Gender hierarchies in the health labor force

Rapid growth and increasing diversity characterize trends of the U.S. health labor force in recent decades. While these trends have promoted change on many different fronts of the health system, hierarchical organization of the health work force remains intact. Workers continue to be stratified by class and race. Superimposed on both strata is a structure that segregates jobs by gender, between and within health occupations. While female health workers outnumber males by three to one, they remain clustered in jobs and occupations lower in pay, less prestigious, and less autonomous than those of their male counterparts. What has prevented women from improving their economic and leadership status as health workers? Is work performed by men of higher prestige because men perform it? Would curative and technical fields have less status if dominated by women? Would health promotion be funded more generously if most health educators were men? In this article, two analytical constructs are presented to take a closer look at occupational categories, selected structural characteristics, differential rewards, and their relationship to gender segregation. Taken together, they demonstrate how women always cluster at the bottom and men at the top, no matter which dimension is chosen.