April 1, 2022: One might think that in a female dominated profession such as nursing, women would no longer earn less than men. However, this is not the case according to new research published in the March 24, 2022 issue of The Journal of the American Medical Association.

In the study that is available here on the JAMA website, Center adjunct faculty member (and former Center postdoctoral fellow) Dr. Ulrike Muench, PhD, RN, and co-authors (Yale’s Jody Sindelar, PhD and Susan H. Busch, PhD, and Center Director Peter I. Buerhaus, PhD, RN) found that the mean unadjusted earnings gap was roughly $10,000 (14%) and the adjusted earnings gap was $5,150 (8%). This gap implies that over a 30-year career, female RNs will earn approximately $300,000 less than male RNs using the unadjusted gap, and $155,000 less than male RNs using the adjusted earnings gap.

The study found that not only was the earnings gap apparent in nearly all nursing specialty areas and job positions, but also the gap has not narrowed over time. The researchers estimated the gender earnings gap for fulltime employed RNs using 1988- 2008 data from the National Sample Survey of Registered Nurses. The National Sample Survey is an ideal data set to use for this analysis because it includes detailed data on RN workforce characteristics that influence RN earnings. Additionally, the analysis used data from the federal government’s American Community Survey. These data enabled the investigators to extend time trends through 2013.

The regression model controlled for hours worked, work setting, specialties, positions, highest education, foreign education, race, age, marital status, children at home, years since graduation, metropolitan statistical area, state, year and a number of interaction terms for gender and year, gender and setting, gender and specialty and gender and job position. Results from the analysis can be interpreted as a pay gap between male and female RNs who possess the same characteristics with the only difference being that one is female and the other male Together, these characteristics explained about half of the unadjusted earnings gap, and the other half (about $5,000 or 8%) remains unexplained.

A gender gap in earnings is not just occurring in nursing – a recent Modern Healthcare article described the latest income data reported by the U.S. Census Bureau showing a pay gap for male and female physicians, including surgeons. The average female physician earned $0.69 on the dollar compared to their male physicians. In a 2013 research letter published by JAMA, Seth A. Seabury, PhD, Amitabh Chandra, PhD, and Anupam B. Jena, MD, PhD reported similar findings about physicians.

The Modern Healthcare article also noted similar gender pay gaps among pharmacists ($0.93), home health aids ($0.83) and dozens of other professions. Pay gaps also exist amongst hospital executives with 1 in 4 CEOs being female and earning $0.76 for each dollar earned by male CEOs.

Only two professions – massage therapists and dietitians/nutritionists – have emerged with women earning at least 97% of their male counter part’s salaries.

According to Dr. Muench, “By themselves, these findings do not suggest that pay differences in nursing are driven by gender discrimination, but they do not rule out this possibility either. More analyses are needed to examine plausible explanations. Nevertheless, the results of the study provide an opportunity for nurse employers to examine their pay structures and policies to determine if pay differences exist among male and female RNs, and if there are, then to ascertain whether there are legitimate reasons for paying men more than women.”

Muench added that the Department of Labor publishes an employers guide to equal pay that contains tips on how to review pay practices and improve transparency in compensation. That document can be found here.