Chapter 2:  The LPN workforce

Relatively little is known about the LPN workforce in the United States.  As far as we have been able to determine, there has only been one national survey of LPNs, conducted in 1983 (U.S. Department of Health and Human Services, 1985). We have not been able to locate a single database providing information about the number of licensed practical nurses in the Nation.  Information about the size, demographics, and employment characteristics of this workforce must be obtained from a variety of disparate sources.  Since none of these sources of data can provide comprehensive information, some of the data are conflicting when compared across sources.

Workforce Size and Distribution

According to estimates from the Census 2000 Special Equal Employment Opportunity Tabulation (U.S. Bureau of the Census, 2000), there were 596,355 licensed practical nurses in 2000.  This figure, however, is lower than the total number of active LPN licenses and number of jobs held by LPNs.  The following table compares figures from various sources.

Table 2.1:  Licensed Practical Nurses in the United States

In Table 2.2 we compare two different measures of LPN supply by State.  In every State except Maryland, the number of active licenses is much larger than the LPN population estimate.  In Maryland the estimated population exceeded the total number of active licenses by 909.  The population estimates as a percent of the total number of active licenses range from 35 percent to 111 percent.  Since a person can have an LPN license in more than one State, using the number of active licenses as a measure of supply most likely overstates the number of LPNs in each State. 

Table 2.2:  Total Active LPN Licenses and Estimated LPN population

*Estimates may not add to total due to rounding

Sources: (1) (Crawford, 2001) (2) (U.S. Bureau of the Census, 2000)

Table 2.3 shows the estimated number of LPNs and RNs per 100,000 population, and ranks States based on these ratios.  There are about four times as many RNs as there are LPNs per 100,000 people in the U.S. population.  Massachusetts and New Hampshire stand out as having the greatest difference between the numbers of RNs and LPNs, having over 1000 RNs and under 200 LPNs per 100,000 population.  Overall, there is more variation in the numbers of RNs per capita than of LPNs.  Though the distribution of LPNs throughout the U.S. does not closely match the distribution of RNs, there are some similarities. 

In 2000, the estimated number of LPNs per 100,000 population ranged from a low of 88 in Oregon to a high of 365 in Arkansas.  Other States with low numbers of LPNs per 100,000 people include Alaska, Nevada, Colorado, Utah, and Hawaii.  In fact, the Western part of the U.S. appears to have the lowest concentration of LPNs, while the South and Midwest (e.g., Arkansas, Oklahoma, Louisiana, Minnesota, and North Dakota) have the highest.  This pattern is similar to that reflected in the data for RNs.  States with the lowest numbers of RNs per 100,000 individuals in the population include Nevada, California, Utah, Idaho, and Texas – mostly western States.  The highest numbers are in the Northeast and Midwest (e.g., Massachusetts, New Hampshire, Iowa, South Dakota, and Rhode Island).

Table 2.3:  LPNs and RNs Per 100,000 Population

Sources: (1) (U.S. Bureau of the Census, 2000) (2) (U.S. Bureau of the Census, 2003)

Demographics of LPNs

Information about the demographic characteristics of LPNs can be obtained from the Current Population Survey (CPS).  The CPS is a monthly survey of households conducted by the Bureau of the Census for the Bureau of Labor Statistics.   It is the primary source of information on the labor force characteristics of the U.S. civilian non-institutional population (see http://www.bls.census.gov/cps/overmain.htm) (U.S. Bureau of the Census, 2004).  The CPS contains individual and family demographic information.  LPNs are self-identified in these data by reporting that their occupation is licensed practical nursing.  We computed all data presented here using weights provided by the Bureau of the Census to ensure that the data represent the U.S. population. With relatively few LPNs in some years of this survey, the data may not represent the LPN workforce accurately.  Furthermore, the CPS was revised in 1994, resulting in the discontinuation of several variables in dataset.  Several questionnaire items were changed, making comparisons across all years difficult or impossible depending on the variable.  Thus, some of the demographic information we report is for recent survey years only. 

Table 2.4 shows the number of LPNs in the CPS from 1984 to 2001. The number of LPNs identified in the CPS has declined from 1,002 in 1984 to 584 in 2001.  This drop follows the decline in the total number of records in the CPS between 1984 and 2001.  Thus, it does not reflect a trend in the supply of LPNs; rather, it reflects the drop in the number of households surveyed by the Census. 

Table 2.4:  Number of LPNs Identified in the Current Population Survey Outgoing Rotation Group Files, 1984-2001 (Unicon Research Corporation, 2002)

The regional distribution of nurses in the 1984-2001 CPS data is shown in Figures 2.1 through 2.3.  All three types of nursing personnel—LPNs, RNs, and nurse aides—have a similar regional distribution.  The major difference is that more LPNs live in the South and fewer in the Northeast, as compared to RNs in the data.  This is in agreement with the population estimates.

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Table 2.5 presents the gender and racial/ethnic characteristics of LPNs in the United States from 1984 through 2001.  Men are a slowly growing share of the LPN workforce, comprising only 3 percent of LPNs in 1984 and 5 percent in 2001.  The share of LPNs that is male is similar to that of the RN workforce (See Spratley et al. (2000) for information on RN gender distribution).

The LPN workforce is predominantly white, although the ethnic diversity of LPNs has grown over time.  In 1984, 77 percent of the LPN workforce was white, but this share dropped to 67 percent by 2001.  The largest minority group of LPNs is blacks, comprising 26 percent of the workforce in 2001.  Blacks are overrepresented in the LPN workforce relative to the total U.S. population.  Hispanics account for 3 percent and Asians account for 2 percent of the LPN workforce; these ethnic groups are significantly underrepresented in this workforce, and these shares have not changed substantially since the 1980s.  About 1 percent of the LPN workforce is Native American; this is consistent with the general population (see Census 2000 population estimates at http://quickfacts.census.gov/qfd/States/00000.htm).

Table 2.5:  Distribution of Licensed Practical Nurses by Gender and Race/Ethnicity