THE SUPPLY OF DENTAL HYGIENISTS IN NORTHERN CALIFORNIA EAST . ...... Regional Distribution of Dental Hygiene Graduates from California Programs.
REGISTERED DENTAL HYGIENISTS IN CALIFORNIA REGIONAL LABOR MARKET CHART BOOK (2005-2006)
ELIZABETH MERTZ, MA TIM BATES, MPP HEALTH WORKFORCE TRACKING COLLABORATIVE NOVEMBER 2008
Acknowledgements This project is supported by a grant from The California Endowment. The California Endowment's mission is to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians. This project is funded in part by a grant from The California Wellness Foundation (TCWF). Created in 1992 as an independent, private foundation, TCWF’s mission is to promote the health of the people of California by making grants for health promotion, wellness education, and disease prevention programs. Supported by a grant from the California HealthCare Foundation, based in Oakland, California. Supported by the DHAI, Foundation of California Dental Hygienists’ Association. This project was made possible by a previous grant from the California Dental Association which funded the Statewide Sample Survey of Dental Hygienists. Founded in 1870, the CDA is part of a membership structure that includes 32 local dental societies and the American Dental Association. The California Dental Association is the largest statewide dental association in the country, and our nearly 24,000 members represent almost 70 percent of dentists practicing in the state. The CDA organization is comprised of CDA, the CDA Foundation, The Dentists Insurance Company, and TDIC Insurance Solutions. Additional support which made this project possible was provided from National Center for Health Workforce Information and Analysis, US Bureau of the Health Professions, HRSA (U79 HP 00004), and the UCSF Center to Address Disparities in Children’s’ Oral Health (NIH Prime, U54 DE 142501), while the California Dental Hygienists’ Association provided in-kind assistance.
Suggested Citation Mertz, E and Bates, T. Registered Dental Hygienists in California: Regional Labor Market Chart Book. San Francisco, CA: Center for the Health Professions, University of California, San Francisco. 2008.
University of California, San Francisco 3333 California Street, Suite 410 San Francisco, CA 94118 http://futurehealth.ucsf.edu
Copyright 2008. Center for the Health Professions
Table of Contents INTRODUCTION.............................................................................................................................................................................. 3 CALIFORNIA.................................................................................................................................................................................... 6 DEMAND FOR DENTAL HYGIENISTS IN CALIFORNIA ........................................................................................................................ 6 THE SUPPLY OF DENTAL HYGIENISTS IN CALIFORNIA ..................................................................................................................... 8 Inflow of Hygienists.................................................................................................................................................................... 8 Outflow of Hygienists ............................................................................................................................................................... 10 THE CALIFORNIA DENTAL HYGIENE LABOR MARKET ................................................................................................................... 11 Demographics & Educational Level ........................................................................................................................................ 11 Practice Characteristics ........................................................................................................................................................... 12 BAY AREA REGIONAL SUMMARY .......................................................................................................................................... 15 DEMAND FOR DENTAL HYGIENISTS IN THE BAY AREA .................................................................................................................. 15 THE SUPPLY OF DENTAL HYGIENISTS IN THE BAY AREA ............................................................................................................... 18 Inflow of Hygienists.................................................................................................................................................................. 18 Outflow of Hygienists ............................................................................................................................................................... 19 BAY AREA DENTAL HYGIENE LABOR MARKET ............................................................................................................................. 19 Demographics & Educational Level ........................................................................................................................................ 19 Practice Characteristics ........................................................................................................................................................... 20 CENTRAL COAST REGIONAL SUMMARY............................................................................................................................. 22 DEMAND FOR DENTAL HYGIENISTS IN THE CENTRAL COAST ........................................................................................................ 22 THE SUPPLY OF DENTAL HYGIENISTS IN THE CENTRAL COAST ..................................................................................................... 25 Inflow of Hygienists.................................................................................................................................................................. 25 Outflow of Hygienists ............................................................................................................................................................... 25 CENTRAL COAST DENTAL HYGIENE LABOR MARKET ................................................................................................................... 26 Demographics & Educational Level ........................................................................................................................................ 26 Practice Characteristics ........................................................................................................................................................... 