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Work stoppages in healthcare and social assistance

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The healthcare and social assistance sector comprises establishments providing healthcare and social assistance for individuals. The sector includes both healthcare and social assistance because it is sometimes difficult to distinguish between the boundaries of these two activities. The industries in this sector are arranged on a continuum starting with those establishments providing medical care exclusively, continuing with those providing healthcare and social assistance, and finally finishing with those providing only social assistance.

The healthcare and social assistance sector consists of these subsectors: (1) Ambulatory Healthcare Services: NAICS 621; (2) Hospitals: NAICS 622; (3) Nursing and Residential Care Facilities: NAICS 623; (4) Social Assistance: NAICS 624.

Between 1993 and 2021 there were 96 major work stoppages in healthcare and social assistance sector. Almost all (88 percent) occurred in hospitals. Nursing and residential care services, and ambulatory healthcare services accounted for about five percent each. Finally, the social assistance industry comprised about 2 percent. (See chart 1).

Chart 1. Work stoppages in healthcare and social assistance 1993-2021

See table for chart 1 ▸

Table 1. Number of major work stoppages in healthcare and social assistance industry, 1993-2021
Industry (NAICS)	Major work stoppages
Hospitals (622)	85
Nursing and Residential Care Facilities (623)	4
Ambulatory Healthcare Services (621)	5
Social Assistance (624)	2
Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.

In oppose to educational services sector, where the vast majority of major work stoppages occurred at the state and local government level, the major work stoppages in healthcare and social assistance prevail in private sector by a great margin. (See chart 2).

Chart 2. Number of work stoppages in healthcare and social assistance by ownership 1993-2021

See table for chart 2 ▸

Table 2. Number of major work stoppages in healthcare and social assistance by ownership, 1993-2021
Ownership	Number of major work stoppages
Private	79
State government	9
Local government	8
Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.

There were 20,230,000 workers employed in healthcare and social assistance in December 2021 nationwide. Within the healthcare and social assistance industry, California had the highest number of workers employed in 2021, 2,485,100 (14 percent). California had the highest number of major work stoppages (54) registered in the state since 1993 as well. Moreover, the number of major work stoppages in California accounted for 56 percent of the total number.

Chart 3. Number of major work stoppages by state in healthcare and social assistance 1993-2021

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Table 3. Number of major work stoppages in healthcare and social assistance industry by state, 1993-2021
State	Number of major work stoppages
California	54
Washington	6
New York	5
District of Columbia	4
Minnesota	4
Rhode Island	4
Maryland	3
Oregon	3
Connecticut	2
Arizona	1
Colorado	1
Florida	1
Illinois	1
Hawaii	1
Pennsylvania	1
Massachusetts	1
Missouri	1
New Jersey	1
Vermont	1
West Virginia	1
Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.

Massachusetts has the largest share of national employment in healthcare and social assistance industry. California has the largest number of major work stoppages between 1993 and 2021.

Chart 4. Percent of total employment and work stoppages in healthcare and social assistance industry by state 1993-2021

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Table 4. Percent of national employment and major work stoppages in healthcare and social assistance industry by state, 1993-2021
State	Employment share	Major work stoppages
California	14.3%	56.3%
Washington	12.6%	6.3%
New York	17.1%	5.2%
District of Columbia	8.8%	4.2%
Minnesota	16.5%	4.2%
Rhode Island	16.0%	4.2%
Maryland	13.3%	3.1%
Oregon	13.8%	3.1%
Connecticut	16.3%	2.1%
Colorado	10.8%	1.0%
Hawaii	11.8%	1.0%
Illinois	12.7%	1.0%
Massachusetts	17.5%	1.0%
Missouri	14.3%	1.0%
New Jersey	14.2%	1.0%
Pennsylvania	17.2%	1.0%
Vermont	16.2%	1.0%
Florida	12.8%	1.0%
Arizona	13.3%	1.0%
West Virginia	17.0%	1.0%
Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.

The longest work stoppage in the healthcare and social assistance industry between 1993 and 2021 occurred in 1996 in New York. Almost 6,000 workers participated in it. The number of work days lost was 48, while the overall length stretched through 66 calendar days. The Oregon Health and Sciences university in Portland, Oregon was the second longest with 37 lost work days and 56 calendar days. It was initiated by Oregon nurses association in 2001.

