Health Workforce Research e-Library

This brief contains highlights of workforce projections for the nursing workforce in the United States. These estimates were generated using HRSA’s Health Workforce Simulation Model (HWSM) and start with the year 2021 and go through 2036. The primary function of the HWSM is to assess the adequacy of the nation’s projected workforce supply to meet the demand.

This report summarizes the results of a retrospective evaluation of the Children’s Hospitals Graduate Medical Education Payment Program (CHGME) program from Academic Year (AY) 2018-2023, which also includes a descriptive summary of accomplishments for those who received CHGME support during AY 2022-2023. The CHGME provides federal funds to the nation’s freestanding children's hospitals to help maintain their graduate medical education programs. Funding supports the education and training of residents and enhances their ability to care for low-income patients.

This report summarizes the results of a retrospective outcome and cost-effectiveness evaluation on the Medical Student Education (MSE) program from Academic Years (AY) 2019-2023. In Fiscal Year 2019, HRSA initiated the MSE program to increase the supply of primary care physicians who practice in underserved communities in states with the highest projected shortages of primary care physicians and with high proportions of federally recognized tribes. Qualifying states included Alabama, Arkansas, Indiana, Kentucky, Mississippi, Missouri, Oklahoma, and Utah. The program prepared and encouraged medical students training in the most underserved states to choose residencies and careers in primary care that serve tribal communities, rural communities, and/or medically underserved communities after they graduate.

This report summarizes the results of a retrospective evaluation of the characteristics and accomplishments of Community Health Worker and Health Support Worker Training Program (CHWTP) trainees during Academic Year (AY) 2022-2023. In Fiscal Year 2022, HRSA funded a three-year CHWTP to expand the public health workforce by training new and existing community health workers (CHWs) and other health support workers. Through didactic instruction and hands-on training via field placement and apprenticeships, individuals trained in the CHWTP develop the knowledge, skills, and expertise to support essential public health services in underserved communities and to increase access to care.

The Clinicians and Diversity Dashboards allow users to visualize data on various health professions at the county and state levels. The dashboards are developed using data from HRSA’s Area Health Resources Files (AHRF).

The Nursing Workforce Dashboard is an interactive dashboard that visualizes data from the 2022 and 2018 National Sample Survey of Registered Nurses (NSSRN) to facilitate understanding of the landscape and challenges of the nursing workforce.

This report summarizes the results of a retrospective evaluation of the first three years of the Addiction Medicine Fellowship (AMF) program, Academic Years (AY) 2020-2023. The AMF program was established in Fiscal Year (FY) 2020 to increase the number of addiction medicine specialists who work in underserved, community-based settings that integrate primary care with mental health and substance use disorder (SUD) prevention and treatment services. To accomplish this, AMF provides stipends to fill new addiction medicine and addition psychiatry fellowship slots at accredited addiction medicine fellowship programs. The AMF program enhances training by establishing close collaborations with community-based partners to provide experiential training opportunities in underserved areas and in community-based settings.

High-quality health care starts with a well-trained, adequately supplied, and well-distributed health care workforce. This report provides detailed data on the occupations within three major health care disciplines in the U.S. health care workforce: medicine, nursing, and oral health. For these critical occupations, this brief presents the most recent data on adequacy, distribution, and the educational pipeline of these future health care providers. It also provides summary data for additional health care disciplines, including behavioral health, allied health, and health support occupations. Finally, this report examines recent changes in the U.S. health care system and care delivery, such as the rise of telehealth and other technological innovations, and how these changes have impacted the health care workforce.

This report summarizes the results of a retrospective evaluation of the Teaching Health Center Graduate Medical Education (THCGME) program for Academic Years (AY) 2018-2023. It also includes a descriptive summary of accomplishments for those who received THCGME support during AY 2022-2023, as well as select outcomes that reflect all 12 years of the program (AY 2011-2023). The THCGME program bolsters the primary care workforce through support for new and expanded primary care physician and dental residency programs, as well as improves the distribution of this workforce into needed areas through an emphasis on underserved communities and populations. In addition to increasing the number of primary care residents training in community-based patient care settings, the THCGME program seeks to increase health care quality and overall access to care.