27 CENTRAL SIERRA REGIONAL SUMMARY ........................................................................................................................... 29 DEMAND FOR DENTAL HYGIENISTS IN THE CENTRAL SIERRA ....................................................................................................... 29 THE SUPPLY OF DENTAL HYGIENISTS IN THE CENTRAL SIERRA .................................................................................................... 31 Inflow of Hygienists.................................................................................................................................................................. 32 Outflow of Hygienists ............................................................................................................................................................... 32 CENTRAL SIERRA DENTAL HYGIENE LABOR MARKET .................................................................................................................. 32 Demographics & Educational Level ........................................................................................................................................ 32 Practice Characteristics ........................................................................................................................................................... 33 GREATER SACRAMENTO REGIONAL SUMMARY ............................................................................................................. 35 DEMAND FOR DENTAL HYGIENISTS IN GREATER SACRAMENTO .................................................................................................... 35 THE SUPPLY OF DENTAL HYGIENISTS IN GREATER SACRAMENTO ................................................................................................. 37 Inflow of Hygienists.................................................................................................................................................................. 38 Outflow of Hygienists ............................................................................................................................................................... 39 GREATER SACRAMENTO DENTAL HYGIENE LABOR MARKET ........................................................................................................ 39 Demographics & Educational Level ........................................................................................................................................ 39 Practice Characteristics ........................................................................................................................................................... 40 INLAND EMPIRE REGIONAL SUMMARY .............................................................................................................................. 42 DEMAND FOR DENTAL HYGIENISTS IN THE INLAND EMPIRE .......................................................................................................... 42 THE SUPPLY OF DENTAL HYGIENISTS IN THE INLAND EMPIRE ....................................................................................................... 45 Inflow of Hygienists.................................................................................................................................................................. 45 Outflow of Hygienists ............................................................................................................................................................... 46 INLAND EMPIRE DENTAL HYGIENE LABOR MARKET ..................................................................................................................... 46 Demographics & Educational Level ........................................................................................................................................ 46 Practice Characteristics ........................................................................................................................................................... 47
NORTHERN SACRAMENTO VALLEY REGIONAL SUMMARY ........................................................................................ 49 DEMAND FOR DENTAL HYGIENISTS IN THE NORTHERN SACRAMENTO VALLEY ............................................................................ 49 THE SUPPLY OF DENTAL HYGIENISTS IN THE NORTHERN SACRAMENTO VALLEY ......................................................................... 52 Inflow of Hygienists.................................................................................................................................................................. 52 Outflow of Hygienists ............................................................................................................................................................... 53 NORTHERN SACRAMENTO VALLEY DENTAL HYGIENE LABOR MARKET ....................................................................................... 53 Demographics & Educational Level ........................................................................................................................................ 53 Practice Characteristics ........................................................................................................................................................... 54 NORTHERN CALIFORNIA EAST REGIONAL SUMMARY.................................................................................................. 56 DEMAND FOR DENTAL HYGIENISTS IN NORTHERN CALIFORNIA EAST .......................................................................................... 56 THE SUPPLY OF DENTAL HYGIENISTS IN NORTHERN CALIFORNIA EAST ....................................................................................... 58 Inflow of Hygienists.................................................................................................................................................................. 59 Outflow of Hygienists ............................................................................................................................................................... 59 NORTHERN CALIFORNIA EAST DENTAL HYGIENE LABOR MARKET............................................................................................... 59 Demographics & Educational Level ........................................................................................................................................ 59 Practice Characteristics ........................................................................................................................................................... 60 NORTHERN CALIFORNIA WEST REGIONAL SUMMARY................................................................................................. 