UCSF-Led Study Finds Lasting Wage Gap Between Male and Female Nurses

April 2015Andrew Schwartz

A research letter published in the March 24/31 issue of JAMA demonstrated an enduring wage gap between male and female registered nurses in the US. According to the study’s lead author, UC San Francisco School of Nursing professor Ulrike Muench, the gap crosses nearly every specialty area and clinical setting. The study’s release generated nationwide media coverage.

After Muench and her co-authors corrected for potential variables such as degree and experience, full-time male nurses still earn roughly $5,000 more per year than their female colleagues – a gap that has remained unchanged for more than a quarter century in this female-dominated profession. “Over a 30-year career, that adds up to a $150,000 difference in earnings, which can affect both quality of life and retirement,” says Muench.

Ulrike Muench However, Muench cautions that at this point, “We have to be careful not to assume this is a function of discrimination – it’s important to look into all of the possible reasons, and we are trying to find answers to some of them in follow-up work.” Nevertheless, she says, with 2.8 million registered nurses working in the US, the gap matters not just to the nurses, but also to the patients to whom they deliver care.

Consider, for example, health care’s increasing emphasis on team-based care and the way the Affordable Care Act has served in some settings to elevate the role of nurses, in part because of the critical role they play in improving patient outcomes. “There is a lot of literature on issues that can emerge from pay inequality,” says Muench. “It can have a negative effect on teamwork and work satisfaction.”

All of these concerns raise questions about how best to address the gap. As a start, Muench says, there is a need to raise awareness.

“When I’ve presented this work at conferences or talked to nurses about it, my sense is nurses are not very aware of this going on, so I hope this work will raise awareness among them and their employers,” says Muench.

She notes that nurse employers are in a great position to use the findings to examine their pay structures and, if differences are found, to look closely at whether these differences are justified. Nurse employers can already turn to a guide produced by the Department of Labor that explains the relevant laws, offers tips on how to achieve equal pay and argues for transparency in compensation. Open pay policies could help nurses better negotiate for pay parity.

“With the increasing demand for health care due to health care reform implementation and an aging population, it is important to create a climate where nurses feel valued and happy, so they stay in the labor force,” says Muench. “We can’t afford to lose any.”