The Workforce Projections Dashboard is an interactive dashboard that shows projections of the supply of and demand for healthcare workers across the United States.

This report summarizes the results of a retrospective evaluation of the first four years of the Primary Care Training and Enhancement - Physician Assistant (PCTE-PA) program, Academic Years (AY) 2019-2023. HRSA established the PCTE-PA program in Fiscal Year 2019 to improve primary care training and to strengthen access to primary care services. This program prepares physician assistants (PAs) to practice in primary care settings, particularly in medically underserved communities and rural areas. To achieve these goals, the PCTE-PA program recruits individuals from underserved areas and veterans; offers experiential training opportunities in underserved settings; and trains PAs on key topics such as opioid and other substance use disorder treatment, integrating behavioral health into primary care, and improving provider wellness. These activities improve access to and delivery of primary care services as well as improve the quality-of-care future PAs provide.

This report summarizes the results of a retrospective outcome evaluation on the entire grant period of the Opioid Workforce Expansion Program (OWEP) Paraprofessionals program, which was administered during Academic Years (AY) 2019-2023, including the program’s influence on the supply and distribution of the behavioral health workforce. In response to the opioid epidemic HRSA established the OWEP in Fiscal Year (FY) 2019. OWEP aimed to increase the number of behavioral health workers in underserved areas who were prepared to deliver integrated, interdisciplinary opioid use disorder (OUD) and other substance use disorder (SUD) prevention, treatment support, and recovery support services. Through two parallel programs, OWEP enhanced community-based experiential training for behavioral health professions such as addiction counselors, psychologists, and social workers (OWEP Professionals program), and paraprofessional students, including community health workers, behavioral health technicians, and outreach workers (OWEP Paraprofessionals program).

This report summarizes the results of a retrospective outcome evaluation covering the entire grant period of the Opioid Workforce Expansion Program (OWEP) Professionals program, which was administered during Academic Years (AY) 2019-2023.In response to the opioid epidemic HRSA established the OWEP in Fiscal Year (FY) 2019. OWEP aimed to increase the number of behavioral health workers in underserved areas who were prepared to deliver integrated, interdisciplinary opioid use disorder (OUD) and other substance use disorder (SUD) prevention, treatment support, and recovery support services. Through two parallel programs, OWEP enhanced community-based experiential training for behavioral health professions such as addiction counselors, psychologists, and social workers (OWEP Professionals program), and paraprofessional students, including community health workers, behavioral health technicians, and outreach workers (OWEP Paraprofessionals program).

This brief contains highlights of workforce projections for occupations based in long-term services and support (LTSS) in the United States. These include direct care workers (such as nursing assistants, home health aides, and personal care aides) as well as physical therapists, occupational therapists and social workers working in long-term care settings. These projections were generated using HRSA’s Health Workforce Simulation Model (HWSM) and start with the year 2021 and go through 2036.

The capacity of the behavioral health workforce to meet the demand is limited by supply and distribution challenges. However, the challenges facing the behavioral workforce extend beyond the supply and demand issues and include patient-level barriers and provider-level barriers. This report provides an overview of the current behavioral health workforce supply and distribution in the United States as well as factors impacting the workforce and access to behavioral health care services.

This report summarizes the results of a retrospective mixed-methods evaluation of the first four years of the Primary Care Training and Enhancement – Training Primary Care Champions (PCTE-TPCC) program, Academic Years (AY) 2018-2022. HRSA’s PCTE-TPCC program strengthens the workforce by preparing practicing primary care physicians and physician assistants to become leaders in health care transformation, and for providers to enhance teaching in community-based settings. Awardees support and train PCTE-TPCC fellows through academic-community partnerships; in leadership, health care transformation, and education; and in the implementation of a health care transformation project at their community-based sites.

