Section 1
Interest of youth in health and health-related occupations
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1.1 Occupational aspirations of youth
1.2 Characteristics of youth by occupation of interest
1.3 Loss of health aspirations between the ages of 15 and 17
Youth is a time when individuals begin to make decisions about and plan for their future career by considering different occupational options. Before deciding to enrol in a health or health-related education program, individuals must have certain motivations for such occupations. Factors that influence youths' career choice include personal interests, aptitudes and skills, academic achievement, demographic and socioeconomic background, and parental and peer influences. However, for some youth, career choice may not be stable over time and others may not eventually achieve their desired career goals for one reason or another.
As a starting point in understanding the flow of individuals into and through health education programs, this section uses findings from Statistics Canada's Youth in Transition Survey (YITS) to learn more about the relative popularity of health occupations among youth, the size and nature of the population of individuals who are interested in health occupations, and whether or not there is a change of interest for such occupations between the ages of 15 and 17 (refer to Appendix 1 for more information on this survey). Developing a better understanding of the occupational aspirations of youth is important for informing efforts to increase the interest in health occupations as well as for designing appropriate and effective recruitment programs.
1.1 Occupational aspirations of youth
There is a great deal of interest in health occupations among youth
Results fromYITS show that health occupations rank high among the jobs that youth would like to have. In 2000, when asked what job they would like at age 30, 15 year-olds in Canada ranked health occupations as the third most popular career, after natural and applied sciences and related occupations, and occupations in art, culture, recreation and sport. The selected health-related occupations of interest in this study (i.e., psychologists, social workers, managers in health care, medical secretaries, court recorders and medical transcriptionists, inspectors in public and environmental health and occupational health and safety) ranked seventh. Health occupations was the fourth most popular career given by youth aged 18 to 20 years in Canada, after natural and applied sciences and related occupations; occupations in social science, education, government service and religion; and occupations in art, culture, recreation and sport (Table 1.1.1).
Health occupations ranked among the top three career choices for 15 year- olds in all provinces. Among 18 to 20 year-olds, health occupations were among the top four occupations in all provinces except Ontario and Quebec, where they ranked fifth and sixth, respectively (Tables 1.1.2 to 1.1.11).
In 2000, about 12% of youth aged 15 in Canada indicated that they wanted a health occupation and another 3% cited selected health-related occupations including psychologist and social worker. The proportion of 18 to 20 year-olds interested in health occupations is lower, but still, 8% aspire to such types of occupations while the proportion interested in selected health-related occupations is similar to that among 15 year-olds (Table 1.2.1).
Still, the number of youth interested in health occupations is considerable when you take into account that only 5% of the Canadian labour force in 2001 worked in a health occupation and another 1% in selected health-related occupations (Statistics Canada 2001a).
The percentage of youth interested in health occupations did not vary considerably by province, with this figure ranging from 10% in Saskatchewan to 16% in Newfoundland and Labrador for 15 year-olds. As was observed at the national level, interest in health occupations among youth was lower for 18 to 20 year-olds in most provinces, with the exception of Manitoba and Saskatchewan where there were no statistically significant differences in the percentage of youth interested in health occupations for both age groups. At age 18 to 20, the proportion of youth interested in health occupations ranged from 7% in Quebec to 11% in Saskatchewan (Tables 1.2.2 to 1.2.11).
Health occupations appear to be a more popular career choice for young women than men. While 12% of youth aged 15 in Canada indicated that they wanted to work in a health occupation, 18% of 15-year-old females indicated that they wanted a career in this field compared to 6% of men in this age group (Table 1.1.1). Among 18- to 20-year-olds in Canada, 8% were interested in pursuing health occupations. This represented 13% of females in this age group who were interested in health occupations and 4% of males (Table 1.1.1). This pattern is observed across these two age groups in all provinces for which there are reliable data (Tables 1.1.2 to 1.1.11).
A notable preference among youth for professional occupations in health
YITS shows that there was a notable preference among youth for professional occupations in health. About 10% of youth aged 15 and 4% of youth aged 18 to 20 said they were interested in pursuing a career as physicians, dentists, diagnosing and treating professionals, pharmacists or as therapy and assessment professionals. Such an interest for professional occupations in health may be attributable to the fact that these occupations are usually better known by the public given the higher attention provided to these occupations by the media.
At the national level, about 7% of 15 year-olds said that they were interested in pursuing a career as physicians, however only 2% of those aged 18 to 20 were interested in pursuing this field. In contrast 1% of youth aged 15 said that they wanted to be nurses, and this proportion was fairly similar among 18 to 20 year- olds (Table 1.2.1). Within the Canadian labour force in 2001, less than 1% worked as physicians. Nursing comprises a larger occupation with slightly less than 2% of the labour force (Statistics Canada 2001a).
