Insights on Canadian Society
Workforce renewal in health occupations
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Overview of the study
This study uses annual data from the Labour Force Survey (LFS) to examine employment trends in health occupations between 1998 and 2024. Data from the 2021 Census of Population are used to provide age profiles by detailed health occupations, to better understand the extent to which younger workers could replace those approaching retirement age. This article also explores the role of immigration in mitigating the impacts of an aging health workforce.
- The number of workers in health occupations more than doubled from 1998 to 2024 (+898,000; +114.8%). Over that period, the health workforce has grown on average by 3% per year, double the pace observed across all occupations (+1.5% on average per year).
- Employment in nursing occupations rose by 30,000 (+6.9%) from 2023 to 2024, accounting for two-thirds of the overall increase in health occupations over the period (+45,000; +2.7%).
- In 2024, 17.9% of health workers were aged 55 and older. This was down slightly from the peak of 19.6% recorded in 2018, but significantly higher than in 1998 (9.5%).
- The renewal ratio for workers in health occupations was 1.9 in 2024, which means that for each worker approaching retirement age (aged 55 to 64), there was close to two younger workers aged 25 to 34 in the health workforce. While the overall renewal ratio for health occupations has been rather stable in recent years, it does vary when considering specific health occupations (e.g., registered nurses, nurse aides, general practitioners).
- Immigration was a major source of workforce renewal in health occupations, particularly among nurse aides, orderlies and patient service associates. In 2021, recent immigrants (13.0%) and non-permanent residents enumerated in the Census (10.8%) together accounted for close to one-quarter (23.8%) of all nurse aides, orderlies and patient service associates aged 25 to 34.
- In 2021, nearly half of recent immigrants (47.1%) who were nurse aides, orderlies and patient service associates had a bachelor’s degree or a higher level of education. In contrast, only 6.3% of workers in this occupation and who were born in Canada had a bachelor’s degree or a higher level of education.
Introduction
Canada’s health care system has strived to maintain a sufficient workforce to meet the rising health care demands of an aging population. From 2016 to 2021, the number of people aged 65 and older rose by 18.3% to reach 7 million, and that number is projected to reach 11.8 million by 2051. Meanwhile, the number of persons aged 85 and older is projected to triple from 861,000 in 2021 to 2.8 million in 2051.Note Note
Across all occupations, the aging of the workforce is putting downward pressure on labour supply. According to the 2021 Census of Population, a record high proportion (21.8%) of the working-aged population was close to retirement age in 2021 (i.e., aged 55 to 64).Note The impacts of an aging population on labour supply can be mitigated by immigration, which has played an increasingly large role in Canada’s labour market, including in the health care sector, where the share of new and recent immigrant workers has grown since 2010.Note
While the overall supply of health care professionals has grown or remained stable,Note growth has not always kept pace with the needs of an aging population. For example, the number of nurses providing direct care per 1,000 seniors (age 65 and older) in Canada has declined from 59 in 2013 to 52 in 2022.Note
In this context—and given projected shortages of health care workers worldwideNote and in CanadaNote Note —much attention has been given to addressing challenges in retention and recruitment of talent in health care.Note
This article examines the age profile of health occupationsNote in Canada, with a focus on renewal ratios, that is, the ratio of younger workers (workers aged 25 to 34) to those approaching retirement age (workers aged 55 to 64). These ratios can be used to measure occupational renewal, with lower ratios signaling potential difficulties meeting labour demand in the future (for more information, refer to the text box “Occupational renewal ratios”). For example, a ratio below 1.0 in a given health occupation would indicate that there are fewer young workers entering that occupation relative to older workers approaching retirement age.
Annual data from 1998 to 2024 from the Labour Force Survey (LFS) are used to examine aggregate employment trends in health occupations, while data from the 2021 Census of Population are used to examine disaggregated age profiles, including renewal ratios, by detailed occupation (for more information, refer to the “Data sources”).
The extent to which immigration is mitigating the impacts of an aging health workforce on renewal ratios is also examined using Census data, by looking at the shares of young workers in select health occupations who are recent immigrants or non-permanent residents. The educational attainment profile of recent immigrants entering the health workforce is also explored and compared to that of workers born in Canada.
Growth in the health workforce has outpaced total employment growth over the past 25 years
The number of workers in health occupations has grown steadily in recent decades. Based on data from the Labour Force Survey (LFS), there were just under 1.7 million workers in health occupationsNote in 2024, up 45,000 (+2.7%) from 2023, and up 212,000 (+14.4%) from 2019, before the COVID-19 pandemic.
The number of workers in health occupations more than doubled from 1998 to 2024 (+898,000; +114.8%). Over the same period, the health workforce has grown on average by 3% per year, double the pace observed across all occupations (+1.5% on average per year) (Chart 1). Consequently, the share of the health workforce in the total workforce in Canada has increased, from 5.6% in 1998 to 8.1% in 2024.