This report summarizes the retrospective mixed methods evaluation of the Nurse Education, Practice, Quality and Retention-Veterans’ Bachelor of Science Degree in Nursing (NEPQR-VBSN) program and the NEPQR-Veteran Nurses in Primary Care (VNPC) programs' key activities and accomplishments from Academic Years (AY) 2016-2017 through AY 2020-2021. HRSA’s Bureau of Health Workforce supported the training of military veteran health professionals through the NEPQR-VBSN program and the NEPQR-VNPC program. The NEPQR-VBSN program focused on the transition of veteran nursing students into civilian nursing careers through targeted recruitment, innovative educational models, career ladder programs, and awarding academic credit for relevant military training. The NEPQR-VNPC program focused on recruiting and training veteran nursing students to practice in community-based primary care teams in medically underserved communities and improving the distribution of the primary care nursing workforce.

Primary care is a fundamental part of the nation’s health care system. The primary care workforce is defined in this report as physicians, nurse practitioners (NPs), and physician assistants (PAs) practicing in primary care specialties: family medicine, general pediatric medicine, general internal medicine, and geriatric medicine. This report describes the primary care workforce, challenges affecting the workforce, and population factors impacting the workforce.

This report summarizes the results of a retrospective, mixed methods evaluation of faculty who received loan repayment through the Dental Faculty Development and Loan Repayment Program (DFDLRP) and the Dental Faculty Loan Repayment Program (DFLRP) grant programs, collectively referred to as the Dental Faculty programs here forward, in Academic Years (AY) 2016-2022. In Fiscal Year 2016, HRSA initiated the DFDLRP and DFLRP to address barriers to accessing quality dental care by: Assisting dental and dental hygiene training programs in attracting, developing, and retaining faculty who in turn prepare dental and dental hygiene students to provide high quality care; and providing student loan repayment to participating faculty to alleviate financial concerns associated with choosing faculty careers.

This report summarizes the results of a retrospective outcome evaluation on the Advanced Nursing Education Workforce Program (ANEW) program and its clinical traineeship from Academic Year (AY) 2017 through 2022. The purpose of the ANEW program is to prepare primary care advanced practice registered nursing (APRN) students to practice in rural and medically underserved communities to increase access to primary care in these communities. Through the development of partnerships with clinical sites, ANEW supports a subset of APRN students in longitudinal (three to six months) traineeships in rural and medically underserved communities.

This brief contains highlights of workforce projections for physician specialties in the United States. These projections were generated using HRSA’s Health Workforce Simulation Model (HWSM) and start with the year 2021 and go through 2036.

This report summarizes the results of a retrospective evaluation of the Health Careers Opportunity Program (HCOP) from Academic Years 2015 to 2020. This report provides a descriptive summary of the characteristics and accomplishments of HCOP during Academic Year (AY) 2015-2020. Since 1972, HRSA’s HCOP has provided grants to educational institutions to create health professions pipeline programs for individuals from economically and/or educationally disadvantaged backgrounds. In turn, awardees contribute to HRSA’s mission of broadening access to health care and social services by recruiting qualified individuals from disadvantaged backgrounds to facilitate their entry into health professions training programs and addressing their academic, social, and financial needs.

This report summarizes the results of a retrospective evaluation of the Centers of Excellence (COE) Program’s activities and accomplishments from Academic Year (AY) 2015 through 2020. The COE Program is part of a national strategy to improve access to culturally appropriate health care by increasing the number of underrepresented minority students who enter and graduate from health professions training programs. Through COE, HRSA funds Centers of Excellence at colleges and universities to recruit underrepresented minority trainees into health professions training programs, provide support to retain underrepresented minority trainees, recruit and develop underrepresented minority faculty, and support collaborative research on underrepresented minority-related health issues.

