Advancing Economic Independence through Healthcare Job Training for Low-Income Women: Findings from the Longitudinal Impact Study of the Health Professional Opportunity Grants 1.0 Program in the United States

Background/Purpose: Women facing economic disadvantages, such as those receiving TANF or living on low incomes, often encounter unique obstacles (e.g., childcare responsibilities, low education, and limited work experience), which can hinder their path to economic independence. Employment in health professions--growing in opportunities and offering wages capable of supporting a family, depending on the types of healthcare occupation--presents a potential avenue for economic independence. However, the effectiveness of programs designed to facilitate entry into these professions has yet to be thoroughly evaluated, particularly regarding which program components most effectively promote economic independence among women with economic disadvantages. To address this gap, our study analyzes data from a randomized controlled trial (Health Professional Opportunity Grants [HPOG] 1.0) to determine whether participation in a workforce development program for health-profession occupations aids in the timing of economic independence for women with economic disadvantages and to examine if there exist any differential impacts of core program activities.

Methods: We utilized data from the baseline and subsequent impact studies of the HPOG 1.0 program across 17 program sites/states, conducted 15, 36, and 60 months following randomization in 2010-2013. We focused on 5,054 female participants aged 55 or younger, receiving TANF benefits or reporting a household income below $20,000 at baseline. Most participants were between 18-45 years old, identified as either Black or white, and had an annual household income of less than $15,000. Our measures included the absence of public assistance receipt (TANF, SNAP, Medicaid, or housing support), treatment status, and key program components received (education/training; employment; and other services [e.g., soft or life skills, job readiness training]). Our statistical approach included (1) inverse probability of treatment weighting to balance the remaining differences between the treatment and control groups, and (2) the use of event history models to evaluate the effect of HPOG participation and core program types on the timing of economic independence, and (3) the estimation of conditional probabilities for economic independence by treatment status and types of core program activities.

Results: Our findings suggest that mere HPOG participation alone did not significantly affect the timing of achieving economic independence among our cohort of women. However, core program components that involve human capital development, i.e., pre-employment education or job training (OR=1.62, 95% CI=1.17-2.25) and employment opportunities (OR=1.43, 95% CI=1.26-1.62), significantly increased the likelihood of attaining economic independence over 60 months compared to those receiving other services. The probabilities of attaining economic independence at the 15, 36, and 60 months were higher for participants in education or job training (22%, 27%, and 38%) and in employment (20%, 24%, and 35%) services, compared to the control group’s probabilities (17%, 22%, 32%), respectively.

Conclusions/Implications: Workforce development services targeted at health professions can offer benefits to women with economic disadvantages, particularly when they incorporate components designed to enhance employability by providing education, job training, or hands-on work experiences tailored to careers in the healthcare industry. However, mere participation in such programs that do not involve training components is unlikely to contribute to economic independence for these vulnerable women.