Data table for Chart 1
| Year | Employment growth | |
|---|---|---|
| Health occupations | All occupations | |
| index 1998=100 | ||
| Source: Statistics Canada, Labour Force Survey, 1998 to 2024. | ||
| 1998 | 100.0 | 100.0 |
| 1999 | 103.3 | 102.5 |
| 2000 | 105.5 | 105.1 |
| 2001 | 108.2 | 106.3 |
| 2002 | 115.6 | 108.9 |
| 2003 | 118.1 | 111.5 |
| 2004 | 122.9 | 113.3 |
| 2005 | 127.2 | 114.8 |
| 2006 | 129.3 | 116.8 |
| 2007 | 131.5 | 119.3 |
| 2008 | 137.9 | 121.0 |
| 2009 | 141.5 | 119.3 |
| 2010 | 146.0 | 120.9 |
| 2011 | 152.5 | 122.6 |
| 2012 | 155.2 | 124.1 |
| 2013 | 157.7 | 125.8 |
| 2014 | 160.1 | 126.3 |
| 2015 | 166.2 | 127.1 |
| 2016 | 172.3 | 127.9 |
| 2017 | 180.9 | 130.8 |
| 2018 | 184.5 | 133.2 |
| 2019 | 187.7 | 135.8 |
| 2020 | 187.7 | 128.6 |
| 2021 | 199.4 | 135.0 |
| 2022 | 206.3 | 140.5 |
| 2023 | 209.1 | 144.8 |
| 2024 | 214.8 | 147.6 |
Growth in the health workforce, since 1998 as well as in more recent years, was reflected across major health occupation groups and specific health occupations. For example, employment in nursing occupationsNote (as measured in the LFS) rose by 30,000 (+6.9%) from 2023 to 2024, accounting for two-thirds of the overall net increase in health occupations over the period (+45,000; +2.7%) (Chart 2).
Compared with before the COVID-19 pandemic, in 2019, employment in nursing occupations in 2024 was up by 21.2%. Over the same period, the number of physiciansNote (+7.2%) and the number of nurse aides, orderlies and patient service associates (+3.7%) also grew, albeit at a slower pace.
Data table for Chart 2
| Year | Health occupations | ||
|---|---|---|---|
| Physicians | Nursing occupations | Nurse aides, orderlies and patient service associates | |
| number | |||
| Note: Selected health occupations were coded using the National Occupational Classification (NOC) 2021 and include the following codes: physicians (NOC 31100, 31101, 31102); nursing occupations (NOC 31301, 31302, 32101); nurse aides, orderlies and patient service associates (NOC 33102).
Source: Statistics Canada, Labour Force Survey, 1998 to 2024. |
|||
| 1998 | 61,000 | 284,100 | 130,900 |
| 1999 | 69,500 | 273,000 | 144,200 |
| 2000 | 62,800 | 270,500 | 155,800 |
| 2001 | 61,500 | 274,000 | 165,400 |
| 2002 | 66,700 | 295,400 | 169,500 |
| 2003 | 70,300 | 283,300 | 188,600 |
| 2004 | 74,300 | 288,400 | 193,800 |
| 2005 | 67,300 | 315,600 | 192,900 |
| 2006 | 77,400 | 305,500 | 194,900 |
| 2007 | 78,800 | 319,000 | 192,500 |
| 2008 | 85,200 | 317,200 | 217,400 |
| 2009 | 82,100 | 330,500 | 222,600 |
| 2010 | 79,000 | 334,500 | 228,000 |
| 2011 | 87,000 | 335,100 | 236,200 |
| 2012 | 88,300 | 347,300 | 250,700 |
| 2013 | 99,000 | 365,500 | 234,200 |
| 2014 | 89,300 | 372,000 | 248,900 |
| 2015 | 99,500 | 366,900 | 251,600 |
| 2016 | 111,800 | 377,400 | 270,100 |
| 2017 | 121,900 | 377,000 | 270,300 |
| 2018 | 120,000 | 395,400 | 288,800 |
| 2019 | 119,800 | 385,900 | 307,300 |
| 2020 | 123,500 | 382,800 | 285,300 |
| 2021 | 121,500 | 401,500 | 311,300 |
| 2022 | 117,100 | 432,200 | 317,200 |
| 2023 | 120,600 | 437,500 | 300,000 |
| 2024 | 128,400 | 467,800 | 318,600 |
This growth in the size of the health workforce was accompanied by changes in its age structure. In 2024, 17.9% of health workers were aged 55 and older. This was down slightly from the peak of 19.6% recorded in 2018, but significantly higher than in 1998 (9.5%) (Chart 3).
