ResearchEmployment
Healthcare is the new working-class jobs engine. Can it become a career pathway for men?
Introduction
The U.S. economy has undergone a dramatic structural transformation over the past half century. Beginning in the early 1980s, the country lost approximately 6 million manufacturing jobs: a hollowing out of the industrial core that reshaped communities, wage structures, and the pathways available to workers without bachelor’s degrees. Healthcare has emerged as the dominant replacement sector, adding roughly 10 million jobs over the same period.
But the shift from manufacturing to healthcare is not a clean substitution. Manufacturing was the backbone of working-class employment for men without college degrees. These jobs were stable, relatively well-compensated, and widely understood as a respectable route into middle-class life. Healthcare, by contrast, is a predominantly female sector, and much of its growth is concentrated in roles that many men have not historically viewed as natural occupational pathways.
Key findings
- Three out of four of the jobs created in 2025 were in healthcare and social services, fields that strongly skew female.
- Healthcare is projected to account for 33% of all net job growth in the United States over the next decade and most (around 70%) of all projected job growth among the working class (those without bachelor’s degrees) through 2034.
- Men held just 22% of healthcare jobs in 2024 — essentially unchanged from 23% in 1980. If men held these jobs at similar rates to women (50-50) men would have almost half a million additional jobs.
- Male representation in healthcare jobs that do not require a bachelor’s degree has risen modestly, from 14% in 1980 to 18% in 2024. The associate-degree tier held flat at 27%.
- The largest healthcare jobs by employment that do not require a bachelor’s degree are largely female. Personal care aides are 18% male. Men are overrepresented in emergency roles like paramedics (70% male) and EMTs (59%), but these tend to be relatively small by comparison.
- Among men without a bachelor’s degree, those working full-time in healthcare are younger, more racially diverse, and earn somewhat lower median wages ($49,700 vs. $53,800) than those outside healthcare.
Healthcare is growing, with most jobs being non-degree
Healthcare accounts for about 11% of the roughly 170 million jobs in the United States. However, that understates the sector’s significance, because healthcare is growing far faster than the rest of the economy. Three out of four of the jobs created in 2025 were in healthcare and social services. Over the next decade, healthcare is expected to account for 33% of all net job growth in the United States.
Critically for working-class men, this growth is concentrated among jobs that don’t require a bachelor’s degree. Today, 56% of healthcare jobs require no degree at all (referred to as non-degree jobs), and 63% require less than a bachelor’s (referred to as non-BA jobs). Looking ahead, non-BA healthcare occupations will account for 71% of all working-class job growth through 2034, as shown in figure 1.
Figure 1
Healthcare jobs with lower pay are growing fastest
The non-BA healthcare jobs growing the fastest are also among the lowest-paid in the economy, as shown in figure 2. Home health and personal care aides are projected to add 740,000 jobs over the next decade—the largest single occupational increase in healthcare—at a median annual wage of just $34,900. Medical assistants follow with about 101,000 new jobs (at a $44,200 wage), then nursing assistants ($39,500) and pharmacy technicians ($43,500). The highest-paying healthcare jobs that don’t require a BA require an associate’s degree: respiratory therapists ($80,400), physical therapist assistants ($65,500), and licensed practical and vocational nurses ($62,300).
These relatively low wages suggest men may not be simply overlooking a straightforward replacement for manufacturing or other male-dominated working-class jobs. In many of the fastest-growing roles, a lack of pay or strong prospects for wage growth may discourage men from pursuing these as practical career pathways.
Figure 2
There has been no increase in the male share of healthcare jobs
Decades of healthcare expansion have done nothing to alter the sector’s gender composition: men hold nearly the same share of healthcare jobs in 2024 (22%) as they did in 1980 (23%).
But while the overall male share has changed little, there are stark differences by occupational level as shown in figure 3. Male representation in non-degree healthcare jobs has risen modestly, from 14% in 1980 to 18% in 2024, while associate-degree occupations have held steady at 27% across the entire period. Bachelor’s-degree healthcare occupations went from 8% to 14% male, mostly due to the fourfold expansion of registered nursing, which drew increasing numbers of men in absolute terms. But the most dramatic shift has occurred among the highest-skilled roles: the share of graduate-degree healthcare jobs filled by men collapsed from 77% in 1980 to 42% in 2024, a 35-point decline.
