In D.C. and Across the Nation, Nursing Provides a Path to Economic Well-Being

This blog was originally posted on the Campaign for Action's website

There are so many reasons to choose a nursing career. Nurses work in a wide range of roles and in almost every setting imaginable. They provide care, advance rehabilitation and cure, provide emotional support, advocate for health promotion, and educate patients, families, and the public on preventing illness and injury. Nurses make a difference in individual lives and communities in ways that have consistently earned them the public’s trust.

In addition to these intrinsic benefits, nursing offers several distinct advantages over some other health careers. The profession welcomes entrants with multiple educational degrees, making it accessible to people from diverse and economically disadvantaged backgrounds. Nursing’s strong career ladder rewards continued education with almost unparalleled opportunities for advancement. And all along the way, nurses can earn real money.  Licensed practical nurses averaged $48,000 a year in 2020, well above the $36,000 personal median income reported by the Census Bureau in 2019—and registered nurses in some markets earn six-figure salaries.

Once the almost exclusive province of white women, the profession has grown increasingly diverse. In 2019, more than a third of new nurse graduates were people of color, and roughly 13% were men; and while statistics on LGBTQ representation are hard to come by, anecdotal reports suggest the field has diversified in this way as well. This increased diversity is making it easier for patients to receive care from nurses who readily understand their expectations. This attribute of care is considered essential to the advancement of health equity—a state in which “everyone has a fair and just opportunity to be as healthy as possible,” according to the Robert Wood Johnson Foundation (RWJF).

How nurses can contribute to achieving health equity is the focus of a recent report on the future of the profession from the National Academy of Medicine (NAM). “The NAM report talks about all the ways nurses can advance health equity—and, remarkably enough, one way is by becoming a nurse in the first place,” says Susan Reinhard, PhD, RN, FAAN, senior vice president and director of the AARP Public Policy Institute and chief strategist for the Center to Champion Nursing in America, an initiative of AARP Foundation, AARP, and RWJF, which runs the Future of Nursing: Campaign for Action. “When individuals choose to pursue a career that gives them financial security, that decision also benefits their family, and by extension, their community,” Reinhard said. The Campaign is also an initiative of AARP Foundation, AARP, and RWJF.

Wealth is a powerful predictor (often called a social determinant) of health and well-being, and nursing has a strong track record of fostering upward mobility. In the United States, the Department of Labor projects growing demand for nurses through 2029, with RN earnings averaging $75,000 annually in 2020. “This career can be a pathway to economic security at a time when that security is elusive for so many people, especially in communities of color,” says Annette Franqui, MBA, CFA, who chairs the AARP Board of Directors. “The 2019 federal Survey of Consumer Finances showed the median wealth of white families was eight times that of Black families and five times that of Hispanic families. There are so many people in vulnerable neighborhoods who have lost their precarious foothold on economic security because of this pandemic,” she says. “A career in nursing can be a very promising path forward.”

AARP wants to close the wealth gap and ensure that all people, especially communities of color and other historically marginalized groups, can access that pathway, according to Jean C. Accius, PhD, AARP’s senior vice president for global thought leadership. “Disparities rob our nation of its full capacity and deplete it of its potential and prospects. When we foster new opportunities for greater wealth, we create a fair and equal chance for everyone to participate in the full opportunities our nation has to offer. This is not just a moral imperative; it’s also an economic necessity,” Accius says. “We believe a nursing education can provide a pathway to financial security to millions of people,” but he adds, “getting people on that pathway will require considerable ingenuity and support.”

People who have limited financial resources often face barriers to acquiring the education needed to become a nurse in the first place. Hurdles go beyond insufficient funds to cover the cost of tuition. Would-be applicants facing housing instability, food insecurity, and other byproducts of poverty, may also lack access to reliable internet and the financial literacy needed to complete the college application process and make sound decisions about college loans.

The District of Columbia (D.C.) is helping some residents overcome these hurdles. In August, the D.C. Council unanimously supported the Nurse Education Enhancement Act of 2021, which provides $5.8 million over three years to support training and education for certified nursing assistants, home health aides, and medication assistants. Program participants are eligible for free tuition and fees as well as transportation costs and school supplies. The program also provides a monthly stipend students can use toward living expenses. Students who find employment in one of these jobs for at least two years are then eligible to apply for a discounted or free nursing education at the University of the District of Columbia (UDC). This includes obtaining higher education credentials for professional advancement.

“For more than a decade here in the District of Columbia, we’ve seen the number of direct care workers shrink, all while the need for them has only increased,” says Louis Davis, Jr., MPA, director, AARP District of Columbia (D.C.). He says a recent survey by the DC Coalition on Long Term Care found that over half of respondents currently did not have enough home health aides to staff other clients for every shift; 67 percent said the closure of several training programs will affect their ability to hire more staff; 95 percent expressed concerns about their ability to hire enough home health aides; and 100 percent of long-term care providers said they support providing more career pathways into the health care sector. “That’s why AARP chose to support and endorse this legislation and worked with the D.C. Council to ensure its passage,” Davis says. “The men and women who become certified and licensed and go on to earn nursing degrees will help people live longer, where they choose to live.”

As someone with a passion for supporting family caregivers, Reinhard—also chief strategist of AARP Public Policy Institute’s family caregiving initiatives—was understandably excited by news of D.C.’s commitment to strengthening the home health workforce. “This effort dovetails beautifully with everything the Campaign for Action has been doing to support health equity by diversifying the nursing workforce,” she says, referencing the Campaign’s ongoing initiative to foster mentoring programs at educational institutions serving Black, Hispanic, and American Indian/Alaska Native students. “It also aligns with the missions of AARP’s Office of Equity, Diversity and Inclusion and our Global Thought Leadership team” she adds. “It’s heartening to see the saying ‘think globally, act locally’ playing out in the service of such important goals: diversifying the nursing workforce and giving people from economically disadvantaged communities a path to financial security.”

To learn more on this topic, listen to the recording of our February, 2021, Health Equity Action Forum, Nursing as a Career to Achieve Financial Security.