Data table for Chart 3
| Year | Age group | ||||
|---|---|---|---|---|---|
| less than 25 years | 25 to 34 years | 35 to 54 years | 55 to 64 years | 65 years and older | |
| number | |||||
| Source: Statistics Canada, Labour Force Survey, 1998 to 2024. | |||||
| 1998 | 50,000 | 210,100 | 447,100 | 64,700 | 9,900 |
| 1999 | 52,900 | 192,300 | 482,700 | 70,100 | 9,500 |
| 2000 | 55,500 | 198,100 | 485,700 | 77,700 | 7,900 |
| 2001 | 52,900 | 208,200 | 492,000 | 84,700 | 8,100 |
| 2002 | 58,200 | 218,400 | 524,200 | 91,700 | 11,700 |
| 2003 | 69,600 | 208,500 | 521,200 | 112,100 | 12,000 |
| 2004 | 69,000 | 222,400 | 542,200 | 112,300 | 15,000 |
| 2005 | 73,500 | 222,800 | 552,300 | 129,000 | 16,900 |
| 2006 | 82,200 | 224,100 | 548,800 | 138,700 | 17,100 |
| 2007 | 75,100 | 237,900 | 546,700 | 149,900 | 18,700 |
| 2008 | 83,900 | 258,800 | 555,000 | 157,600 | 23,000 |
| 2009 | 82,400 | 263,800 | 571,500 | 165,300 | 23,500 |
| 2010 | 89,300 | 268,000 | 572,200 | 185,100 | 26,600 |
| 2011 | 87,400 | 280,900 | 605,800 | 186,400 | 32,100 |
| 2012 | 99,600 | 298,400 | 594,500 | 186,700 | 34,200 |
| 2013 | 82,800 | 312,500 | 605,200 | 191,500 | 41,300 |
| 2014 | 99,500 | 307,000 | 606,400 | 205,100 | 33,700 |
| 2015 | 98,100 | 334,900 | 624,800 | 200,000 | 42,000 |
| 2016 | 100,800 | 357,200 | 628,800 | 216,100 | 43,800 |
| 2017 | 96,400 | 387,400 | 659,700 | 225,400 | 45,200 |
| 2018 | 114,600 | 391,500 | 654,100 | 231,200 | 50,900 |
| 2019 | 114,400 | 386,200 | 691,900 | 218,800 | 56,100 |
| 2020 | 107,100 | 399,800 | 696,700 | 212,700 | 51,600 |
| 2021 | 138,700 | 441,100 | 700,600 | 226,200 | 52,300 |
| 2022 | 137,900 | 450,700 | 740,400 | 227,100 | 56,700 |
| 2023 | 120,000 | 441,800 | 779,800 | 230,300 | 62,600 |
| 2024 | 134,400 | 453,900 | 789,900 | 239,200 | 62,000 |
Occupational renewal ratios
In this study, the occupational renewal ratio for occupation i is defined as follows:
(Number of workers aged 25 to 34 in occupation i) / (Number of workers aged 55 to 64 in occupation i).
Renewal ratios can be used to assess occupational renewal, that is, the extent to which workers approaching retirement age can be replaced by younger workers entering the workforce.Note Lower ratios indicate that there are fewer younger workers who have entered the occupational workforce, relative to workers approaching retirement age. For occupations in which the demand is expected to remain stable or increase, lower ratios typically suggest increased risks of unmet labour demand in the future.
Renewal ratios have some limitations. First, there is no pre-determined target value above which occupational renewal would be ensured. For example, occupations with a renewal ratio above 1.0 (which would mean that there are more young workers relative to workers approaching retirement age) may still experience labour shortages in the future, if the demand for the occupation grows.
Moreover, renewal ratios do not take into account other factors, such as employee retentionNote and age to retirement, which may have a significant impact on the current and future size and composition of an occupation’s workforce.
In addition, young workers with education in a health-related field, but who work in an occupation not related to health, would not be represented in the renewal ratios, but could still represent a potential source of occupational renewal in the future.Note Note
The renewal ratio for workers in health occupations has remained steady in recent years
According to the Labour Force Survey (LFS), the renewal ratio for workers in health occupations was 1.9 in 2024, which means that for each worker approaching retirement age (aged 55 to 64), there was close to two younger workers aged 25 to 34 in the health workforce (Chart 4). The ratio has been rather stable in recent years, and in 2024, it remained relatively unchanged from before the COVID-19 pandemic, in 2019. In comparison, the renewal ratio for the total workforce (which includes all occupational groups) in Canada was 1.5 in 2024.
It is important to note, however, that there hasn’t always been this continuous stability in the renewal ratios of workers in health occupations. Specifically, in the early 2000s, the renewal ratio for workers in health occupations fell sharply and reached a low of 1.4 in 2010, before partially recovering in the years that followed. A similar downward trend was observed for the total workforce, with the renewal ratio falling to a low of 1.3 in 2015. Unlike with health occupations, there was no notable increase in the overall renewal ratio in the past decade to partially offset the decline observed in the early 2000s (Chart 4).
Data table for Chart 4
| Year | Ratio of entrants to potential leavers | |
|---|---|---|
| Health occupations | All occupations | |
| ratio | ||
| Note: Renewal ratios can help assess occupational renewal by examining the extent to which workers approaching retirement (referred to as potential leavers and are between the age of 55 to 64) can be replaced by younger workers entering the workforce (between the age of 25 to 34).
Source: Statistics Canada, Labour Force Survey, 1998 to 2024. |
||
| 1998 | 3.2 | 2.9 |
| 1999 | 2.7 | 2.7 |
| 2000 | 2.5 | 2.5 |
| 2001 | 2.5 | 2.4 |
| 2002 | 2.4 | 2.2 |
| 2003 | 1.9 | 2.0 |
| 2004 | 2.0 | 1.9 |
| 2005 | 1.7 | 1.8 |
| 2006 | 1.6 | 1.7 |
| 2007 | 1.6 | 1.7 |
| 2008 | 1.6 | 1.6 |
| 2009 | 1.6 | 1.5 |
| 2010 | 1.4 | 1.5 |
| 2011 | 1.5 | 1.5 |
| 2012 | 1.6 | 1.4 |
| 2013 | 1.6 | 1.4 |
| 2014 | 1.5 | 1.4 |
| 2015 | 1.7 | 1.3 |
| 2016 | 1.7 | 1.3 |
| 2017 | 1.7 | 1.3 |
| 2018 | 1.7 | 1.3 |
| 2019 | 1.8 | 1.3 |
| 2020 | 1.9 | 1.3 |
| 2021 | 2.0 | 1.3 |
| 2022 | 2.0 | 1.4 |
| 2023 | 1.9 | 1.4 |
| 2024 | 1.9 | 1.5 |
Despite sustained employment growth and relatively high renewal ratios in health occupations compared with other occupational groups, Canada has faced persistent challenges filling available positions in the health care sector. The number of job vacancies in health occupations reached a record-high 97,415 in the third quarter of 2022, more than double the number of vacant positions before the pandemic (40,895 in the third quarter of 2019). Meeting the growing needs of an aging population may therefore require not only replacing retiring workers but also expanding the workforce.