62 DEMAND FOR DENTAL HYGIENISTS IN NORTHERN CALIFORNIA WEST ......................................................................................... 62 THE SUPPLY OF DENTAL HYGIENISTS IN NORTHERN CALIFORNIA WEST ...................................................................................... 64 Inflow of Hygienists.................................................................................................................................................................. 65 Outflow of Hygienists ............................................................................................................................................................... 65 NORTHERN CALIFORNIA WEST DENTAL HYGIENE LABOR MARKET.............................................................................................. 66 Demographics & Educational Level ........................................................................................................................................ 66 Practice Characteristics ........................................................................................................................................................... 66 SAN JOAQUIN VALLEY REGIONAL SUMMARY.................................................................................................................. 69 DEMAND FOR DENTAL HYGIENISTS IN THE SAN JOAQUIN VALLEY ............................................................................................... 69 THE SUPPLY OF DENTAL HYGIENISTS IN THE SAN JOAQUIN VALLEY ............................................................................................ 72 Inflow of Hygienists.................................................................................................................................................................. 72 Outflow of Hygienists ............................................................................................................................................................... 73 SAN JOAQUIN VALLEY DENTAL HYGIENE LABOR MARKET .......................................................................................................... 73 Demographics & Educational Level ........................................................................................................................................ 73 Practice Characteristics ........................................................................................................................................................... 74 SOUTHERN BORDER REGIONAL SUMMARY ...................................................................................................................... 76 DEMAND FOR DENTAL HYGIENISTS IN THE SOUTHERN BORDER.................................................................................................... 76 THE SUPPLY OF DENTAL HYGIENISTS IN THE SOUTHERN BORDER ................................................................................................ 79 Inflow of Hygienists.................................................................................................................................................................. 79 Outflow of Hygienists ............................................................................................................................................................... 80 SOUTHERN BORDER DENTAL HYGIENE LABOR MARKET............................................................................................................... 80 Demographics & Educational Level ........................................................................................................................................ 80 Practice Characteristics ........................................................................................................................................................... 81 SOUTHERN COAST REGIONAL SUMMARY.......................................................................................................................... 83 DEMAND FOR DENTAL HYGIENISTS IN THE SOUTHERN COAST ...................................................................................................... 83 THE SUPPLY OF DENTAL HYGIENISTS IN THE SOUTHERN COAST ................................................................................................... 85 Inflow of Hygienists.................................................................................................................................................................. 86 Outflow of Hygienists ............................................................................................................................................................... 87 SOUTHERN COAST DENTAL HYGIENE LABOR MARKET ................................................................................................................. 87 Demographics & Educational Level ........................................................................................................................................ 87 Practice Characteristics ........................................................................................................................................................... 88 METHODOLOGY........................................................................................................................................................................... 90 STUDY LIMITATIONS.................................................................................................................................................................. 91 DEFINITION OF TERMS.............................................................................................................................................................. 91
Introduction
INTRODUCTION Registered dental hygienists (RDHs) focus on providing preventive and therapeutic dental hygiene services designed to reduce the incidence and severity of periodontal disease and caries (cavities) for the population of California. The labor market for dental hygienists is responsive to variations in multiple factors at the local level. This study explores the labor market for the California dental hygiene workforce at a regional level, providing policy makers, professionals and educators an unprecedented look at local labor market dynamics which contribute to the provision of preventive dental care. Much is known about the dentist workforce and about the utilization of dental care at a national level, but few studies have focused on the supply of and demand for dental hygienists at the regional level. Prior studies have identified that California dentists perceived a shortage of RDHs. Statewide economic trends in wages substantiate the possibility of earlier shortages of assistants and hygienists, but also show this easing somewhat since 2000.1,2,3 Our data support the conclusion that the labor market is trending toward an increased supply of dental hygienists statewide, however the regional analyses provided here show the variation in current and projected supply at a local level which has been previously unavailable. Key findings from this chart book are:
