OHA releases health care workforce needs assessment

The 2021 Oregon Health Care Workforce Needs Assessment report finds the state’s health care workforce needs increased diversity and better geographic distribution. The Oregon Health Authority released the biennial report, which focuses on evaluating diversity in the work force and specific needs in underserved parts of the state, on Wednesday.


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Diversity findings:

According to the report, Hispanic/Latinx, African American/Black, and American Indian/Alaska Native providers are underrepresented in most licensed health care professions. White individuals make up 76% of Oregon’s population, according to the report, but account for 81.6% of the health care workforce. Hispanic/Latinx people make up 12.8% of the state’s population but are just 5.8% of the health workforce.

This lack of representation is particularly apparent among behavioral health providers. In this field, people of color make up just 13% of licensed behavioral health providers despite accounting for 24% of the population.

There is generally more diversity in lower-wage health occupations such as certified nursing assistants compared to positions that require more years of formal training.

The report notes, however, that while diversity is lacking in the workforce, the state has improved in recent years. Since 2016, the percentage of white providers has decreased 3.7%, dropping from 83.4% of the total workforce to 80.3%. There is also more racial and ethnic diversity among young providers compared to older ones. Leann Johnson, Director of OHA’s Equity and Inclusion Division, says,

“The conclusions of these reports confirm a hard truth about health care inequity in Oregon: Our workforce, while gradually increasing in its racial and ethnic diversity, is not changing quickly enough to ensure we meet the needs of all Oregonians today.”

By understanding the scale and scope of the problem, we can continue to make meaningful progress to change our system and break down the barriers to health equity.”


Rural vs. Urban findings:

The report also illustrates inequities in access across the state. In rural/frontier areas, behavioral health provider FTE per capita is 65% lower than in urban areas. Dentist FTE per capita is 40% lower in rural/frontier areas and the report states:

“The ability of current primary care providers to meet demand is 23% lower in rural and frontier areas compared with urban areas.”

The areas with greatest unmet need in the state include: “Cascade Locks and Warm Springs in North/Central Oregon, East Klamath and Chiloquin in Klamath County, Shady Cove in Jackson County, and communities near the coast and the Oregon Coast Range: Blodgett-Eddyville, Drain/Yoncalla, Glendale, Port Orford, Powers, Swisshome/Triangle Lake, and Yachats,” reads the report.


The impact of COVID-19:

The report also details the impacts of the COVID-19 pandemic on the workforce. At the start of the pandemic, the number of outpatient visits in the United States decreased by more than half with the largest drops seen in ophthalmology (-79%), dermatology (-73%), and surgery (-66%).

Particularly for providers under a fee-for-service model, the reduced visits translated to decreased revenue and layoffs or furloughs of staff. According to data from the Oregon Employment Department, between March 15 to May 16, 2020, 11.4% of the health care practitioner workforce had filed for unemployment benefits. For the health care support workforce, 27.9% had filed for unemployment benefits during that time.

National data shows dental clinics saw the greatest loss of employment (-56% from February to April 2020) at the start of the pandemic, compared to -11% in physician offices and -2% in hospitals.


Future Recommendations:

Recent projections from the Oregon Employment Department show private health care will be one of the fastest growing industries between 2019 and 2029 in the state, with an expected 15% growth. Employment for behavioral health and mental health counselors is expected to increase 28%.

The report identifies four specific workforces needed to create an equitable, integrated health care system: traditional health workers, health care interpreters, behavioral health providers, and oral health providers. Traditional health workers in Oregon include community health workers, peer wellness specialists, peer support specialists, personal health navigators, and birth doulas.

The findings of the report will be submitted to the Oregon Legislature and will then be used to inform the use of the Health Care Provider Incentive Fund.