The age profile and renewal ratios can also differ significantly across specific occupations. In the following sections, Census data and the National Occupational Classification (NOC) 2021 are used to examine five occupations in more detail: i) registered nurses, registered psychiatric nurses (NOC 31301) and nurse practitioners (NOC 31302); ii) licensed practical nurses (NOC 32101); iii) nurse aides, orderlies and patient service associates (NOC 33102); iv) general practitioners and family physicians (NOC 31102) and; v) specialists in clinical and laboratory medicine (NOC 31100) and specialists in surgery (NOC 31101)—medical specialists.Note
These occupations were chosen because they accounted for the majority (57.1%) of the overall health workforceNote (excluding managers in health care) at the time of the 2021 Census. These occupations are also central to primary health care and require varying degrees of education and experience.Note
Renewal ratios higher among registered and licensed practical nurses; lower among nurse aides, orderlies and patient service associates
Results from the 2021 Census show that there were 326,265 registered nurses (including registered psychiatric nurses and nurse practitioners) in Canada in 2021, and 72,735 licensed practical nurses. The renewal ratio was 1.9 for registered nurses and 2.2 for licensed practical nurses. These renewal ratios were higher than for health occupations overall (1.6) (Chart 5).
Data table for Chart 5
| Selected health occupations | Ratio of entrants (workers aged 25 to 34) to potential leavers (workers aged 55 to 64) |
|---|---|
| ratio | |
| Notes: Selected health occupations were coded using the National Occupational Classification (NOC) 2021 and include the following codes: specialists in clinical and laboratory medicine (NOC 31100) and specialists in surgery (NOC 31101); general practitioners and family physicians (NOC 31102); registered nurses and registered psychiatric nurses (NOC 31301) and nurse practitioners (NOC 31302); licensed practical nurses (NOC 32101); nurse aides, orderlies and patient service associates (NOC 33102). Renewal ratios can help assess occupational renewal by examining the extent to which workers approaching retirement (referred to as potential leavers and are between the age of 55 to 64) can be replaced by younger workers entering the workforce (between the age of 25 to 34).
Source: Statistics Canada, Census of Population, 2021. |
|
| All health occupations | 1.6 |
| Specialists in clinical and laboratory medicine and specialists in surgery | 1.3 |
| General practitioners and family physicians | 1.5 |
| Registered nurses and registered psychiatric nurses and nurse practitioners | 1.9 |
| Licensed practical nurses | 2.2 |
| Nurse aides, orderlies and patient service associates | 0.9 |
In contrast, the renewal ratio among the 331,790 nurse aides, orderlies and patient service associates was 0.9. This means that there were fewer nurse aides, orderlies and patient service associates entering the workforce (aged 25 to 34) relative to those approaching retirement age (aged 55 to 64).
The renewal ratio for this occupation was lower than for all assisting occupations in support of health services (1.1) and significantly below the average for all health occupations (1.6). This signals potential current and future difficulties meeting labour demand for nurse aides, orderlies and patient service associates, especially if needs for care increase in the context of an aging population.
Among the 60,410 general practitioners and family physicians enumerated in the 2021 Census, the renewal ratio was 1.5, while it was 1.3 for the 46,785 medical specialists (which included 36,115 specialists in clinical and laboratory medicine and 10,670 specialists in surgery). The lower renewal ratio for medical specialists is in part attributable to the longer years of schooling and training normally required to become a specialist (which translates into proportionally fewer specialists aged 25 to 34).
Relatively high percentage of recent immigrants and non-permanent residents offset the impacts of an aging workforce for nurse aides, orderlies and patient service associates
Newcomers, particularly young recent immigrants and non-permanent residents, can help alleviate the impacts of an aging workforce on labour supply and can contribute to increasing renewal ratios in health occupations. This aspect is examined in the following sections based on detailed age profiles by immigrant status, which include the shares of younger workers who are recent immigrants and non-permanent residents (Table 1).
| Selected health occupations by age group | Immigrants admitted before 2011 | Immigrants admitted between 2011 to 2015 | Immigrants admitted between 2016 to 2021 | Non-permanent residents | Non-immigrants |
|---|---|---|---|---|---|
| percent | |||||
| Note: Selected health occupations were coded using the National Occupational Classification (NOC) 2021 and include the following codes: specialists in clinical and laboratory medicine (NOC 31100) and specialists in surgery (NOC 31101); general practitioners and family physicians (NOC 31102); registered nurses and registered psychiatric nurses (NOC 31301) and nurse practitioners (NOC 31302); licensed practical nurses (NOC 32101); nurse aides, orderlies and patient service associates (NOC 33102).
