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The caring economy: As more men drop out of the workforce, health-care jobs could be key to keeping them employed

Nurse Chauncey Incarnato, seen at Northwestern Memorial Hospital in Chicago in May, is part of a small but growing contingent of men in health care jobs traditionally dominated by women. He works in the neurological trauma intensive care unit at the hospital. (Terrence Antonio James / Chicago Tribune)

CHICAGO — Chauncey Incarnato cycled through a variety of jobs after graduating from college: construction, personal trainer, hotel bellman, bouncer at bars. But none stuck, and even long workweeks barely covered his bills.

Incarnato was skeptical when his mom, a nurse for more than 30 years, suggested a career in health care. But after a six-month course to become a certified nursing assistant, Incarnato discovered caregiving instincts he didn't realize he had.

Working at a skilled nursing facility, Incarnato found the physicality of the job, plus the relationships he formed with patients, deeply rewarding. He went back to school to become a registered nurse, and hopes more men follow suit.

"Once you're the person in the room talking to the patient, seeing the ramifications of the choices you make, I don't see how anyone can not be pulled into it," said Incarnato, 31, a nurse in the neurological trauma intensive care unit at Northwestern Memorial Hospital in Chicago.

Incarnato is part of a small but growing contingent of men pursuing jobs traditionally dominated by women in the fast-growing health sector, a choice some economists say may be key to stanching a troubling exodus of men from working life.

The rate of U.S. men participating in the labor force, meaning they're working or looking for work, has been declining for 50 years, a trend that could carry ramifications for economic growth as well as individual and family well-being. And more automation, particularly advancements in artificial intelligence, threatens to disproportionately hit traditionally male-dominated jobs going forward.

Manufacturing, agriculture and utilities, all of which employ mostly men, are projected to lose jobs over the next decade, according to the Bureau of Labor Statistics.

Meanwhile, nine of the 12 fastest-growing jobs in the U.S. are in health care, topped by occupational therapy assistants, physical therapy assistants and nurse practitioners, all positions that are held mostly by women.

"The growing professions are more caring," said Nicholas Eberstadt, a political economist at the American Enterprise Institute and author of "Men Without Work," which was published last year. "Can this be a man's world too?"

Some say it needs to be, not just for the sake of men, but for the sake of the health-care field. Take nursing, which will need an estimated 1.13 million new registered nurses over the next decade, half of them to replace retirements, according to the American Nurses Association.

Efforts to bring more men into the nursing ranks seem to be working, albeit modestly. About 10 to 12 percent of registered nurses are men, compared with less than 3 percent in the early 1970s, according to census figures.

Their value isn't just in their numbers. Diversity among nurses, gender and otherwise, is good for patients because those relationships are intimate and it helps to have access to someone who can relate, said Marquis Foreman, dean of the College of Nursing at Rush University in Chicago, who was the only man in his nursing graduating class in 1976.

It could also bode well for men's future employment prospects, given projections that the jobs that will survive advancements in artificial intelligence are those that require distinctly human capabilities, like empathy, said Kristin Sharp, executive director of the Shift Commission on Work, Workers and Technology, an initiative of public policy think tank New America and Bloomberg.

Under one scenario outlined by Shift, technological innovation over the long run could mean jobs will increasingly revolve around caring for others, including in fields such as elder care, child care, teaching and coaching. Keeping men engaged in the workplace will mean finding ways to interest them — and help them thrive — in these jobs.

Reasons for the decline

Most disconcerting in the decline in work among men is the decline for those of prime working age, 25 to 54, when they should be most productive. The drop has been particularly acute among men with a high school degree or less, according to a paper issued last year by the White House.

It's not that these men are staying home with the kids — just 2 to 3 percent of men say they don't work because they are taking care of family, compared with 30 to 40 percent of women who say so, Eberstadt said. Nonworking men report spending less time taking care of family members than employed women.

Part of the reason less-educated men are opting out of work is that offshoring, globalization and automation have squeezed the manufacturing jobs that used to be their bread and butter, leaving them with fewer options. Depressed wages at the bottom of the ladder also provide little incentive to work, the White House paper said.

But many advanced economies have faced globalization and automation pressures without as severe a decline in working men, so the labor market likely isn't the only culprit, Eberstadt said.

The difficulty people with criminal records have trying to land employment, and drug addiction, particularly the opioid epidemic, also could be sidelining people from work, Eberstadt said.

Accelerated format

At Resurrection University's College of Nursing, there has been significant growth in interest from men, many of them drawn to the career for the income, said Jeri Bingham, vice president of marketing and enrollment management.

Resurrection's nursing student population is 17 to 22 percent male, which Bingham largely attributes to its continuous format that runs classes through the summer so students can obtain their bachelor's in nursing in 16 months, rather than the standard 24.

Incarnato, the former bouncer who is now a nurse at Northwestern, chose Resurrection because of its accelerated format. Making only $9.50 an hour as a certified nursing assistant, he wanted to hurry to make a better living.

He worried at first that he'd be a fish out of water. Growing up in a small town in Ohio, the son of a steelworker, he didn't know men who were nurses. Also, Incarnato, a former college football player who majored in sociology, was more confident in his brawn and his work ethic than his ability to understand medicine.

While he never considered himself particularly nurturing, "the job brings it out in you," Incarnato said, and seeing his care heal people "is really an unreal experience, almost spiritual."

It taps into stereotypically male tendencies as well.

"I think any guy will feel like this: It's this sense of, I need to take control of the situation and take care of this person," he said. "I need to control chaos and keep everything running in the right direction."