Regional analyses show a wide range in baseline supply of RDHs (20.2 to 47.9 per 100,000 population) as well as growth (from -0.4% to 33.6% between 2002-2005) indicating the uneven nature of the supply and growth around the state. There is wide variability by region in baseline supply (dentists and hygienists in relation to the population), relational supply (the number of hygienists per dentist), supply projections (new graduates and retirements or other labor market exits), and perceptions of supply (RDH vacancies and difficulty finding work). Within most regions contradictory indicators exist, indicating that one single indicator is insufficient to understand the full nature of the local labor market. The labor market for RDHs contracted statewide between 2000 and 2005. However, the barriers to finding employment encountered by RDHs and the level of contraction varied by region. The San Joaquin Valley, Greater Sacramento, Northern Sacramento Valley, Central Sierra, Central Coast and Inland Empire experienced more severe contractions than the other regions. The five regions reported greater than average proportions of RDHs having some to extreme difficulty finding employment in 2005. There was variation by region in the barriers to RDH employment. The most common difficulty cited was the inability to find a satisfactory work environment, closely followed by extended travel time (more common in rural regions) and the need for one specific day and not being able to find it (more common in urban regions). The increase in both the number of dental hygiene educational programs (23 currently) and graduates in recent years (523 in 2007) has led to a decrease in the percent of younger hygienists educated out of state. Still, about one sixth of hygienists under the age of 34 report being educated out of state. The Bay Area, Southern Border, Northern California East and West and the Northern Sacramento Valley continue to report a higher than average percent of out-of-state educated RDHs under the age of 34. Projecting from 2005 to 2010, there will be a net gain of 293 RDHs. Estimates suggest 2605 new graduates will enter the field, whereas survey data reporting intention to retire suggest 2312 RDHs will exit the profession during that period. Projecting out ten years to 2015, if the numbers remain generally stable and all graduates remain in the state, California will face a net loss of 537 RDHs statewide due to the exits of 5747 RDHs and the entrance of 5210 graduates. Continued inmigration at current levels would add another 16% annually (about 860 additional RDHs over 10
1
Brown TT, Finlayson TL, Scheffler RM. How do we measure shortages of dental hygienists and dental assistants? Evidence from California: 19972005. J Am Dent Assoc. Jan 2007;138(1):94-100. 2 Pourat N, Brown TT. Is there a Shortage of Dental Hygienists and Assistants in California? Sacramento: CDA Foundation; November 2005. 3 Pourat N, Roby D, Wyn R, Marcus M. Findings from the 2003 California Dental Survey. Los Angeles: UCLA Center for Health Policy Research; November 2005.
3
Introduction
years) changing the overall projection to a net gain of just over 300 RDHs statewide by 2015. The lack of consistent data on the practice status and geographic distribution of dentists, combined with the lack of any projected data on dentist’s employment patterns of RDHs, renders it impossible to say whether these projections indicate “too many”, “not enough”, or “just the right number” of RDHs for the future. Conclusions and Recommendations Discussions with leaders and educators in the various regions confirmed that the trend toward increased difficulty in finding full RDH employment continued from 2005 to 2008. Many younger graduates report difficulty when first entering the labor market, particularly with locating listings, receiving job interviews, and finding employment for a sufficient number of days per week. The primary issue which confounds the understanding of the levels of supply and demand for RDHs is the uneven utilization of dental hygienists by dentists. About half of dentists do not employ RDHs, others employ multiple RDHs, and some only employ part time RDHs.4 This creates a situation whereby a single vacancy does not represent a full time equivalent RDH. As well, many RDHs do not want to work more than a few days a week. Therefore, regions with high supply of RDHs may also have high number of vacant part time positions, due to the mismatch between what each provider is looking for in the employment/employee relationship. The mismatch between supply and demand of RDHs creates a large latent supply of RDH labor in the state. This is shown resoundingly in the number of RDHs statewide who report a difficulty in finding one more day of work, one specific day of work, or part time work. It is likely that there is widespread under-employment of RDHs, although again this varies by region of the state. New avenues for employment of RDHs in non-traditional settings are opening up in community health centers, public health settings and other community based locations as policy makers attempt to deal with problems in access to care and health disparities. New laws allowing for alternative practice and unsupervised public health practice allow for a decoupling of RDHs from the primary employment option of a dental office. Non-traditional employers and the public may benefit from the under-employment of RDHs if viable alternatives to accessing dental hygiene care are created. Nonetheless, the non-traditional jobs provide a small proportion of overall RDH employment to date. The contraction in the RDH labor market occurred in conjunction with a number of new education programs and the economic downturn of the early 2000’s. It is difficult to project what the future holds for the dental hygiene labor market as the US economy falters, reducing the disposable income available to pay for dental procedures, half of which are paid out of pocket. If business slows for dental practices, dentists may lay off RDHs and provide hygiene services themselves. Yet, educational programs continue to grow, with several new RDH programs under development, as well as a new dental school opening in 2009.