Source: Statistics Canada, Census of population, 2021. |
|||||
| Specialists in clinical and laboratory medicine and specialists in surgery | |||||
| Total | 26.8 | 3.7 | 3.1 | 3.8 | 62.7 |
| 25 to 34 years | 18.7 | 1.5 | 2.2 | 8.6 | 69.0 |
| 35 to 44 years | 17.9 | 4.2 | 5.0 | 5.7 | 67.2 |
| 45 to 54 years | 30.9 | 7.2 | 4.0 | 1.0 | 57.0 |
| 55 to 64 years | 37.5 | 2.7 | 1.1 | 0.3 | 58.5 |
| 65 years and over | 42.3 | 1.0 | 0.3 | 0.0 | 56.2 |
| General practitioners and family physicians | |||||
| Total | 28.5 | 3.9 | 2.7 | 1.5 | 63.3 |
| 25 to 34 years | 21.1 | 1.9 | 2.0 | 2.6 | 72.5 |
| 35 to 44 years | 19.9 | 7.0 | 5.5 | 2.3 | 65.2 |
| 45 to 54 years | 36.1 | 6.9 | 3.6 | 1.2 | 52.2 |
| 55 to 64 years | 35.0 | 2.1 | 0.5 | 0.2 | 62.2 |
| 65 years and over | 41.3 | 0.1 | 0.7 | 0.0 | 57.8 |
| Registered nurses and registered psychiatric nurses and nurse practitioners | |||||
| Total | 19.3 | 4.4 | 2.0 | 0.9 | 73.3 |
| 25 to 34 years | 11.9 | 3.8 | 3.9 | 1.8 | 78.6 |
| 35 to 44 years | 18.4 | 8.6 | 2.6 | 0.7 | 69.8 |
| 45 to 54 years | 29.2 | 3.9 | 0.7 | 0.3 | 66.0 |
| 55 to 64 years | 23.6 | 1.0 | 0.3 | 0.1 | 75.1 |
| 65 years and over | 25.1 | 0.2 | 0.0 | 0.1 | 74.5 |
| Licensed practical nurses | |||||
| Total | 20.9 | 7.2 | 3.6 | 1.0 | 67.4 |
| less than 25 years | 8.5 | 5.6 | 2.6 | 3.4 | 80.0 |
| 25 to 34 years | 11.2 | 7.0 | 6.6 | 1.7 | 73.3 |
| 35 to 44 years | 19.2 | 11.4 | 4.4 | 0.7 | 64.3 |
| 45 to 54 years | 32.7 | 6.4 | 1.2 | 0.3 | 59.3 |
| 55 to 64 years | 29.8 | 1.7 | 0.2 | 0.1 | 68.2 |
| 65 years and over | 28.9 | 0.0 | 0.0 | 0.0 | 70.2 |
| Nurse aides, orderlies and patient service associates | |||||
| Total | 23.6 | 8.8 | 7.2 | 5.2 | 55.2 |
| less than 25 years | 5.7 | 4.0 | 3.9 | 6.0 | 80.4 |
| 25 to 34 years | 8.7 | 7.9 | 13.0 | 10.8 | 59.6 |
| 35 to 44 years | 19.3 | 14.9 | 12.1 | 7.7 | 46.0 |
| 45 to 54 years | 32.3 | 11.0 | 5.5 | 3.0 | 48.1 |
| 55 to 64 years | 36.6 | 4.1 | 1.6 | 0.8 | 56.9 |
| 65 years and over | 42.6 | 2.3 | 1.0 | 0.4 | 53.7 |
Close to half (44.8%) of all nurse aides, orderlies and patient service associates were immigrants—the largest share among the health occupations considered—including 7.2% who had immigrated in the previous five years and 5.2% who were non-permanent residents enumerated in the Census.Note
Accordingly, immigration was a major source of workforce renewal for this occupation and contributed to increasing an otherwise much lower renewal ratio. In 2021, recent immigrants (i.e., those who had become permanent residents in the previous five years) (13.0%), and non-permanent residents enumerated in the Census (10.8%) together accounted for close to one-quarter (23.8%) of nurse aides, orderlies and patient service associates aged 25 to 34.
Recent immigrants who were nurse aides, orderlies and patient service associates often had qualifications acquired abroad which were much higher than those typically required for the occupation. For example, in 2021, nearly half of this group (47.1%) had a bachelor’s degree or a higher level of education (Chart 6-A; Chart 6-B). This included just under one-quarter (24.6%) who had a degree acquired abroad in a health-related field. In contrast, only 6.3% of workers in this occupation and who were born in Canada had a bachelor’s degree or a higher level of education.Note
Data table for Chart 6-A
| Immigrant status and period of immigration | Educational attainment | ||
|---|---|---|---|
| High school diploma or lower level of education |
Postsecondary certificate or diploma below a bachelor's degree |
Bachelor's degree or higher | |
| percent | |||
| Note: Based on the National Occupational Classification (NOC) 2021 and includes the following code: nurse aides, orderlies and patient service associates (NOC 33102).
Source: Statistics Canada, Census of Population, 2021. |
|||
| Non-immigrants | 31.1 | 62.6 | 6.3 |
| Immigrants (admitted before 2011) | 21.2 | 57.5 | 21.3 |
| Immigrants (admitted between 2011 and 2015) | 14.2 | 46.9 | 38.9 |
| Immigrants (admitted between 2016 and 2021) | 15.4 | 37.5 | 47.1 |
| Non-permanent residents | 17.5 | 37.1 | 45.4 |
Data table for Chart 6-B
| Immigrant status and period of immigration | Bachelor's degree in health care field, acquired in Canada | Bachelor's degree in health care field, foreign-educated | Bachelor's degree in non-health care field (Canada and foreign) |
|---|---|---|---|
| percent | |||
| Note: Based on the National Occupational Classification (NOC) 2021 and includes the following code: nurse aides, orderlies and patient service associates (NOC 33102).