This report summarizes the results of a retrospective evaluation of the characteristics and accomplishments of full and part-time dental residents who received Children’s Hospital Graduate Medical Education Program (CHGME) and the Teaching Health Center Graduate Medical Education Program (THCGME) support during Academic Years (AY) 2015-2020. The CHGME and THCGME programs provide federal funds to maintain and expand graduate medical education, including dental residencies. While the programs focus on different patient populations—pediatric patients in free-standing children’s hospitals for CHGME and patients in community-based settings for THCGME—both programs share similar goals for their dental residencies.

This report summarizes the results of a retrospective evaluation of the Predoctoral Training in General, Pediatric, and Public Health Dentistry and Dental Hygiene (PD) program from Academic Years (AY) 2015 through 2020. The purpose of the PD is to enhance dental workforce education and training to prepare predoctoral dental students, dental hygiene students, and dental hygienists to practice in new and emerging models of care that are designed to meet the needs of vulnerable, underserved, or rural communities. Beginning in 2017, the emphasis of the program was to enhance clinical pediatric predoctoral dental and dental hygiene training focusing on children ages 0-5 to improve the oral health of vulnerable, underserved, and rural pediatric populations.

This report provides data on the maternal health workforce, including information on demographics and comparisons to the female population of childbearing age, to assist policymakers and other stakeholders in analyzing the maternal health workforce and developing workforce education, training, and other programs to improve maternal health outcomes, particularly for under-resourced populations.

This report summarizes the results of a retrospective evaluation of Regional Public Health Training Centers Program (PHTC) from Academic Year (AY) 2015 to 2020. The PHTC seeks to expand and enhance the quality of the public health workforce, and improve its ability to meet national, state, and local health care needs. Specifically, PHTC aims to strengthen the public health workforce through the following activities: serving a designated geographic area, involving faculty members and students in collaborative projects, assessing the needs of health personnel, and providing training.

This report summarizes the results of a retrospective evaluation of the Nurse Faculty Loan Program (NFLP)’s activities and accomplishments from Academic Year (AY) 2015 through 2020, excluding the loan cancellation component. The purpose of HRSA’s NFLP is to increase the number of qualified nurse faculty in the United States. The NFLP provides funding to accredited schools of nursing to establish and operate a student loan fund for students enrolled in advanced nursing degree programs who also commit to becoming nurse faculty. In addition to awarding loans to students, the NFLP also provides loan cancellation, up to 85 percent of the original loan amount, in exchange for completing up to four years of qualified full-time nurse faculty employment after graduation.

This report summarizes the results of a retrospective evaluation on the characteristics and accomplishments of awardees and individual trainees who received Postdoctoral Training in General, Pediatric, and Public Health Dentistry program (PDD) support during Academic Years (AY) 2014-2019. The purpose of the PDD program is to improve access to, and the delivery of, oral health care services for all individuals, particularly vulnerable populations and individuals located in rural and/or underserved areas.

This report summarizes the results of a retrospective evaluation of the Nursing Workforce Diversity (NWD) program’s efforts to diversify the nursing workforce for Academic Years (AY) 2014 through 2019. One of the goals of the NWD program is to increase nursing education opportunities for individuals from disadvantaged backgrounds. This program also aims to train registered nurses who are underrepresented minorities (URMs).

This report summarizes the results of a retrospective evaluation of the Preventive Medicine Residency (PMR) program during Academic Years (AY) 2014-2019. The aim of HRSA’s PMR program is to increase the number and quality of preventive medicine physicians who address public health needs and advance preventive medicine practices. The PMR Program provides support for residents in medical training in preventive medicine, including stipends for residents to defray the costs associated with living expenses, tuition, and fees.

This report summarizes the results of a retrospective evaluation of the characteristics and accomplishments of awardees and individual trainees who received Primary Care Training and Enhancement (PCTE)program support during Academic Years (AY) 2015-2019. The PCTE Program aims to strengthen the primary care workforce by supporting enhanced training for future primary care clinicians, educators, and researchers, as well as promoting primary care practice in rural and underserved areas. The focus of this program is to produce primary care providers who will be well prepared to practice in and lead transforming health care systems aimed at improving access, quality of care, and cost effectiveness.

