Workforce diversity and earnings differentials in Canadian nursing.

BACKGROUND

Studies from different countries document persistent female/male wage gaps in the health workforce, including in female-dominated professions such as nursing. Evidence is less clear on inequalities by gender, sexual, and racial-ethnic minority status.

OBJECTIVE

To analyze whether nurses of diverse identities are receiving comparable compensation for comparable work.

METHODS

This national observational study leverages microdata from the 2021 Canadian Population Census, the first large-scale source collecting information on gender diverse persons, along with ethnic origins and labour force activities. We describe whether the nursing workforce ages 20-64 reflects the demographic diversity of the population it serves. Disparities in annual earnings are assessed using log-linear regression analysis, adjusting for a range of personal and professional characteristics.

RESULTS

The shares of nurses who were cisgender or transgender women were greater than the total population, while cisgender men, transgender men, and non-binary persons were under-represented. Nurses who were cisgender women or transgender men earned significantly less on average than cisgender men, but not transgender women. Nurses with Filipino or Black identities were over-represented compared to the total population; a relatively wider earnings gap was found among Black nurses and a narrower gap among those of Filipino origin compared with their White counterparts. No discernible representation or earnings differences were seen for nurses with certain other ethnicities (Southeast Asian, Japanese origins).

CONCLUSIONS

Heterogeneity in nursing labour market outcomes by gender and ethnocultural diversity precludes one-size-fits-all policy actions for optimizing equity and redressing barriers to workforce inclusion to meet changing societal health challenges.