Source: Statistics Canada, Census of Population, 2021. |
|||
| Non-immigrants | 1.6 | 0.1 | 4.6 |
| Immigrants (admitted before 2011) | 1.4 | 5.8 | 14.0 |
| Immigrants (admitted between 2011 and 2015) | 1.1 | 16.3 | 21.4 |
| Immigrants (admitted between 2016 and 2021) | 0.9 | 24.6 | 21.7 |
| Non-permanent residents | 2.1 | 19.1 | 24.2 |
This highlights the barriers immigrants can face, particularly those with foreign credentials, when looking to apply their skills in Canada. For many new immigrants, the occupation of nurse aide, orderlies or patient service associate is an entry point for work in the health care system, even for those with qualifications significantly above those required for the job, with a small proportion of them intending to work in the occupation upon admission.Note
Recent immigrants in nursing more likely to work as licensed practical nurses, despite higher educational attainment
Young recent immigrants were also more likely to work as licensed practical nurses than as registered nurses, despite the renewal ratio being lower for registered nurses (1.9) than for licensed practical nurses (2.2). In 2021, 6.6% of licensed practical nurses aged 25 to 34 were recent immigrants, while for registered nurses, the proportion was 3.9%.Note
The majority (62.0%) of recent immigrants who worked as licensed practical nurses had a bachelor’s degree or a higher level of education, including about half (49.0%) who had a degree acquired abroad in a health-related field (Chart 7-A; Chart 7-B). This level of education is usually not required of licensed practical nurses, who usually work under the direction of registered nurses and medical practitioners. In this context, the results again suggest a high prevalence of overqualification for this group and highlight potential barriers to attaining equivalent licensure.
Data table for Chart 7-A
| Immigrant status and period of immigration | Educational attainment | |
|---|---|---|
| Postsecondary certificate or diploma below a bachelor's degree | Bachelor's degree or higher | |
| percent | ||
| Note: Based on the National Occupational Classification (NOC) 2021 and includes the following code: licensed practical nurses (NOC 32101). Source: Statistics Canada, Census of Population, 2021. |
||
| Non-immigrants | 92.3 | 4.9 |
| Immigrants (admitted before 2011) | 68.6 | 27.2 |
| Immigrants (admitted between 2011 and 2015) | 42.7 | 54.4 |
| Immigrants (admitted between 2016 and 2021) | 36.1 | 62.0 |
| Non-permanent residents | 47.2 | 48.6 |
Data table for Chart 7-B
| Immigrant status and period of immigration | Bachelor's degree in health care field, acquired in Canada | Bachelor's degree in health care field, foreign-educated | Bachelor's degree in non-health care field (Canada and foreign) |
|---|---|---|---|
| percent | |||
| Note: Based on the National Occupational Classification (NOC) 2021 and includes the following code: licensed practical nurses (NOC 32101). Source: Statistics Canada, Census of Population, 2021. |
|||
| Non-immigrants | 2.1 | 0.0 | 2.8 |
| Immigrants (admitted before 2011) | 4.0 | 9.7 | 13.5 |
| Immigrants (admitted between 2011 and 2015) | 3.5 | 39.8 | 11.0 |
| Immigrants (admitted between 2016 and 2021) | 2.3 | 49.0 | 10.8 |
| Non-permanent residents | 3.5 | 37.3 | 8.5 |
Indeed, the educational attainment profile of recent immigrants who worked as licensed practical nurses was largely similar to that of registered nurses born in Canada, with similar shares of each group holding a bachelor’s degree or a higher level of education (61.8% of registered nurses born in Canada versus 62.0% of licensed practical nurses who were recent immigrants) (Chart 8).
Data table for Chart 8
| Immigrant status and period of immigration | Educational attainment | |
|---|---|---|
| Postsecondary certificate or diploma below a bachelor's degree | Bachelor's degree or higher | |
| percent | ||
| Note: Based on the National Occupational Classification (NOC) 2021 and includes the following codes: registered nurses and registered psychiatric nurses (NOC 31301) and nurse practitioners (NOC 31302).
Source: Statistics Canada, Census of Population, 2021. |
||
| Non-immigrants | 36.6 | 61.8 |
| Immigrants (admitted before 2011) | 34.3 | 63.3 |
| Immigrants (admitted between 2011 and 2015) | 26.8 | 71.1 |
| Immigrants (admitted between 2016 and 2021) | 21.2 | 76.3 |
| Non-permanent residents | 26.4 | 69.7 |
These results are consistent with previously reported findings from the 2021 Census, which highlighted the high rates of job mismatch among immigrants with foreign degrees in a health-related field, including in nursing. In 2021, over one-third (36.5%) of immigrants with a foreign bachelor's degree in nursing worked as registered nurses or in closely related occupations such as nurse practitioners. In comparison, close to 9 in 10 (87.4%) workers with a Canadian nursing degree worked as registered nurses.Note
Non-permanent residents comprise a notable share of young medical specialists
Non-permanent residents enumerated in the 2021 Census comprised a notable share of young medical specialists and have thus contributed to increasing the renewal ratio for this occupation. In 2021, they accounted for 8.6% of medical specialists aged 25 to 34, and 5.7% of those aged 35 to 44. In comparison, the shares of recent immigrants among medical specialists aged 25 to 34 (2.2%) and 35 to 44 (5.0%) were smaller.
