U.S. labor market booms in April, adding 253,000 jobs

The labor market added 253,000 payrolls in April, while the unemployment rate dipped to 3.4% — a historically low level.

Why it matters:

Job growth continued to boom last month, the latest sign that economy has strong momentum despite recent bank failures.

  • Economists expected a gain of 185,000 jobs last month.


The April job figures are a pickup from the 165,000 jobs added the previous month, which were revised down by 71,000, the Labor Department said on Friday.

  • The Labor Department said that jobs growth in the previous two months was lower than first estimated: jobs growth was revised down by a combined 149,000 for February and March.

The big picture:

In recent months, more Americans have joined the workforce, helping to ease labor force shortages.

  • The labor force participation rate — or the share of workers employed or looking for work — held at 62.6% in April.
  • Average hourly earnings, a measure of wage growth, rose to 0.5% in March. Wages rose 4.4% from the same time last year.

Where it stands:

The Federal Reserve has been concerned about an out-of-balance labor market that it fears could stoke inflation that’s already running high.

  • But Fed Chair Jerome Powell said this week that there were signs that the workforce was “coming back into better balance,” though it remained “very tight.”

Rebound in Labor Supply

One of the most persistent economic narratives of 2021 and 2022 was that of missing workers. Many Americans seemed to have simply vanished from the labor force during the pandemic, leaving employers in a lurch.

  • That’s no longer the case, White House economists argue in a new post presenting evidence that labor supply has returned to its pre-pandemic trend.

Why it matters: 

It would be way less painful if the U.S. labor market were to come into a better, non-inflationary balance because labor supply increased, rather than labor demand decreased.

  • And contrary to a widespread economic narrative of the last couple of years, that seems to be happening — as the Biden team seeks to emphasize.

State of play: 

There has been ample speculation about why labor supply was depressed in the aftermath of the pandemic, the White House Council of Economic Advisers notes.

  • Maybe fear of COVID, or long COVID symptoms, kept people out of work. Maybe it was excess savings from the pandemic, or reassessment of life priorities, or a “collective loss of work ethic.”

Nah. It increasingly looks as if it just took some time for potential workers to match up with jobs and return to the labor force.

By the numbers: 

The share of prime-age workers — those between 25 and 54 — who are part of the workforce is now a tick higher than it was before the pandemic: 83.1%, compared with 83.0% in February 2020.

  • The overall participation rate is down (62.6%, from 63.3% in February 2020), but that is due to the Baby Boom generation retiring. It’s on track with what forecasters at the Congressional Budget Office anticipated before the pandemic.
  • Moreover, immigration rates surged in 2022 after a pandemic collapse, also adding to the supply of labor.

What they’re saying: 

“The swift but lagged response of labor supply to surging demand suggests that with time workers do respond to favorable economic conditions,” the White House economists write.

  • “There are many plausible reasons that explain why this response is lagged. Most obviously, the job search process itself is not frictionless; it may take workers some time to find a good job,” they wrote.
  • “Also, if households adapted to the pandemic in ways that can take a while to unwind (such as giving up formal child care), this would delay the labor supply response to growing demand.”

The bottom line: 

“There’s still an inaccurate view that prime-age labor supply is depressed,

that immigration is way down, and that labor force participation rates aren’t back on trend following the pandemic shock to our economy,” Ernie Tedeschi, the chief economist at the CEA, tells Axios.

  • In fact, he said, tight labor markets “pull folks back into the workforce and, while we have more to do to break down barriers to entry, the ‘missing worker’ story doesn’t quite apply anymore.”

The No. 1 problem keeping hospital CEOs up at night

Workforce problems in U.S. hospitals are troublesome enough for the American College of Healthcare Executives to devote a new category to them in its annual survey on hospital CEOs’ concerns. In the latest survey, executives identified “workforce challenges” as the No. 1 concern for the second year in a row.

Financial challenges, which consistently held the top spot for 16 years in a row until 2021, were listed the second-most pressing concern in the American College of Healthcare Executives’ annual survey.

Although workforce challenges were not seen as the most pressing concern for 16 years, they rocketed to the top quickly and rather universally for healthcare organizations in the past two years. Most CEOs (90 percent) ranked shortages of registered nurses as the most pressing within the category of workforce challenges, followed by shortages of technicians (83 percent) and burnout among non-physician staff (80 percent). 

Here are the most concerning issues hospital CEOs ranked in 2022, along with the score of how pressing CEOs find each issue. 

1. Workforce challenges (includes personnel shortages and staff burnout, among other issues) — 1.8 

2. Financial challenges — 2.8

3. Behavioral health and addiction issues — 5.2 

4. Patient safety and quality — 5.9

5. Governmental mandates — 5.9

6. Access to care — 6.0  

7. Patient satisfaction — 6.6

8. Physician-hospital relations — 7.6

9. Technology — 7.7 

10. Population health management — 8.6

11. Reorganization (mergers and acquisitions, partnerships and restructuring) — 8.7 

Within financial challenges, most CEOs (89 percent) ranked increasing costs for staff and supplies as the most pressing, followed by operating costs (66 percent) and Medicaid reimbursement (63 percent). CEOs are less concerned about price transparency and moving away from fee-for-service.

