"We're Not the Enemy and We're Not Asking for the World": Low-Wage Hospital Workers' Advocachy for Fair Wages

Background and Purpose. Nearly half of the U.S. workforce earns less than $15 per hour, despite evidence that this is not enough to meet the needs of most workers and their families.  Workers earning low wages face multiple hardships, such as housing instability; food insufficiency; inability to afford health insurance, medical care, and medications; and financial, work, and family stress.  Less attention has been given to what workers describe as fair compensation and how they advocate for increased wages.  This paper reports the testimonial arguments that low-wage workers make in advocating for higher wages.

Methods. Testimonies were offered to a city-council appointed wage review committee at two public hearings in late 2015.  One hundred, sixty workers employed by either of the two local, major health care systems testified.  Sixty-two workers (38.8%) provided wage information.  Their wages ranged from $10/hour to $19.40/hour; 56 (90.3%) earned under $15/hour.  The testimonies were public and available  on the committee’s web-site. Testimonies were coded using thematic analysis.  Four coders examined the first 20 transcripts to identify elements and potential codes, which were discussed and revised; emerging themes that categorized the codes were then identified.  Next, each coder evaluated a unique group of 17 transcripts plus an additional three transcripts that overlapped with another coder and discrepancies were discussed and reconciled.  Finally, the remaining testimonies were split among the four coders; after coding was complete, each coder assessed a major theme and coding questions were discussed and reconciled.

Results: Workers described how difficult it is to live on low wages.  They live paycheck to paycheck, have nothing left each month, and have trouble making ends meet.  Workers highlighted the stress economic insecurity created for them and their families.  As one said, “Every time I see my paycheck I cry.”

The workers argued for fair compensation – wages that would allow for more than survival. They said they deserved higher wages because their work was important and arduous, and they had long years of loyal service.  How could a hospital function, they asked, without clean rooms, sterile equipment, food preparation and delivery, and direct patient care? 

They framed their advocacy comparatively: why shouldn’t they receive a “livable” wage when top hospital administrators got millions. Further, they equated wage rates with respect, claiming that higher wages would demonstrate their employers respect and appreciation.  Finally, workers recognized the impact their low-wages have on the broader community.  One worker summed this up: “I want to be part of making a positive change – not just for me, but for everyone in <City>.”

Conclusion and Implications: The hospital workers’ arguments for higher wages shed light on their conceptions of fairness as well as on their lives as low-wage workers.  Social workers, with our historic commitment to social and economic justice, can contribute through research, community organization, and policy practice to the efforts of low-wage workers and their communities to create livable futures.