The percentage of 15 year-olds who said that one day they would like to become physicians or nurses was similar across most provinces. The exceptions were Manitoba and Saskatchewan, where 5% and 3% of this age group indicated that they wanted to become physicians, figures that were statistically different from the 7% of 15 year-olds wanting to be physicians at the national level. Compared to the Canada average of 1%, a slightly higher percentage of 15 year- olds indicated an interest in becoming nurses in Newfoundland and Labrador (3%) and New Brunswick (2%) (Tables 1.2.2 to 1.2.11).
At the provincial level, it is difficult for the most part to obtain a reliable read on the preferences for specific health occupations for youth aged 18 to 20 as the sample size limits the provision of reliable information at this level of detail.
1.2 Characteristics of youth by occupation of interest
Youth aspiring to health occupations tend to be female
As shown by YITS, three-quarters of Canadian youth who aspire to health occupations are female. This mirrors the demographic profile of recent graduates from health programs, where 82% are female (see section 4) and the labour force in 2001 where 79% of workers in health occupations are women (Statistics Canada 2001a). This means that the predominately female profile of the health sector in general will likely not change in the near future. Almost all youth (97%) who are interested in a nursing career are women; however women also account for about three-quarters (72%) of 15 year-olds who said they wanted to become physicians. This drops to 59% among 18 to 20 year-olds (Table 1.3.1). According to a report published in 2007 by the Association of Faculties of Medicine Canada, about half of youth graduating from M.D. programs in Canada were female in 2000 and this proportion increased to about 60% in 2007.
The composition in terms of gender of youth aspiring to careers in nursing and medicine did not vary much across Canada. In all provinces, about 90% or more of youth citing nursing as a career aspiration were female in both the 15- year-old and 18- to 20-year-old age groups. The percentage of 15 year-olds aspiring to become physicians who were female ranged from 65% in Manitoba and British Columbia to 77% in Quebec (Tables 1.3.2 to 1.3.11). Among 18 to 20 year-olds, women accounted for about 60% of those who wanted to become physicians in Ontario (57%) and British Columbia (59%), reflecting the national picture, but accounted for a somewhat higher percentage in Quebec and Newfoundland and Labrador (70%) (these were the only provinces for which reliable data were available).
A substantial proportion of youth aspiring to health occupations were members of a visible minority
A significant proportion of the youth in Canada who wanted to work in health occupations are members of a visible minority (20% compared to 13% of all youth). Among the youth who wanted to be physicians, the difference is substantial.
Over one-quarter of the 15 year-olds and over one-third of the 18 to 20 year-olds who aspired to be physicians were members of a visible minority (Table 1.3.1).
This is also reflected in the language of 15 year-olds who aspired to health occupations. In Canada, almost one in five (18%) reported a mother tongue other than English or French (compared to 12% of all youth) (Table 1.3.1).
The six provinces where members of visible minorities accounted for a particularly significant proportion of the school age population were Nova Scotia, Quebec, Ontario, Manitoba, Alberta and British Columbia. In these provinces in 2000, between 5% and 23% of 15 year-olds were members of visible minorities. In each of these provinces, with the exception of British Columbia, the proportion of members of visible minorities among those interested in health occupations was in-line with their representation in the population of 15 year-olds overall. In British Columbia, members of visible minorities accounted for 23% of all 15 year- olds but they accounted for 36% of 15 year-olds who aspired to health occupations. However, the data at the provincial level suggest that this may vary by occupation. In Ontario and British Columbia (the two provinces for which reliable data are available), members of visible minorities accounted for a higher proportion of those wanting to be physicians compared to their representation among 15 year- olds overall (Tables 1.3.4, 1.3.6, 1.3.7, 1.3.8, 1.3.10 and 1.3.11).
In Canada, among those interested in health occupations overall, the proportion reporting French as mother tongue was typical of youth overall (about one in five). However, this varied by province and occupation. For example, in Quebec where youth with French as their mother tongue represented 84% of all 15 year-olds, they represented 71% of youth aspiring to become physicians (Table 1.3.6). New Brunswick is another province with a high proportion of French- speaking people in their population. In this province, youth with French as their mother tongue comprised 30% of all 15 year-olds, and a similar proportion (35%) of them aspiring to become physicians had French as their mother tongue (Table 1.3.5).
At the national level, youth with English as their mother tongue accounted for 62% of 15 year-olds who wanted to pursue a career in a health occupation. This is slightly lower than their representation among all 15 year-olds in Canada (66%) (Table 1.3.1). In Quebec, the only province where youth with English as a mother tongue are the minority (9%), the proportion of 15 year-olds who aspire to health occupations was similar to their representation among this population in general (Table 1.3.6).