This report is organized as a series of labor market regional summaries, following a California statewide summary. The eleven regions used were adapted from the nine California Economic Strategy Panel Regions.5 Each regional summary has three parts. First there is a section on demand for dental hygienists which looks at population, provider and employment trends. Second is a section on the supply of dental hygienists, including inflow from local educational supply and migration and outflow from migration and labor market exits. Finally each region has a section describing the state of the labor market in that region, including demographics of the workforce, wages, benefits, and practice characteristics. The data used in this report come from a number of sources, primarily the 2005-2006 Statewide Sample Survey of Registered Dental Hygienists in California. The data are explained in detail in the Methodology section at the end of the report. 4
Pourat N, Roby D, Wyn R, Marcus M. Findings from the 2003 California Dental Survey. Los Angeles: UCLA Center for Health Policy Research; November 2005. 5 http://www.labor.ca.gov/panel/espcrep.htm
4
Introduction
5
California Summary
CALIFORNIA Demand for Dental Hygienists in California The demand for registered dental hygienists (RDHs) in California is driven by dental offices response to the demand for dental care by the population, which will continue to grow and change over the next few decades. California’s population is projected to grow from 34 million in 2000 to over 54 million people by 2040. There is a bifurcated age distribution in the state, with projected growth in both the over 65 population as well as the under 18 population. California has no racial/ethnic majority, and the population will continue to increase in racial and ethnic diversity. Population trends ultimately drive the need for dental services; however the supply of general practice dentists, the primary employer of RDHs, is a key indicator determining demand for dental hygienists. Grow th of General DDS, Active RDH and Total Population in California (2002-2005)
In 2005, the statewide supply of dentists was growing faster than the supply of RDHs, and was outpacing population growth. As a result, the ratio of RDH to dentists dropped to 0.43 in 2005, from a reported 0.47 in 2002.6 The ratio of dentists to population in California (70.0/100,000) is significantly higher than the national average (59.0/100,000),7 while the ratio of RDHs to population in California (29.8/100,000) is less than the national average (51.0/100,00). However, the supply and growth of practitioners varies widely across regions of the state, reflected by a wide variability of dentist to population ratios as well as dentist to RDH ratios.
10% 9% 8% 7% 6%
8.7% 7.8%
4.4%
5% 4% 3% 2% 1% 0% General DDS
Active RDH
Population
General DDS and Active RDH per Population (2005-2006)
Active RDH per General DDS (2005-2006)
DDS per 100,000 P o p
RDH per 100,000 P o p
Number o f RDH per Dentist
California Southern Coast Southern Border
0.92
Central Sierra
0.76 0.62
Bay Area 0.2
0.4
0.6
46.5 43.5
Central Sierra
39.0
Central Co ast
41.1
0.8
0
1.0
6
69.5
51.2 66.0
37.0
B ay A rea
0.40 0.0
20.2
Greater Sacramento
0.63
72.5
47.9 51.9
Inland Empire
Central Coast
54.2 49.3
N. Sacramento Valley
0.43
Greater Sacramento
44.2
N. Califo rnia East
0.68
N. Sacramento Valley
68.9
32.5
N. Califo rnia West
0.60
N. California East
25.5
San Jo aquin Valley
0.58
N. California West
74.1 37.6
So uthern B o rder
0.55
San Joaquin Valley
70.0
23.9
So uthern Co ast
0.32
Inland Empire
29.8
Califo rnia
0.43
20
40
91.5 60
80
100
Pourat N, Roby D, Wyn R, Marcus M. Findings from the 2003 California Dental Survey. Los Angeles: UCLA Center for Health Policy Research; November 2005. 7 American Dental Education Association. Trends in Dental Education. American Dental Education Association [Online Presentation]. Available at: http://www5.adea.org/tde/mainindex.htm. Accessed October 2, 2008.
