Chains and Ladders: Exploring the Opportunities for Workforce Development and Poverty Reduction in the Hospital Sector

In this article, the authors investigate the potential of hospitals to offer low- and semiskilled workers employment and adva ncement options. This study uses the job chains approach to measuring economic development impacts devised by Persky, Felsenstein, and Carlson to compare hospitals with three other industries highly concentrated in central cities and examines the practical challenges facing workforce development professionals. The findings suggest that growth in hospital employment has the potential to outstrip the impact of growth in accommodations, legal services, and securities and commodities on the well-being of low-income workers and should prompt economic development practitioners to take the sector more seriously as a locus for attention and investment. To maximize welfare gain and distributional equity, economic development policy makers must accompany investments in health care--based economic development both with strategies to promote skills attainment and credentialing among low-paid health care workers and with formal strategies to facilitate upward movement.