Commuting Patterns of Healthcare Workers

Background: Nationwide job trends show people are increasingly seeking jobs in urban areas in search of higher pay, more flexible hours, or better career opportunities. The tradeoffs include longer distances for travel and more time spent commuting, especially for those who are not able to afford living near these job opportunities. Little is known about whether certain healthcare professions are at risk of longer commute times and whether there are financial benefits to the longer commute.

Methods: We use the 2015 American Community Survey (ACS) data, a nationally representative household survey conducted by the U.S. Census Bureau that includes detailed sociodemographic and work characteristics. We focus on low- and middle-skilled healthcare occupations (i.e., those that require a Bachelor’s degree or below for entry), which may be more likely to not have the resources to obtain affordable housing in urban areas. We identify the most frequent permutations of commuting patterns of healthcare workers, the frequency of mode of transportation (drive alone, carpool, public, and other) across occupations, and the extent to which work hours (time of arrival and time of departure) are associated with commuting patterns. We conduct descriptive and regression analyses to identify predictors of commuting patterns, and examine how commuting patterns relate to wages and hours worked.

Results: Most individuals commuted to a different public use microdata area (PUMA, the smallest geographic unit available in ACS) for work compared to their home. Commute time between home and work did not vary greatly across occupations. Across occupations, over 70% had a commute time of 30 minutes or less. EMTs/paramedics had the largest percentage (3.9%) of extreme commuters (defined as traveling more than 90 minutes on average) followed by home health aides (HHAs) at 3.6%. The majority of healthcare workers drove alone, ranging from 70.8% of HHAs to 91.2% of dental hygienists. Across the other forms of transportation, most notable was that 18.3% of HHAs took public transportation, which is more than two and a half times the rate of the occupation with the next highest percentage of public transportation, personal care aides (PCAs) at 7.3%. In a regression analysis, the greater the commuting time, the significantly lower the odds of driving alone across all occupations, controlling for sociodemographics, departure time, and mode of transportation. Across most occupations, minorities were significantly less likely to drive alone. When pooling occupations, we found a 0.02% significant (p<0.001) increase in wages for every minute increase in commute time. Additional results on the effect of the local labor market on commuting patterns will be presented.

Conclusions: Those in low-skilled occupations, which tend to have higher representation of racial/ethnic minorities, are more likely to use public transportation and have longer commute times compared to middle-skilled occupations. Healthcare employers need consider how employees’ wages in the local community compared to other communities affect the local labor market. Further study is warranted to examine how these trends may affect rural and underserved communities such that needed workers are drawn away from areas that need qualified health professionals.