6
California Summary
25%
In a 2006 statewide sample survey, dental hygienists reported the number of RDH vacancies in their primary clinical practice. Statewide only 2.8% of practices had a full-time position available, while 11.8% had a part-time position available. There was wide regional variation in the percent of practices with vacant positions, ranging from 0%-5% for fulltime positions, and 7.1%-20.8% for part-time positions. The data likely underreport vacancies as they are only for practices where an RDH already worked, and would not include dental practices with a vacancy where no RDH currently was employed. Alternately, only about half of dentists in the state report employing RDHs at all.8
Percent of Clinical RDH's Reporting One or More RDH Vacancies in their Prim ary Practice (2005-2006)
20% 15% 10% 5%
N
B C ay . S en Ar a c tra ea ra l S N me ier .C n ra G a to re l ifo Va at e rni ... Sa r S a W n acr e Jo am s t aq e So uin nto ut V he al N . C rn l ey B al if or So orn der u t ia he Ea r s C nC t en oa tr a s In l C t la oa To nd E st ta l C mp al ire i fo rn ia
0%
Full Time Vacancy
P art Time Vacancy
In 2005, 9.9% of RDHs reported they were actively looking for work. The dental hygiene labor market contracted significantly between 2000 and 2005. Over 40% of hygienists who had looked for work in the past 12 months (indicating the year 2005) reported some level of difficulty finding employment, up from only 11% five years prior (indicating the year 2000). However, the majority of hygienists (59.4%) still reported “no difficulty” finding employment in 2005. Clinical RDH's Type of Difficulty Encountered Finding Em ploym ent the Last 12 Months (2005-2006)
Clinical RDH's Level of Difficulty Finding Em ploym ent When Last Sought (2005-2006) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
40.0%
20.0%
26.3% 26.0%
25.4%
30.0%
18.8% 19.9% 11.3% 9.4%
10.2%
10.0%
5+ years ago No Difficulty
3-5 years ago
1-3 years ago
Some Difficulty
Difficulty
< 12 months Extreme Difficulty
N ee de d Fu N ee llde Ti N m d ee e Pa de r t- T d Sp im ec e Sa ifi la c ry D ay In Be ad n U e e ns qu fit s at at In is e a fa d ct eq or ua y te W or k En Tr v. av el Ti m e O th er
0.0%
The type of difficulty encountered in the prior 12 months varied, with the top difficulties reported being: (1) could not find a satisfactory work environment (26.3%); (2) long travel times (26.0%); and (3) unable to find employment on a specific day (25.4%). Clinical RDHs were asked their opinion of local supply of RDHs. The response was mixed with 12.1% reporting too many hygienists, 20.4% reporting not enough, and 67.5% reporting adequate supply. The opinion on supply varies by region and is shown in more detail in the regional analyses.
8
Pourat N, Roby D, Wyn R, Marcus M. Findings from the 2003 California Dental Survey. Los Angeles: UCLA Center for Health Policy Research; November 2005.
7
California Summary
The Supply of Dental Hygienists in California The local supply of dental hygienists is impacted by the number of new graduates in the region who are licensed, by migration into and out of the region of licensed providers, and exits from the occupation for reasons such as retirement or change of career.