Chart 5. Longest work stoppages in healthcare and social assistance 1993-2021

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Table 5. Longest major work stoppages in healthcare and social assistance industry, 1993-2021
Organization(s) involved	State(s)	Area(s)	Ownership	Union	Work stoppage beginning date	Work stoppage ending date	Calendar days	Work days lost	Number of workers
League of Voluntary Hospitals & Service Employees International Union	NY	New York	Private Industry	Service Employees International Union	6/24/1996	8/28/1996	66	48	5,800
Oregon Health and Sciences University & Oregon Nurses Association	OR	Portland	Private Industry	Oregon Nurses Association	12/17/2001	2/10/2002	56	37	1,000
Stanford Hospital and Clinics and Lucile Salter Packard Children's Hospital & Committee For Recognition of Nursing Achievement	CA	Palo Alto	Private Industry	Committee For Recognition of Nursing Achievement	6/7/2000	7/27/2000	51	36	1,700
Washington Hospital Center & District of Columbia Nurses Association/American Nurses Association	DC	Washington	Private Industry	District of Columbia Nurses Association/American Nurses Association	9/20/2000	11/8/2000	50	35	1,000
Kuakini Medical Center; Queen's Medical Center; St. Francis Medical Center & Hawaii Nurses Association/American Nurses Association^[1]	HI	Honolulu	Private Industry	Hawaii Nurses Association/American Nurses Association	12/3/2002	1/16/2003	45	31	1,400
^[1] Stoppage began on 12/02/2002, but involved less than 1,000 workers until 12/03/2002. On 01/17/2003, the number of workers involved decreased below 1,000. Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.

Three out of the five largest major work stoppages in the healthcare and social assistance between 1993 and 2021 happened in the private industry, however the largest one occurred in the state government. Also, four out of five happened in California. The largest number of workers involved in a major work stoppage was 53,000 in 2018. The dispute between the University of California medical center and the American Federation of State, County, and Municipal Employees, the California Nurses Association and the University Professional and Technical Employees led to a 3 day work stoppage.

Chart 6. Largest work stoppages in healthcare and social assistance by number of workers involved 1993-2021

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Table 6. Largest work stoppages in healthcare and social assistance industry by number of workers involved, 1993-2021
Organization(s) involved	State(s)	Area(s)	Ownership	Union	Work stoppage beginning date	Work stoppage ending date	Number of workers	Days idle, cumulative for this work stoppage
University of California Medical Centers & American Federation of State, County, and Municipal Employees, California Nurses Association, University Professional and Technical Employees	CA	Statewide	State Government	American Federation of State, County, and Municipal Employees, California Nurses Association, University Professional and Technical Employees	5/7/2018	5/9/2018	53,000	159,000
Kaiser Permanente Hospitals & California Nurses Association, National Union of Healthcare Workers, International Union of Operating Engineers (Stationary Engineers)	CA	Oakland	Private Industry	Service Employees International Union-United Healthcare Workers West (SEIU-UHW) Local 20 and Local 29, the California Nurses Association and National Union of Healthcare Workers (NUHW)	11/18/2021	11/19/2021	40,000	40,000
Sutter Hospitals, Kaiser Permanente Hospitals, Children's Hospital and Research Center & California Nurses Association / National Nurses United, National Union of Healthcare Workers and International Union of Operating Engineers	CA	Statewide	Private Industry	California Nurses Association / National Nurses United, National Union of Healthcare Workers and International Union of Operating Engineers	9/22/2011	9/22/2011	29,000	29,000
University of California Medical Centers^[1]	CA	Statewide	State government	American Federation of State, County and Municipal Employees	4/10/2019	11/13/2019	25,000	75,000
Home Health Care Agencies & Service Employees International Union	NY	New York	Private Industry	Service Employees International Union	6/7/2004	6/9/2004	23,000	57,000
^[1] Estimates based on identified closings on 4/10, 5/16 and 11/13. Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.NY

The largest work stoppage in the healthcare and social assistance between 1993 and 2021 was registered in 1996 in New York with 272,000 days of cumulative idleness and 5,800 participants. The dispute between the League of Voluntary Hospitals and the Service Employees International Union lasted for 47 work days.

Chart 7. Largest work stoppages in educational services by days of idleness in thousands 1993-2021

See table for chart 7 ▸

Table 7. Largest major work stoppages in healthcare and social assistance industry by days idle, 1993-2021
Organization(s) involved	State(s)	Area(s)	Ownership	Union	Work stoppage beginning date	Work stoppage ending date	Number of workers	Days idle, cumulative for this work stoppage
League of Voluntary Hospitals & Service Employees International Union	NY	New York	Private Industry	Service Employees International Union	6/24/1996	8/28/1996	5,800	272,600
University of California Medical Centers & American Federation of State, County, and Municipal Employees, California Nurses Association, University Professional and Technical Employees	CA	Statewide	State Government	American Federation of State, County, and Municipal Employees, California Nurses Association, University Professional and Technical Employees	5/7/2018	5/9/2018	53,000	159,000
Allina Health & Minnesota Nurses Association/National Nurses United	MN	Minneapolis- St. Paul	Private Industry	Minnesota Nurses Association/National Nurses United	9/5/2016	10/13/2016	4,800	129,600
University of California Medical Centers^[1]	CA	Statewide	State government	American Federation of State, County and Municipal Employees	4/10/2019	11/13/2019	25,000	75,000
Connecticut nursing homes & Service Employees International Union^[2]	CT	Statewide	Private Industry	Service Employees International Union	5/2/2001	5/24/2001	4,600	69,700
^[1] Estimates based on identified closings on 4/10, 5/16 and 11/13. ^[2] Work stoppage started on 05/01/2001, and involve less than 1,000 workers until 05/02/2001. On 05/25/2001, the number decreased below 1,000 again. Source: U.S. Bureau of Labor Statistics, Major Work Stoppages Program.