Figure 3
Overall, men’s presence in non-BA healthcare has grown slightly but remains low, while the high-credential roles that were once male bastions have undergone a fundamental transformation.
Most non-BA healthcare jobs are minority male, except in emergency response
The largest healthcare jobs (by employment) that do not require a bachelor’s degree are largely female: only 18% of personal care aides (the non-BA healthcare job with the greatest employment numbers) are male; among nursing assistants and medical assistants, men make up just 11% and 10%, respectively. Among the ten largest non-BA healthcare jobs, those with the highest male share are pharmacy technicians (22%), radiologic technologists and technicians (32%), and other healthcare support (30%).
Figure 4
There are a handful of healthcare jobs where men are actually overrepresented, namely emergency and technical roles. Paramedics are 70% male while EMTs are 59%. Other more heavily male roles include orderlies and psychiatric aides (52%), nuclear medicine technologists (48%), and MRI technologists (43%). However, these tend to be small occupations in absolute terms. Paramedics, for instance, make up only 6% of all non-BA healthcare jobs held by men.
Men in non-BA healthcare jobs are younger and more diverse
Men in non-BA healthcare jobs show some demographic differences from other jobs not requiring bachelor’s degrees. In terms of race and ethnicity, Black and Asian men make up 18% and 10% of the male healthcare workforce, respectively, compared to 12% and 5% in other non-healthcare jobs that don’t require a bachelor’s degree.
The age profile also skews younger: 48% of male non-BA healthcare workers are between 25 and 44, compared to 43% in male-dominated fields, and just 31% are 45-64 (vs. 36%). This may reflect the sector’s recent rapid growth attracting newer entrants, or lower retention of older workers.
Figure 5
In terms of work outcomes, men in non-BA healthcare are slightly less likely to work full time than those in other non-BA fields (66% vs. 69%). Among full-time workers, male healthcare workers also earn less than their counterparts in other fields ($49,700 vs. $53,800 in median annual wages).
Implications
Healthcare is becoming America’s defining engine of working-class job growth, but it is reaching working-class men only at the margins. Four implications follow:
The decline of manufacturing has not, for men, been replaced by an equivalent stable working-class career path. The sector that has actually grown is one where men hold one in five jobs, and where the largest and fastest-growing roles, like home health aides and nursing assistants, are relatively low-paid. More can be done to make healthcare a comparably attractive and upwardly mobile career path for working-class men.
Men’s footprint in non-BA healthcare is concentrated in a narrow band. Men are clearly succeeding in some urgent-response or technical roles, like paramedics, EMTs, and nuclear medicine technologists. Expansion of male representation may run through adjacent roles before the larger, more female-coded occupations.
The men in non-BA healthcare roles are demographically distinct. They are younger, more racially diverse, and slightly less likely to work full time. Whether this is because the sector is drawing them in or because other parts of the labor market are pushing them out is unclear.
Working-class men are missing out on healthcare job growth. With huge job growth occurring and projected in healthcare, especially for workers without college degrees, the absence of men in these fields is no longer just an issue of gender representation in key HEAL (health, education, and literacy) fields. It points to broader challenges in improving the pay, stability, and career ladders of the jobs themselves.
Subscribe to our newsletter
Get the latest developments on the trends and issues facing boys and men.
Grant Martsolf is an interdisciplinary teacher and scholar at the University of Pittsburgh School of Nursing, focusing on the impact of public policy, culture, education, and the healthcare system on human flourishing.
Brendan W. Case is the associate director for research at Harvard University’s Human Flourishing Program.
Related Research
Employment
Dads are taking more parental leave than the headlines suggest
As state paid family leave programs have expanded rapidly across the United States, Anders Knospe and Richard Reeves find that fathers' leave-taking has grown dramatically, and that the gap between fathers and mothers is narrower than standard measures suggest.
Employment
What’s really going on with men and work? Seven facts
This brief provides seven key facts about men and work by mapping who is affected, tracing how trends have shifted over time, and confronting the questions we may still not have good answers to.
Employment
Higher rents keep men at home
Rising housing costs are pushing men out of the workforce as more live with parents instead of working.