Inflow of Hygienists California, like the nation, has been rapidly expanding the number of dental hygiene programs and graduates. Statewide the number of programs increased 64% in the past 14 years, and stood at 23 programs in 2007. The growth in graduates is even steeper with an 84.8% increase from 1985-2007, indicating not only growth in programs but in class size. All of the growth in graduates has been at the associate degree (or equivalent) level. Although a new baccalaureate program did come on line, another one closed. Degree Type Aw arded by California Dental Hygiene Program s (1985-2007)
Num ber of Dental Hygiene Education Program s in California (1985-2007) 25
500 Degrees Awarded
23
20 . 15
300
AS 181
BS
200 100 0
98 101
19 85 19 88 19 91 19 94 19 97 20 00 20 03 20 06
2007
2005
2003
2001
1999
1997
1995
1993
1991
1989
1987
1985
10
423
400
Dental hygiene programs are not distributed evenly around the state. Only seven of eleven economic regions have one or more dental hygiene programs. The number of graduates in each region varies over time. Significant growth was experienced in the San Joaquin Valley, Southern Border and Greater Sacramento regions, while mixed growth was experienced in the Bay Area, Northern Sacramento Area, and the Inland Empire. Some decline was seen in the Southern Coast (Los Angeles) region. Regional Distribution of Dental Hygiene Graduates from California Programs (1985-2007) 180 Bay Area
140
N. Sacramento
120
Greater Sacramento
100
San Joaquin Valley
80 Southern Border
60 40
Southern Coast (LA)
20
Inland Empire
*Regions not listed do not have a dental hygiene education program
8
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
0 1985
Number of Graduates
160
California Summary
The diversity of the health care workforce is an ongoing concern. Dental hygiene has been traditionally a white female profession. The gender composition of graduates changed very little, with male graduates rising from 3.5% to 6.9% of all graduates from 1995-2007. The racial/ethnic composition of graduates changed with 44.5% of graduates in 2007 from a non-white group, up from 31.8% in 1995, but slightly down from 48.5% in 2004. Racial Distribution of Dental Hygiene Graduates from California Programs (1995-2007) Percent of Graduates
80% 70% White
60%
Asian
50% 40%
Latino
30%
African American
20%
Native American
10%
Unknow n
0% 2000 *Includes imputed data
2001
2002
2003
2004
2005
2006
2007
Year
The migration pattern of dental hygiene graduates is very difficult to track. Educators report that individuals seeking hygiene education prefer to stay close to where they live, but many are willing to relocate for their education. How likely they are to return is unknown. In the 2005-06 statewide sample survey, licensed providers reported where they were first licensed, demonstrating the extent to which local labor markets depend on an out-of-state supply of practitioners. According to the survey 22.6% of the state’s hygiene workforce received their first dental hygiene license in another state, and according to license file data, a similar number, 26.2%, were educated out of state. Data show that older hygienists are more likely to have been educated and licensed outside of California, reflecting a growing trend towards home grown dental hygiene graduates. Percent of Active RDHs in California w ith Out-of-State Dental Hygiene Education and First Licensure (2005-2006) 50 40 30 20 10
Ar ea en N tra .S lS ac ie ra rr m a en to N Va .C ll e al y ifo rn G re ia at W er es S t ac ra Sa m n en Jo to aq ui n V So al le ut y he rn Bo N .C rd er al ifo rn ia So Ea ut st he rn C oa C st en tra lC oa In st la nd Em To pi re ta lC al i fo rn ia
0
Ba y
Education Out-Of-State
C
Percent Out-Of-State
60
Licensed Out-of-State
9
California Summary
Outflow of Hygienists The health care workforce is aging, and dental hygiene practitioners reflect this general trend; 4.1% of clinical RDHs in the state (about 450 individuals) expect to retire in less than 2 years, and another 16.5% (about 1811 individuals) expect to retire in 2 to 5 years. Currently, new graduates exceed RDHs leaving the profession. If graduation rates remain stable there should be net increase of about 350 hygienists statewide by 2010. Looking forward, 51.1% of active RDHs say they intend to retire by 2015, which would result in a net loss of 537 RDHs statewide. With the continued in-migration of another 16% annually (current rate for younger RDHs) and California graduation rates this becomes a net gain of just over 300 RDHs statewide by 2015. It is unclear whether or not the inflow of RDHs to California and new graduates will meet demand for dental hygiene services as there is wide variation by region. Clinical RDHs Reported Years Left in Practice in California (2005-2006)
Percent of Licensed RDHs Currently Active in Practice in California (2005-2006) 100 90 80 70 60 50 40 30 20 10 0
4.1% 16.6%
48.9%
