” he says. “Government and nongovernmental entities from different areas need to work together.”
Our report provides insights into health care workforce needs in communities across Oregon as well as general guidance on how to expand and diversify the health care workforce to meet the needs of patients and communities throughout Oregon and eliminate health inequities.
Workforce shortages and lack of diversity in many areas of the health care workforce are a national problems experienced in Oregon, stemming from historic underinvestment, current economic and social forces, and systemic racism.
There are barriers to entry and advancement for people of color in the health care workforce, and to receiving culturally and linguistically responsive care for people experiencing health inequities.
In order to stabilize, expand and diversify Oregon’s health care workforce so that it can deliver culturally responsive, effective health care services to all:
- Some professions need increased compensation to attract new individuals and increase retention
- Many professions with unclear career pathways need better, focused paths for increasing skills, pay, and impact
- All professions need more support around resiliency and well-being
All the report’s recommendations warrant action by government and non-governmental entities to ensure Oregon has the workforce it needs to deliver on the commitments of optimal health for everyone and the elimination of health inequities.