Career technical education (CTE) programs at community colleges are a promising way to prepare the workforce for jobs in growing occupations. But the programs with the best outcomes for students often have limited capacity or very low completion rates. One solution: Start students on a path towards high-returns fields early, through efforts such as high school CTE programs.
A growing body of research shows that there are high payoffs to CTE programs, especially in healthcare fields. In a new study, forthcoming in the American Economic Journal: Economic Policy, I provide some of the starkest evidence yet. Community college nursing degree programs, which train students for work as registered nurses, often admit students using random lotteries. My data follow the earnings of lottery winners and losers at a large California community college program for five years.
The impacts I find are huge. Applicants who start the nursing program earn 44 percent more than applicants who don’t enroll. To put this number in perspective, most research finds that the payoff of a year at a four-year college is “only” up to 15 percent. In prior work, I’ve shown large payoffs for associate degrees that train students for jobs in health care fields other than nursing, like dental hygienists, surgical technicians, and X-Ray technicians.
If these programs have such large positive effects on people’s careers, then why do more people not complete them? I can think of two key reasons.
The first is capacity. Almost all high-return community college healthcare programs have many more applicants than they can admit. Healthcare programs are expensive to operate and there are not always incentives for college systems to expand them. In California, the state in my study, it costs more than four times as much for a college to expand a nursing degree program by one student than the college is reimbursed for educating that pupil. On the other hand, I find that expanding these programs is worth the cost for both students and taxpayers. States and the federal government have gotten involved recently, but progress is slow.
The second reason more students do not complete these programs is that they are not always prepared for them. Programs like nursing require many prerequisite courses, full-time enrollment, participation in labs, and field placements at local hospitals and clinics. But many of the students are not in a great position to succeed. In the program I study, the average applicant was employed and thirty years old, many years removed from having last been in a classroom. Most also had families to take care of, which makes going to school even harder. As a result of these factors, around half the students who started the program I study did not earn a degree.
One clear policy prescription is to increase the capacity of these programs, but as I mentioned earlier, this process is slow and expensive. Another solution is to start students on the path to high-paying degrees in health earlier in their education through entering lucrative career pathways while still in high school.
High school CTE programs have great promise in improving educational attainment and connecting students to the labor market, especially for students at risk of not completing high school or attending college. However, high school CTE programs can be improved by focusing on career-technical fields with high payoffs, like health. A recent Fordham study on high school CTE, for example, found promising results on high school persistence and completion, but only 3 percent of the students studied health care. Instead, a quarter were in fields like childcare and home economics, which have fewer outlets to high-paying jobs. So while these programs might be effective at helping students finish high school, they will have a smaller impact on how they do later on in the labor market.
I am not recommending that high schools develop all-out nursing programs. Instead, high schools with CTE programs could pivot to certificates and certifications in fields such as medical assisting and medical coding. These certificates do not necessarily pay well in the short run, but they are the first step in the ladder towards fields like registered nursing. Recent research shows that students on health care pathways see better outcomes than those on pathways in other fields. This also makes sense in terms of affordability: Students engaged in a health care pathway while they are still young—recently out of high school—might have lower opportunity costs for their time.
In short, we now have new evidence that CTE programs in nursing and health care offer very large payoffs, but completion rates are low and capacity is limited. At the same time, providing more career-technical training in high school seems to have positive effects, too. Why not combine the two? High school students can be steered towards fields—like health care—that could lead them to lucrative careers down the line.
