Evidence map›Paper›PMID 40335855›Full record

ArticleJournal of general internal medicine2026

Earnings and Earnings Disparities in the Veterans Health Administration and Other Healthcare Sectors.

Steffie Woolhandler, David U Himmelstein

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Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Steffie WoolhandlerCity University of New York at Hunter College, New York, NY, USA.
David U HimmelsteinCity University of New York at Hunter College, New York, NY, USA. dhimmels@hunter.cuny.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany healthcare workers, particularly women of color, are poorly paid, and even among physicians, women and some minoritized groups earn less. Earnings inequalities are generally smaller in the public sector and might be attenuated in the Veterans Health Administration (VHA).

objectiveTo compare earnings and earnings disparities among VHA and non-VHA healthcare workers.

designCross-sectional analysis of 2018-2022 American Community Survey data.

participantsPersonnel in hospitals or outpatient care settings (n=591,265; weighted n=12,717,305/year, including n=358,118 VHA employees). MAIN MEASURES: Annual earnings overall and for individual occupation groups among VHA and non-VHA personnel; and gender-based or race/ethnicity-based earnings disparities assessed using linear regressions controlled for annual work hours and occupation. KEY

resultsMean earnings were higher in VHA than non-VHA settings; $88,964 (95% CI $86,373-89,754) vs. $81,125 ($80,718-$81,532), and pay inequalities were smaller in the VHA. Earnings in the VHA were lower for a few higher-income occupations, including physicians, whose earnings averaged $255,158 [95% CI 244,733-265,583] in the VHA vs. $286,090 [95% CI 283,613-288,567] in non-VHA settings, a difference (after control for annual work hours) of $26,702 [95% CI 15,691-37,713]. Gender- and race-based disparities were present but smaller in VHA than non-VHA settings. Adjusted for work hours and occupation, the pay disparity between women and men was $12,215 [$9151-$15,279] in the VHA and $26,859 [$25,981-$27,737] in non-VHA settings (p for interaction <0.0001). The adjusted earnings gaps for non-Hispanic Black vs. non-Hispanic white personnel were $5496 [$2384-$8608] vs. $9111 [$7825-$9093] (p for interaction = 0.015). Hispanic personnel earned less than non-Hispanic white personnel in both settings, and disparities were similar.

conclusionsAlthough physicians earn somewhat less in the VHA than in other settings, overall VHA personnel earn about 10% more on average, overall earnings inequalities are smaller, as are earnings disparities for women and Black personnel.

Indexed as

Health Care SectorHealth PersonnelIncomeSalaries and Fringe BenefitsUnited States Department of Veterans AffairsAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedUnited States

Identifiers

PMID40335855
PMCPMC13083662

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