Youth interested in health occupations slightly less likely to come from rural areas than youth overall
As shown by YITS, about three-quarters (76%) of youth aged 15 were living in urban centres in 2000. Not surprisingly, the proportion of youth living in urban areas varied widely across the provinces, from about 43% of 15 year-olds in Newfoundland and Labrador to more than 80% of them in Ontario and British Columbia (Tables 1.3.2 to 1.3.11).
There is a need to know more about the career aspirations of rural youth and whether their aspirations differ from those of urban youth, in particular whether rural youth have lower occupational goals.
Rural or urban geography is derived from the parent / guardians' address as of the data of the interview. The rural or urban indication, based on Metropolitan Influence Zone (MIZ) coding, is coded from the Statistical Area Classification code based on the 1996 Census geography.
Results fromYITS indicated that in 2000, youth who were interested in health occupations in general were only slightly less likely to come from rural areas than youth overall. This has implications for health planning for rural areas particularly in light of other studies that suggest that students with a rural background are the most likely to ultimately choose rural practice as a career.1 According to a study by Rourke in 2005, achieving an adequate supply of rural physicians depends in part on ensuring the admission of an adequate number of students of rural origin to medical school.
In Canada, 20% of 15 year-olds who aspired to health occupations were from rural areas, compared to the roughly one-quarter of the 15-year-old population who come from these areas (Table 1.3.1). In most provinces, 15 year-olds who were interested in a health occupation as their career goal were only slightly less likely than 15 year-olds overall to come from rural areas. In Quebec and Manitoba, however, the difference between the proportion of rural youth among those wanting to get into health occupations and the population of 15 year-olds living in rural areas was more pronounced (9 percentage points difference in Quebec and10 percentage points in Manitoba). In those provinces for which reliable data are available (i.e., Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, and Ontario), the percentage of rural youth among those aspiring to health occupations is stable between youth aged 15 and those aged 18 to 20 in all provinces with the exception of Nova Scotia where this figure for 18 to 20 year-olds was 49% compared to 33% for the 15 year-olds (Tables 1.3.2 to 1.3.11 and Chart 1.1).
In all provinces, those aspiring to be physicians were more likely than average to come from urban centres
Fifteen year-olds aspiring to be nurses were more likely than youth overall to come from rural areas in most provinces, with the exception of Nova Scotia, New Brunswick and Alberta. In contrast, those aspiring to be physicians were more likely than youth overall to come from urban centres in all provinces. The difference between the percentage of rural youth among those wanting to become physicians and the population of 15 year-olds living in rural areas in general was smallest in Newfoundland and Labrador (4 percentage points) and largest in Manitoba (15 percentage points) (Tables 1.3.2 to 1.3.11 and Chart 1.2).
1.3 Loss of health aspirations between the ages of 15 and 17
Despite the popularity of health occupations as a career choice, many youth changed their minds between ages 15 and 17
According to YITS, many youth changed their aspirations between the ages of 15 and 17. Asked again at age 17 what job they would like at age 30, 59% of youth cited a different occupation from the one reported at age 15. This is also true for those who first aspired to a health occupation. Only 20% still reported the same occupation; another 26% reported a different occupation in health; 32% reported a non-health occupation; and 22% did not respond or said they did not know (Table 1.4.1 and Chart 1.3).
Overall, this means that 58% of 15 year-olds who said they wanted to work in health, no longer do so (excluding those who did not respond or did not know). On the other hand, 8% of the population who earlier aspired to a non-health occupation have changed their minds and were now interested in health (Table 1.4.1 and Chart 1.3).
The loss of interest in health occupations between the ages of 15 and 17 was also reflected across the provinces. There was not much variability by province in the proportion of 15 year-olds who said that they wanted to work in health but no longer did so at age 17, ranging from 52% in Prince Edward Island to 65% in Nova Scotia. As was observed at the national level, a much lower proportion of youth who earlier aspired to a non-health occupation changed their minds and was now interested in health. This proportion ranged from 6% in Quebec to 12% in Prince Edward Island (Tables 1.4.2 to 1.4.11 and Chart 1.3).
More research is required to fully understand the factors that are related to gaining and losing interest in health occupations and whether these youth will realize their aspirations. Possible factors that can be explored include changes in academic performance over time, growing awareness of other occupations available, changing perceptions about realistic occupational choices, and changing life experiences. Subsequent cycles of YITS will provide information on those youth who pursue or do not eventually pursue health and health-related postsecondary education based on their previously cited career aspirations.
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