Young medical specialists who were immigrants tended to be more established. In 2021, 18.7% of medical specialists aged 25 to 34 and 17.9% of those aged 35 to 44 were immigrants who had been admitted more than 10 years earlier.
Compared with medical specialists, general practitioners and family physicians aged 25 to 34 were more likely to be born in Canada. In 2021, non-permanent residents (2.6%) and recent immigrants (2.0%) accounted for relatively small shares of general practitioners and family physicians aged 25 to 34.
Conclusion
Employment growth in health occupations has remained relatively high in recent years and has outpaced growth across all occupations. Workforce renewal ratios in health occupations were generally higher than in other occupations. For most health occupations, the number of younger workers entering the workforce was larger than the number approaching retirement age.
There were, however, differences across detailed occupations within the health workforce. In particular, the renewal ratio among nurse aides, orderlies and patient service associates was below 1.0, meaning that there were fewer younger workers in this occupation relative to older workers approaching retirement age.
Recent immigrants and non-permanent residents represented a relatively large share of young nurse aides, orderlies and patient service associates; however, they often had qualifications well above those typically required for the occupation. This reflects the significant barriers immigrants can face, particularly those with foreign credentials, to using their skills in Canada, as highlighted in previous research.
Vacancies in health occupations have been elevated in recent years, and significant proportions of Canadians report having unmet health care needs.Note With projected growing needs for care in the context of a growing and aging population, the health care system may need to expand beyond replacing retiring workers. The results presented in this study highlight the central role of new immigrants and non-permanent residents aged 25 to 34 years old in the supply of young health workers, including in direct care roles, and in ensuring workforce renewal and growth. At the same time, the results also highlight persistent issues around over-qualification and labour under-utilization observed among immigrant workers.
André Bernard is an Assistant Director and Yasmina Seddiki is an analyst with the Centre for Labour Market Information at Statistics Canada.
Data sources
The analysis presented in the article are based on data from the Labour Force Survey (LFS) and the 2021 Census of Population.
The LFS is a monthly household survey conducted by Statistics Canada. Recently, the LFS monthly sample has included over 65,000 households, resulting in labour data for well over 100,000 individuals. The target population of the LFS includes all persons aged 15 years and older whose usual place of residence is in Canada, with some exclusions.Note
In this study, indicators from the LFS are based on annual averages of the monthly LFS data.
The Census of Population is conducted every five years and provides a detailed and comprehensive statistical portrait of Canada. The Census long-form questionnaire, which is administered to a sample of 25% of the Canadian population, includes questions on respondents' labour force status and occupation during the week preceding the census, or during the previous year.
Occupational data in this study are based on the National Occupational Classification (NOC) 2021. The NOC has been developed and maintained as part of a collaborative partnership between Employment and Social Development Canada and Statistics Canada. The NOC 2021 is the result of an extensive revision from the NOC 2016.
Appendix
| Professional occupations in health based on the National Occupational Classification (NOC) 2021 | Age group | Renewal ratio | |||||
|---|---|---|---|---|---|---|---|
| Total | less than 25 years | 25 to 34 years | 35 to 54 years | 55 to 64 years | 65 years and over | ||
| number | |||||||
| Source: Statistics Canada, Census of Population, 2021. | |||||||
| Specialists in clinical and laboratory medicine (NOC 31100) | 36,115 | 65 | 7,700 | 18,660 | 5,880 | 3,810 | 1.3 |
| Specialists in surgery (NOC 31101) | 10,670 | 15 | 2,200 | 5,400 | 1,850 | 1,195 | 1.2 |
| General practitioners and family physicians (NOC 31102) | 60,410 | 360 | 16,195 | 26,255 | 10,920 | 6,675 | 1.5 |
| Veterinarians (NOC 31103) | 11,385 | 50 | 2,890 | 5,605 | 2,095 | 750 | 1.4 |
| Dentists (NOC 31110) | 23,135 | 50 | 4,735 | 11,455 | 4,790 | 2,105 | 1.0 |
| Optometrists (NOC 31111) | 6,705 | 20 | 1,735 | 3,510 | 1,030 | 415 | 1.7 |
