It is important for health organizations to monitor progress toward gender equity and inclusion goals among health human resources. Within the Canadian healthcare management workforce, however, recent investigations are lacking. This study examines gender differences in composition and compensation among health leadership in Canada using national census data. Findings show that although women represent over half (57%) of senior managers in health and social services, the pipeline from middle management (72%) suggests persistent career barriers disproportionately affect women. Women health and social care managers’ earnings averaged $0.83-.89 for every dollar that a man earned. The gender wage gap remained statistically significant, with women health managers earning 12-20% less than men, after adjusting for age, education and other characteristics. Dynamic decomposition analyses highlighted that most of the gender wage gap could not be explained within the available data—a finding attributable, at least in part, to (unmeasured and unmeasurable) gender discrimination.

Background Gendered challenges have been shown to persist among health practitioners in countries at all levels of development. Less is known about non-clinical professionals, that is, those who do not deliver services directly but are essential to health systems performance, such as health policy researchers. This national observational study examined gender occupational segregation and wage gaps in the Canadian health policy research workforce using a cross-domain comparative labour market analysis approach. Methods Sourcing data from the 2016 population census, we applied linear regression and Oaxaca–Blinder decomposition techniques to assess wage differentials by sex, traditional human capital measures (e.g., age, education, place of work), and social identity variables intersecting with gender (household head, childcare, migrant status) among health policy researchers aged 25–54. We compared the gender composition and wage gap with seven non-health policy and programme domains, as mapped under the national occupational classification by similarity in the types of work performed. Results The health policy research workforce (N = 19 955) was characterized by gender segregation: 74% women, compared with 58% women among non-health policy research occupations (N = 102 555). Women health policy researchers earned on average 4.8% (95% CI 1.5‒8.0%) less than men after adjusting for other professional and personal variables. This gap was wider than among education policy researchers with similar gender composition (75% women; adjusted wage gap of 2.6%). Wages among health policy researchers were 21.1% (95% CI 19.4‒22.8%) lower than their counterparts in the male-dominated economics policy domain, all else being equal. Overall, women’s earnings averaged 3.2% lower than men’s due to factors that remained unexplained by policy domain or other measured predictors. Conclusions This investigation found that the gender inequalities already widely seen among clinical practitioners are replicated among health policy researchers, potentially hindering the competitiveness of the health sector for attracting and retaining talent. Our findings suggest intersectoral actions are necessary to tackle wage gaps and devaluation of female-dominated health professions. Accountability for gender equity in health must extend to the professionals tasked with conducting equity-informative health policy research.

This study examines gender, geographic, and earnings inequalities within and across 13 health, education, and STEM (science, technology, engineering, and mathematics and computer science) professions in Canada. Data from the 2006 and 2016 population censuses were pooled and linked to a continuous geospatial remoteness index for assessing trends in occupational feminization and associated employment earnings among degree-holding professionals aged 25–54. Linear regression and Oaxaca-Blinder decomposition methods were used to analyze how personal, professional, and socioenvironmental factors may attenuate or magnify wage differentials by sex. Results show the STEM professions tended to remain male-dominated, heavily urbanized, and subject to significantly lower earnings for women compared to men. Other historically female-dominated professions, notably nursing professionals and secondary school teachers, were characterized with geographic distributions most closely approaching the general population, relatively narrower gender wage gaps, but also lower average annual earnings. A significant gender wage differential was found in each profession, with women earning 4.6‒12.5% less than men, after adjusting for traditional human capital measures, social characteristics intersecting with gender, and community remoteness and accessibility. Residential remoteness and census period generally explained little of the gender wage gap. Despite decades of pay equity policies in Canada, women’s earnings averaged 2.3‒7.9% less than men’s due to unexplained factors, a finding which may be attributed, at least in part, to persistent (unmeasured) gender discrimination even in highly educated professions.

Introduction: Health workforces around the world are characterized with geographic maldistribution, often leading to inequalities in rural health outcomes. Monetary incentives are frequently raised as a policy option to bolster recruitment of healthcare practitioners to rural and underserved communities; however, few rural health workforce studies focus on allied health professionals (AHPs), include urban comparators, integrate gender considerations, or measure rural diversity. This population-based observational study examines trends in the geographic and gender distribution and earnings of AHPs in Canada across the ruralurban continuum. Methods: Nationally representative data from the 2006 and 2016 Canadian population censuses were pooled and linked with the geocoded Index of Remoteness for all inhabited communities. Five groups of university-educated AHPs providing prevention, diagnostic evaluation, therapy, and rehabilitation services were identified by occupation. Multiple linear regression models were used to estimate the associations between relative remoteness and annual earnings of AHPs aged 25-54 years, controlling for gender and other personal and professional characteristics. Results: The density of AHPs was found to be 15 times higher in more urbanized and accessible parts of the country (23.6-25.6 per 10 000 population in 2016) compared to the most rural and remote areas (1.6 per 10 000 population), a pattern that changed little over the previous decade. A positive correlation was seen across occupations in terms of the degree of feminization and Rural and Remote Health rrh.org.au