Canadian Occupational Projection System (COPS)

(NAICS 6211-6219; 6221-6223; 6231-6239)

This industry comprises establishments primarily engaged in providing health care by diagnosis and treatment and providing residential care for medical and social reasons. It is composed of three segments: ambulatory health care services which include offices of physicians, dentists and health care practitioners, and medical and diagnostic laboratories (42% of real GDP and 34% of employment in 2023); hospitals which include general medical, surgical, psychiatric and substance abuse hospitals (41% and 48%); and nursing and residential care facilities which provide services to people with developmental handicaps, mental illness and substance abuse problems and services to the elderly and persons who are unable to fully care for themselves or who do not desire to live independently (17% and 18%). With about 2.1 million workers in 2023, the health care industry was the second largest employer of the Canadian economy, behind retail trade. The workforce is primarily composed of women (79%) and characterized by a high level of education and a significant concentration of part-time workers (20%). The ambulatory health care services segment is also characterized by a strong concentration of self-employed (32%). Health care employment is distributed proportionately to population: 37% in Ontario, 22% in Quebec, 14% in British Columbia, 12% in Alberta, and 15% in the remaining provinces.

The key occupations (5-digit NOC) include:

• Registered nurses and registered psychiatric nurses (31301)
• Nurse aides, orderlies and patient service associates (33102)
• Licensed practical nurses (32101)
• General practitioners and family physicians (31102)
• Specialist in clinical and laboratory medicine (31100)
• Medical administrative assistants (13112)
• Physiotherapists (31202)
• Dental assistants and dental laboratory assistants (33100)
• Nursing co-ordinators and supervisors (31300)
• Managers in health care (30010)
• Dental hygienists and dental therapists (32111)
• Medical laboratory assistants and related technical occupations (33101)
• Psychologists (31200)
• Therapists in counselling and related specialized therapies (41301)
• Massage therapists (32201)
• Social workers (41300)
• Social and community service workers (42201)
• Medical radiation technologists (32121)
• Other assisting occupations in support of health services (33109)
• Dentists (31110)
• Health policy researchers, consultants and program officers (41404)
• Paramedical occupations (32102)
• Medical laboratory technologists (32120)
• Occupational therapists (31203)
• Respiratory therapists, clinical perfusionists and cardiopulmonary technologists (32103)
• Dietitians and nutritionists (31121)
• Pharmacists (31120)
• Traditional Chinese medicine practitioners and acupuncturists (32200)
• Audiologists and speech-language pathologists (31112)
• Chiropractors (31201)
• Optometrists (31111)
• Kinesiologists and other professional occupations in therapy and assessment (31204)
• Medical sonographers (32122)
• Opticians (32100)
• Cardiology technologists and electrophysiological diagnostic technologists, n.e.c. (32123)
• Denturists (32110)
• Health information management occupations (12111)
• Other technical occupations in therapy and assessment (32109)

* Occupations in the industry also include a significant number of Light duty cleaners (65310); Food counter attendants, kitchen helpers and related support occupations (65201) ; and Cooks (63200).

Projections over the 2024-2033 period

Real GDP is projected to grow at an average annual rate of 2.8%. Driving the growth is the expected increase in population as well as the rise in the number of Canadians over the age of 65. In addition, the federal government has announced that it will be committing significant amounts funds to finance various health care initiatives such as the new Canadian Dental Care Plan and the Youth Mental Health Fund to increase youth access to mental health services. Further boosting growth in this industry’s output is the continued reduction in stigma around mental health, which should help boost the demand for mental health services.

Productivity is expected to grow at an average annual rate of 0.2%. While opportunities still exist for the sector to increase the use of technology, the most important productivity gains are believed to have already been observed. However, the concept and measurement of productivity in public health care may differ from the other sectors of the economy, where goods and services are traded and more easily valued in monetary terms. Health care providers have implemented several measures to improve efficiencies and lower costs over the past decade, but these changes were not reflected in the productivity numbers due to the large gains in employment. Examples of such measures include a greater focus on primary care, prevention and home care services. That said, there are still some difficulties to embrace new technologies in health care services, as evidenced by the ongoing use of paper records at the offices of some family physicians and the continued use of fax machines.

Employment is projected to increase by 2.6% annually. Health care is expected to remain a labour intensive industry, and in order to meet the needs of a growing and aging population the number of workers in the sector is projected to grow at a pace over double the national average over the 2024-2033 period. However, sufficient job creation required to meet potential demand for health care services may be constrained by labour shortages in high demand occupations (such as doctors and nurses) and fiscal challenges in provinces.

Challenges and Opportunities

Relatively low wages and poor working conditions for some health care professions such as nurses, home care providers, and family physicians (relative to other physician specialties) have kept the job vacancy rate above the national average for all industries. If wages in health care fail to rise sufficiently over the coming decade, employment growth could face a significant slowdown. In addition, if poor working conditions persist employee retention issues could further intensify a slowdown in employment growth. Finally, labour shortages are currently observed in many of the industry’s key occupations, which may limit growth as strict education and regulation requirements make the process of increasing the number of workers in these occupations through either education or immigration lengthy. These issues tend to be more acute in rural areas which struggle to attract the highly skilled workers required by the sector. On the other hand, something which could help boost demand would be to offer universal mental health care. Currently, many mental health care services are not covered by Medicare in Canada, which means many people are currently going untreated. The Act for Mental Health campaign led by the Canadian Mental Health Association (CMHA) is putting pressure on political leaders to provide universal mental health care. If the campaign were to succeed, demand for mental health services would rise, which could boost overall industry performance.

On the productivity front, the recent bilateral funding agreements that the federal government has signed with the provincial and territorial governments have included elements to hold the provinces/territories accountable for achieving performance milestones in exchange for the funding. Introducing enhanced accountability into the system may provide an upside risk to the productivity outlook.

Real GDP , Employment and Productivity Growth rate (2024-2033)

Sources: ESDC 2024 COPS projections.