This report summarizes the results of a retrospective evaluation of the Nurse Anesthetist Traineeship (NAT) program contributions to increasing the number of CRNAs for Academic Years (AY) 2014 through 2019. The purpose of the NAT program is to increase the number of Certified Registered Nurse Anesthetists (CRNAs) providing care, especially to rural and underserved populations.

This report summarizes the results of a retrospective evaluation of the Scholarships for Disadvantaged Students (SDS) program during Academic Years (AY) 2014 through 2019. This covers the final two years of the 2012 to 2016 project period and the first three years of the 2016 to 2020 project period. HRSA’s Bureau of Health Workforce (BHW), SDS grant program increases diversity in the health professions workforce by providing awards to eligible health professions schools. These schools award scholarships to students from disadvantaged backgrounds who have financial need.

This report summarizes the results of a retrospective evaluation of the Area Health Education Center (AHEC) program during Academic Years (AY) 2014 through 2019. HRSA’s Bureau of Health Workforce’s (BHW) AHEC grant program develops and enhances education and training networks within communities, academic institutions, and community-based organizations. AHEC grantees provide specialized community-based training, develop strategic partnerships, prioritize rural and underserved areas and populations, emphasize practice transformation, and deliver inter-professional education and training.

This report provides a cumulative summary of the programmatic outcomes and evaluation of the impact of the Behavioral Health Workforce Education and Training Program (BHWET) program on the supply and distribution of the behavioral health workforce during Academic Years (AY) 2014-2022. The BHWET supports several initiatives aimed to enhance the quality of education and clinical training in behavioral health and to increase the number of practicing behavioral health professionals and health support workers, with a particular emphasis on the integration of behavioral health into primary care. Further, research suggests that training tomorrow’s behavioral health workforce in rural and other community-based settings is more likely to produce providers who will ultimately serve these high-need areas later in their career.

Burnout has long been a concern among health care workers, leading to various mental and physical health conditions. The COVID-19 pandemic exacerbated this issue, as health care workers faced extended hours, increased workloads, and the emotional toll of caring for a higher number of dying patients. These factors have contributed to a significant rise in common mental health conditions such as anxiety and depression among health care workers. This article compares health outcomes across various occupations and settings, controlling for sociodemographic factors known to influence health, and also provides a comparison with the overall US population.

Since 1883, the United States has had civil service laws in place to prevent cronyism and insulate public employees from political influence. Critics argue that such laws impose an undue burden on managers with regard to hiring and dismissing employees. Given that governmental public health agencies have experienced longstanding challenges in recruiting individuals at the state and local level, understanding civil service laws as they relate to the hiring processes is an important component of increasing public health workforce capacity. This article presents state hiring laws and regulations governing the public health government workforce to inform related policy changes to support workforce development.

This study explores the use of 2 publicly available Medicare datasets—Provider Enrollment, Chain, and Ownership System (PECOS) and Doctors and Clinicians—to track provider movement across states and organizations from 2017 to 2023. We found an increase in state-to-state movement of providers post–COVID-19, with an initial spike in physician movement in the first year (April 2020 to March 2021). Movement varied across specialties and professions. Between organizations, we saw an initial increase in movement for family physicians but not internal medicine physicians. Overall, provider movement was generally to larger organizations.

The physician assistant (PA) profession is among the least racially and ethnically diverse health professions requiring advanced education. Between 1995 and 2020, the percentage of Black PA graduates fell from 7% to 3.1%, while Hispanic representation increased from 4.5% to 7.9%. PA programs that transitioned from bachelor's to master's degrees experienced a 5.3% point decline in Black representation and a 3.8% point decline in Hispanic representation. This article examines the impact of transitions to master’s degrees for PAs on Black and Hispanic representation between 1995 and 2020, using the federal Integrated Postsecondary Education Data System and individual universities as the unit of analysis. Don't have access to the full text? Email jordan_herring@email.gwu.edu to request a pdf version.

