Health Care Careers: The Last Bastion of Middle-Class Stability?

In recent decades, the American job landscape has shifted, altering the middle class. According to the Pew Research Center, the share of middle-class households dropped from 61% to 51% between 1971 and 2023. As shifts continue and AI disrupts industries, we wanted to explore if health care jobs remain a reliable path to the middle class.

The Pew Research Center defines middle-income earners as those making between two-thirds and two times the national annual median household income. To compare occupations, we set the upper and lower bounds at two-thirds and twice the annual median income for all occupations, rather than households—$32,040 and $96,120. This analysis uses salary data from the Bureau of Labor Statistics (BLS).

Health care careers likely lead to the middle class or above, based on our definition of the middle class. All the professions in our study land in the middle or upper class. We’ll explore which jobs pay within the middle- and upper-class categories, the impact of education level, and trends across jobs to identify which professions will remain in these classes as the demand for medical professionals shifts.

Key Findings

1. In our study, all health care jobs offer salaries within or above the middle-class range. In 2023, America's lower bound for middle-class salaries was $32,040. Physical therapist aides made the least among health care professions, earning a median salary of $33,520, $1,480 more than the lowest middle-class earners. Out of 73 medical professions analyzed, 20 (27%) had median salaries exceeding $96,120 annually, placing them in the upper-class income bracket.‍
2. High-paying health care careers extend beyond nursing and medicine. Our study puts other high-paying health care jobs in perspective, while doctors and nurses are often associated with high-paying health care jobs. Pharmacists rank as the 10th-highest earners in our analysis, with a median annual salary of $136,030, placing them in the upper-class income bracket.‍
3. In health care careers, the education level isn't always a direct salary predictor. While higher education often leads to increased earnings, the chosen profession can be equally or more influential. Our study reveals significant salary overlaps across different education levels in health care. For example, dietetic technicians with associate degrees ($36,520) earn less than medical transcriptionists with postsecondary certificates ($37,060). Even more striking, hearing aid specialists with only a high school diploma ($58,670) out-earn athletic trainers with master's degrees ($57,930).

Which Health Care Jobs Are Middle Class?

Does More School Equal Higher Wages? Not Necessarily...

While salaries usually follow the expected trend—more time in school leads to higher wages—this isn’t always the case.

High School Diploma

Highest paid: Hearing aid specialists, $58,670 per year or $28.21 an hour

Lowest Paid: Physical therapist aides, $33,520 or $16.12 per hour

We analyzed 73 health care professions and found 12 requiring only a high school diploma, with an average annual salary of $40,463. Hearing aid specialists top this group, earning $58,670 annually - $10,610 more than the median U.S. household income.

They are the exception rather than the rule. This education category includes six of our study's 10 lowest-paying jobs. At the bottom, physical therapist aides earn $33,520 annually. Despite the lower salaries, the lowest-paid job in this group still falls within our definition of middle-class earnings.

Certificate or Diploma

Highest Paid: Surgical technologists, $60,610 a year or $29.14 an hour

Lowest Paid: Medical transcriptionists, $37,060 or $17.82 an hour

Certificate and diploma options offer an attractive pathway for those looking to enter the health care field without committing to a full degree. Our analysis identified 16 healthcare professions requiring a postsecondary certificate or diploma but not an associate's degree or higher.

Professionals in this category earn $48,368 annually. While this is below the national median household income, nearly half (44%) earn above the national average.

Associate Degree

Highest Paid: Radiation therapists $98,300 a year or $47.26 an hour

Lowest Paid: Dietetic technicians, $36,520 a year or $17.56 an hour

Earning an associate degree increases one’s salary by nearly 50% compared to those with a postsecondary certificate or diploma. Professionals in this category earn an average of $72,186, including dental hygienists, MRI technologists and physical therapist assistants. Dietetic technicians earn the least ($36,520), and radiation therapists earn the most ($98,300). Dietetic technicians are one of two of the 13 professions in this group to earn below the national average, the other being veterinary technicians.

Bachelor’s degree

Highest Paid: Medical dosimetrists, $132,880 per year or $63.88 an hour

Lowest Paid: Exercise physiologists, $54,860 a year or $26.38 an hour

A health care bachelor's degree offers a 4% increase in median annual salary compared to associate degrees. Professionals in this group earn $75,006 annually.

Our study identified only seven health care professions requiring a bachelor's degree, the smallest number among all education categories. Despite this, all seven careers offer a stable path to middle-class earnings, surpassing the national average salary.

This group includes dietitians, lab technicians, and registered nurses. At the top end, medical dosimetrists are the sole six-figure earners, with an average annual salary of $132,880. Exercise physiologists earn at least $54,860 annually.

The small salary boost for bachelor's degree holders, compared to associate degree earners, raises questions about the return on investment for additional education in some health care fields. However, the above-average salaries and potential for six-figure earnings suggest that a bachelor's degree remains valuable in the health care sector.

Master’s degree

Highest paid: CRNAs, $212,650 a year or $102.24 an hour

Lowest Paid: Athletic trainers, $57,930 a year (no hourly wage data)

The master's degree category in health care showcases diverse professions and salaries, with an average income of $109,295. This group includes roles like speech-language pathologists, nurse midwives, and acupuncturists, all earning above the national average. However, the salary disparity is striking, with CRNAs earning 3.7 times more than athletic trainers, the lowest-paid profession.

Doctorate or Professional Degree

Highest paid: Physicians, $236,000 per year or $113.46 an hour

Lowest paid: Audiologists $87,740 a year or $42.19 an hour

Doctoral or professional degrees are the highest earners on our list, averaging $164,518 annually. However, this figure may be understated for physicians. The Bureau of Labor Statistics (BLS) data for doctors can be misleading as it doesn't capture the range of medical specialties. For a more accurate representation, we turn to Medscape's 2023 Physician Compensation Report, which indicates physicians earn an average of $363,000 per year, significantly higher than the BLS estimate.

There’s a stark contrast between physician and audiologist salaries (lowest in this category at $87,740). While audiologists typically have shorter training periods and less intensive residency requirements than medical doctors, they require a doctoral degree.

Not all doctorate or professional degrees in healthcare are equal. The study duration, post-graduation training, and career trajectories can vary. For instance, becoming a qualified physician requires 11 to 15 years of education and training (undergraduate, medical school, residency, and potentially fellowship). A Doctor of Audiology (Au.D.) program takes four years after a bachelor's degree.

Bottom Line

Our study suggests that healthcare offers a reliable path to financial stability and middle-class status, with clear career advancement opportunities. While healthcare jobs provide steady income progression, money shouldn't be the sole factor in choosing a career. Additionally, health care careers vary widely in nature and responsibilities.

From our study, you can conclude that

• If your goal is financial stability, to enter the middle class, and to have a clear career ladder and income progress, health care is a reliable option.
• Money isn’t the most important factor in choosing a career. Health care jobs can vary greatly.

Between 2000 and 2014, middle-class American households fell by 4%. There are fewer middle-class jobs. Pursuing any health care profession is a reliable path to the middle class. Depending on education and career choice, health care jobs can lead to the upper class. Thus, health care careers offer one of the few remaining opportunities for social mobility.

Methodology

Our study used 2023 Bureau of Labor Statistics data. We defined our income classes (middle and upper) based on Pew’s middle-class definition: those with an income of two-thirds to double the U.S. median household income for a three-person household. For our study, we adapted the household to the profession.

Fifteen professions in our study lacked salary data and were excluded from that portion of this report. Each would fall within the upper-class salary range. To present information on specific professions, those listed as “all other” in the data were omitted from top rankings.