Seventy-eight percent of CEOs ranked lack of appropriate facilities/programs as most pressing within the category of behavioral health and addiction issues. That was followed by lack of funding for addressing behavioral health and addiction issues (77 percent).

The results are based on a survey administered to CEOs of community hospitals (non-federal, short-term, non-specialty hospitals). ACHE asked respondents to rank 11 issues affecting their hospitals in order of how pressing they are. Results are based on responses from 281 executives.

Hospitals living paycheck to paycheck, unable to make long-term investments

Healthcare added almost 45,000 jobs in November, but many hospitals and health systems will continue to struggle to meet staffing needs, retain top executives and providers, and foster long-term pipelines for talent, Ted Chien, president and CEO of independent consulting firm SullivanCotter, wrote in a Dec. 15 article for Nasdaq.

Hospitals and health systems are living “paycheck to paycheck” and unable to make long-term investments at the height of the current workforce crisis, Mr. Chien said.

The challenge boils down to a healthcare delivery problem, not a demand problem. 

Baby Boomers are the greatest source of care demand on the healthcare system, but are unable to contribute to the provider workforce in the numbers needed to achieve balance, according to Mr. Chien. To compound that issue, burnout is a major factor why “too many” frontline workers have left or plan to exit healthcare, he said. 

Last year, an estimated 333,942 healthcare providers dropped out of the workforce, including about 53,000 nurse practitioners, which has led hospitals to spend more on contract labor and feeling more pressure to consolidate, according to an October report published by Definitive Healthcare.

Long term, a continued lack of healthcare workers would force hospitals to operate in a heightened crisis mode, according to Mr. Chien, depriving non-critical patients of sufficient health prevention and demanding too much of providers who are already overly taxed. 

Mr. Chien highlighted three key areas to tackle the workforce crisis: smarter technology, resilient teams and excellent leadership. 

Technologies that alleviate providers’ administrative burdens will be critical to reduce burnout and keep caregivers focused on patient care, while smarter tech can also forge pipelines for future providers by streamlining clinical experience operations and aligning student placements with existing opportunities.

Building resilient teams begins with competitive pay and robust benefit packages, which fosters trust and demonstrates that a hospital values its staff, according to Mr. Chen. Supporting career growth, including upskilling and redeploying staff when appropriate, empowers employees.

Lastly, capable executive leadership teams, under intense scrutiny from industry stakeholders, must clearly outline their hospital or health system’s strategy and provide the change needed to support their staff. Lack of trust in leaders drives staff out of healthcare, so it is crucial to recruit and retain “modern, strategic thinkers with depth of experience who are prepared to lead,” Mr. Chien wrote. 

Click here to read the full article.

The dire state of hospital finances (Part 1: Hospital of the Future series)

About this Episode

The majority of hospitals are predicted to have negative margins in 2022, marking the worst year financially for hospitals since the beginning of the Covid-19 pandemic.

In Part 1 of Radio Advisory’s Hospital of the Future series, host Rachel (Rae) Woods invites Advisory Board experts Monica WestheadColin Gelbaugh, and Aaron Mauck to discuss why factors like workforce shortages, post-acute financial instability, and growing competition are contributing to this troubling financial landscape and how hospitals are tackling these problems.


As we emerge from the global pandemic, health care is restructuring. What decisions should you be making, and what do you need to know to make them? Explore the state of the health care industry and its outlook for next year by visiting advisory.com/HealthCare2023.

COVID’s lingering effects on the US workforce


As the nation continues to grapple with the fallout from COVID, one of the greatest unknowns is “long COVID”, the broad range of health problems experienced by a significant number of individuals after contracting the virus. The Centers for Disease Control and Prevention defines long COVID as any post-COVID condition lasting three months or longer.

In the graphic above, we aim to quantify the prevalence of long COVID and its ongoing impact on the US workforce. While estimates for these numbers vary, data compiled by Brookings show that COVID infections in roughly one in four working age adults have resulted in long COVID, and up to one in four individuals with long COVID are unable to work due to their lingering health problems. Long COVID is also more prevalent in middle-aged adults, who are often at the peak of their working years. Dealing with symptoms like chronic fatigue and brain fog, long COVID patients are more likely to be unemployed or working reduced hours, compared to a pre-COVID baseline of the general adult population. 

While it’s difficult to assess the precise impact on the nation’s current labor shortage, the estimate that 4M working age adults are no longer working because of long COVID equals about 40 percent of the 10M total job openings in August of this year, undoubtedly exacerbating ongoing economic challenges.