COVID‐19 placed incredible strain on health care systems and the global health workforce. The pandemic rapidly increased demand for health care services and created an acute need for the health workforce in many areas of care. Yet, it also brought the health workforce to the forefront of the policy agenda and revealed many innovative solutions that can be built upon to overcome persistent workforce challenges. This article is based on a policy brief prepared for the WHO Fifth Global Forum on Human Resources for Health, which explores global emergency workforce strategies implemented during the pandemic and lessons learned from them for the long-term sustainability of the health workforce. Don’t have access to the full text? Email Margaret Ziemann (mziemann@email.gwu.edu) to request a pdf version.

The COVID-19 pandemic shifted the delivery of primary care, including a rapid transition to telehealth. While this shift provided critical access to services, not all patients have the capacity to optimally utilize telehealth, raising concerns for health equity during and after the pandemic. This article discusses the challenges of providing primary care services to vulnerable populations via telehealth during the pandemic.

Increasing access to behavioral health providers in safety-net clinics is vital to ensuring behavioral health care equity. However, there is a lack of knowledge about the factors that better prepare behavioral health providers to practice in these settings. This article explores how experiences with medically-underserved populations during the education of behavioral health professionals affects their satisfaction and retention when subsequently working in safety-net settings.

This qualitative study adopted a constructivist approach to feature IBH team members’ perspectives, examine how the pandemic impacted communication, collaboration, and coordination of care, and determine what factors could be leveraged to advance IBH in the future.

Nurse workforce shortages are not new, yet concerns about a shortfall of nurses intensified across health care settings during the COVID-19 pandemic. To understand how a health care crisis such as COVID-19 can impact nurse turnover at national and regional levels, documentation of a baseline national turnover metric is needed for comparing future registered nurse (RN) workforce changes. This article aims to provide a baseline understanding of national RN turnover using a cross-sectional analysis of the most recent data from the 2018 National Sample Survey of Registered Nurses (NSSRN).

By employing evidence-based methods, harm reduction seeks to lessen the negative health and social consequences associated with substance use. As harm reduction services continue to expand without the need for professional certification, there remains considerable variation in how the workforce is perceived and trained in harm reduction principles and practices. This article explores the harm reduction workforce's perspectives on how certification would impact service delivery and their profession.

Pediatric medical subspecialists offer care to children with uncommon or atypical health issues, those who haven't responded well to standard primary care treatments, or those requiring specialized diagnostic or therapeutic procedures. Evaluating whether the number and distribution of these subspecialists meet the needs of the nation’s children is difficult due to a lack of evidence about how frequently their services are utilized. This article discusses a study that used 3 complementary data sources to quantify children's use of pediatric medical subspecialties from 2011 to 2021. Electronic health record data from large pediatric medical centers and administrative data from Medicaid and commercial plans were also evaluated.

Harm reduction, an evidence-based approach that mitigates the effects of substance use through prevention, treatment, and recovery, has recently been identified as an important facet of efforts in the US to address the opioid epidemic and substance use disorders. However, little is known about the behavioral health workforce working in harm-reduction settings. This article aims to fill the knowledge gap on the harm reduction workforce through a mixed-methods study executed in partnership with the National Harm Reduction Coalition.

This study investigated the challenges of providing primary care services to vulnerable populations (as defined by the CDC) via telehealth during the pandemic and how the patient-provider relationship was impacted by these barriers.

Higher levels of certified nursing assistant (CNA) staffing are positively associated with improved care quality outcomes for nursing home residents, but low wages and other job-quality concerns drive high turnover and job vacancies within the CNA workforce. Evidence suggests that nursing homes have addressed workforce pressures by increasing their reliance on contract CNAs from staffing agencies in recent years, particularly during the COVID-19 pandemic. This trend raises concerns about staffing quality and continuity in nursing homes, with pre-pandemic research indicating that adding contract CNA staffing does not improve care quality outcomes. This report examines trends in contract CNA staffing from 2017-2022 and their impacts on resident care quality.