| Audiologists and speech-language pathologists (NOC 31112) | 12,275 | 155 | 4,135 | 6,340 | 1,400 | 250 | 3.0 |
| Pharmacists (NOC 31120) | 42,085 | 690 | 13,305 | 21,405 | 5,215 | 1,470 | 2.6 |
| Dietitians and nutritionists (NOC 31121) | 11,190 | 340 | 3,975 | 5,255 | 1,330 | 290 | 3.0 |
| Psychologists (NOC 31200) | 19,535 | 120 | 3,495 | 9,930 | 3,395 | 2,600 | 1.0 |
| Chiropractors (NOC 31201) | 9,390 | 10 | 2,230 | 5,170 | 1,330 | 645 | 1.7 |
| Physiotherapists (NOC 31202) | 26,610 | 315 | 9,220 | 13,515 | 3,010 | 555 | 3.1 |
| Occupational therapists (NOC 31203) | 17,700 | 350 | 6,480 | 9,070 | 1,585 | 220 | 4.1 |
| Kinesiologists and other professional occupations in therapy and assessment (NOC 31204) | 10,350 | 1,210 | 4,510 | 3,795 | 760 | 85 | 5.9 |
| Other professional occupations in health diagnosing and treating (NOC 31209) | 7,190 | 25 | 1,820 | 3,945 | 1,010 | 390 | 1.8 |
| Nursing coordinators and supervisors (NOC 31300) | 13,960 | 165 | 2,655 | 7,935 | 2,735 | 485 | 1.0 |
| Registered nurses and registered psychiatric nurses (NOC 31301) | 319,765 | 17,310 | 95,270 | 147,505 | 48,660 | 11,005 | 2.0 |
| Nurse practitioners (NOC 31302) | 6,500 | 25 | 1,450 | 3,885 | 975 | 165 | 1.5 |
| Physician assistants, midwives and allied health professionals (NOC 31303) | 2,905 | 95 | 1,045 | 1,425 | 300 | 50 | 3.5 |
| Technical occupations in health based on the National Occupational Classification (NOC) 2021 | Age group | Renewal ratio | |||||
|---|---|---|---|---|---|---|---|
| Total | less than 25 years | 25 to 34 years | 35 to 54 years | 55 to 64 years | 65 years and over | ||
| number | |||||||
| Source: Statistics Canada, Census of Population, 2021. | |||||||
| Opticians (NOC 32100) | 9,365 | 640 | 2,375 | 4,110 | 1,720 | 515 | 1.4 |
| Licensed practical nurses (NOC 32101) | 72,735 | 3,820 | 21,645 | 35,875 | 9,825 | 1,575 | 2.2 |
| Paramedical occupations (NOC 32102) | 29,985 | 2,800 | 10,510 | 13,635 | 2,665 | 375 | 3.9 |
| Respiratory therapists, clinical perfusionists and cardiopulmonary technologists (NOC 32103) | 13,065 | 610 | 4,180 | 6,630 | 1,435 | 215 | 2.9 |
| Animal health technologists and veterinary technicians (NOC 32104) | 20,355 | 5,115 | 8,110 | 6,125 | 890 | 115 | 9.1 |
| Other technical occupations in therapy and assessment (NOC 32109) | 17,225 | 2,305 | 5,490 | 7,265 | 1,865 | 305 | 2.9 |
| Denturists (NOC 32110) | 2,525 | 75 | 440 | 1,140 | 565 | 300 | 0.8 |
| Dental hygienists and dental therapists (NOC 32111) | 27,200 | 1,700 | 8,365 | 13,545 | 3,250 | 340 | 2.6 |
| Dental technologists and technicians (NOC 32112) | 4,955 | 160 | 755 | 2,460 | 1,240 | 340 | 0.6 |
| Medical laboratory technologists (NOC 32120) | 19,570 | 895 | 5,345 | 9,210 | 3,430 | 680 | 1.6 |
| Medical radiation technologists (NOC 32121) | 19,515 | 1,335 | 6,270 | 9,110 | 2,440 | 365 | 2.6 |
| Medical sonographers (NOC 32122) | 6,505 | 250 | 2,030 | 2,915 | 1,120 | 190 | 1.8 |
| Cardiology technologists and electrophysiological diagnostic technologists (NOC 32123) | 3,005 | 185 | 885 | 1,375 | 465 | 95 | 1.9 |
| Pharmacy technicians (NOC 32124) | 25,660 | 4,540 | 6,470 | 11,465 | 2,850 | 335 | 2.3 |
| Other medical technologists and technicians (NOC 32129) | 4,890 | 345 | 1,450 | 2,065 | 890 | 145 | 1.6 |
| Traditional Chinese medicine practitioners and acupuncturists (NOC 32200) | 4,795 | 10 | 545 | 2,600 | 1,155 | 485 | 0.5 |
| Massage therapists (NOC 32201) | 38,540 | 1,660 | 10,000 | 20,700 | 4,820 | 1,355 | 2.1 |
| Other practitioners of natural healing (NOC 32209) | 4,690 | 50 | 605 | 2,295 | 1,260 | 485 | 0.5 |
| Assisting occupations in support of health services based on the National Occupational Classification (NOC) 2021 | Age group | Renewal ratio | |||||
|---|---|---|---|---|---|---|---|
| Total | less than 25 years | 25 to 34 years | 35 to 54 years | 55 to 64 years | 65 years and over | ||
| number | |||||||
| Source: Statistics Canada, Census of Population, 2021. | |||||||
| Dental assistants and dental laboratory assistants (NOC 33100) | 34,780 | 4,005 | 9,660 | 16,160 | 4,440 | 520 | 2.2 |
| Medical laboratory assistants and related technical occupations (NOC 33101) | 19,550 | 2,210 | 4,780 | 9,190 | 2,880 | 480 | 1.7 |
| Nurse aides, orderlies and patient service associates (NOC 33102) | 331,790 | 36,360 | 59,055 | 155,630 | 66,780 | 13,970 | 0.9 |
| Pharmacy technical assistants and pharmacy assistants (NOC 33103) | 29,570 | 7,340 | 8,090 | 10,540 | 3,170 | 430 | 2.6 |
| Other assisting occupations in support of health services (NOC 33109) | 34,210 | 6,540 | 6,935 | 13,230 | 6,165 | 1,330 | 1.1 |
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