Comparable worth: A concept worth fighting for

Public Policy Comparable Worth: A Concept Worth Fighting For Nursing's first use of the concept of job worth was in 1978, when nurses employed by the City and County of Denver sued for wage equity. They had noted that the entry-level salary for registered nurses was lower than that for city/county employees who were tree trimmers, sign painters, plumbers, and parking meter repair personnel. The key classification system used to cluster jobs obviously incorporated sex as a variable, and the standard used to determine the dollar amount paid to groups of workers was the prevailing wage level paid for the key job in the community. This resulted in a system in which first-level nursing jobs were at a 55 per cent disadvantage when compared to male-dominated jobs. In the middle range, head nurses were at a 40 per cent disadvantage, whereas directors of nursing in the hospital and the community health agency were at an 80 per cent disadvantage when compared to male administrators with similar spans of control and similar educational requiremeats) The federal district court judge ruled against the nurses. He acknowledged that the evidence presented showed that comparable occupations in which men predominated commanded higher levels of pay than nursing, but he held that this type of differential payment was not prohibited by Title VII of the 1964 Civil Rights Act or any other law. He also indicated that he felt it was necessary to rule against the nurses because a favorable ruling would have the potential of "disrupting the entire economic system of the United States of America:'6 An appeal of this case was lost, and the Supreme Court refused to hear it. Alaskan public health nurses also lost their case before the State Commission on Human Rights. They had claimed that public health nurses (some of whom were nurse practitioners) were entitled to pay that was equal to that of physician assistants.7 The findings in Christensen vs the State of Iowa were similar. The University of Northern Iowa was paying its secretaries less than its physical plant employees, even though they were ranked at the same grade level. The judge ruled that the differences were the result of market forces rather than discrimination. 8 The landmark decision that provides nurses with a glimmer of hope was made in the case of Gunther vs the County of V/ashington. A group of Oregon jail matrons brought suit against the county because their salaries were only 70 pet cent of those paid to male correction officers. The matrons argued that the two jobs were substantially equal. The district court refused to admit evidence showing intentional sex discrimination and ruled that the two jobs were not the same. The case went all the way to the Supreme Court, which held that Title VII actions are

IN APRIL, 1985, the United States Civil Rights Commission rejected the concept of comparable job worth and issued a lengthy report arguing that the courts and federal civil rights enforcement agencies should define sex-based job discrimination only in terms of equal pay for equal work. The vote was a divided one, with the two holdover Carter administration commissioners, Mary Frances Berry and Cardenas Ramirez, voting against the action. Voting with the majority, Morris B. Abram, Vice Chairperson of the Commission, indicated that "there is sex-based discrimination in America but it is declining. The repetitious charge that women earn only 60 percent of what men earn in this country obscures the significant fact that women work less hours, have less seniority, and work more intermittently.' '1 This decision marks a serious setback in a stmggle that dates back to the passage of the Equal Pay Act of 1963 and Title VII of the Civil Rights Act of 1964. Early interpretation of these laws was similar to the interpretation that the Commission is now advocating. For example, it was clearly illegal to pay a black assembly-line worker less than a white colleague with the same job title, or to pay a female registered nurse less than a male registered nurse, but even minor differences in title or work role raised questions about whether or not the two jobs were really equal. Although early application of the two laws helped to right the most obvious inequalities resulting from racial discrimination, it failed to combat discrimination against women in the work force. Women tend to work in sex-segregated occupatious, so the discriminatory patterns ate more subtle, z Broadening the coverage by invoking the concept of comparable job worth has been the goal of the women's movement for at least the last decade. The concept was borrowed from economics, where it was used as an analytical tool, and from business administration, where it was used to establish equitable pay systems in complex organizations. Factors such as the knowledge base requited for the job, the supervisory span of control, the complexity of the job, the job's physical and interpersonal demands, and the characteristics of the work environment were used as factors in the analysis of jobs. Sometimes all of these factors were used, sometimes only a few. Probably the most complex analysis was done by the West German government when it analyzed the entire public work force; even individual finger movements were considered. The simplest of the popular formats was designed by Willis and uses four factors: (1) knowledge and skill, (2) mental demands, (3) accountability, and (4) working conditions.3.4

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can be attributed to the labor-intensive environment and the absence of ethical and philosophical dialogue between the nurse and the physician. The end result is a high turnover and vacancy rate among intensive care nurses. Hay and Oken compare intensive care nursing to being in a strategic war bunker.e Preventive measures need to be taken to support nurses in such ethicsintensive and labor-intensive environments. Preventive measures begin with formal education and continue with regular dialogue between health professionals and others, as well as with continuing education on ethics. The practice expectations of today are very different from those of the past; thus the educational and support systems should be structured to conform with the change. RACHEL Z. B O O T H , P H D

Assistant Vice-President for Health Affairs Dean, School of Nursing Duke University Durham, North Carolina References 1. ThompsonJE, Thompson HO: Bioethical Decision Making for Nurses. Norwalk, c r , Appleton-Century-Crofts, 1985 2. Smith DP: A suggested viewpoint from which to approach bioethical issues, in McCIoskeyJ,Grace H (eds): Current Issues in Nursing. Boston, MA, Blackwell Scientific Publications, 1981. p 761 3. ThompsonJE, Thompson HO: Bioethical Decision Making for Nurses. Norwalk, CT, Appleton-Century-Crofts, 1985, pp 121-22 4. Selby G: A time to die happily. New York Times, March 10, 1985 5. Overton S: Who decides when enough is enough? News and Observer, Raleigh, NC, March 31, 1985 6. Hay 13, Oken D: The psychological stresses of intensive care unit nursing. Psychosom Med 34:109-18, 1972

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not required to meet the equal work standard. 9 Thus, in effect, the Supreme Court acknowledged the doctrine of comparable worth and indicated that the Equal Pay Statutes Act of 1963 and Title VII of the Civil Rights Act of 1964 covered not only people in the same jobs, but also people in jobs requiring comparable skills, effort, and respomibility>° However, since jail matrons and correction officers are performing almost the same job, the long-range implications of Gunther in support of job worth analysis are not clear. Consequently, subsequent decisions are being watched with concern, and the upcoming State of Washington case is an important one. In 1973, the state government used the Willis formula to compare the pay of its top administrators with the pay of administrators in the private sector. Significant discrepancies were found, and the salaries of state officials were raised. The State

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Women's Council of the Federation of State Employees (AFLCIO) asked the governor to do a second study comparing maledominated and female-dominated state jobs. As might be expected, it was found that people in female-dominated jobs were paid only 80 per cent of what those in comparable maledominated jobs were paid. In 1977, the govemor requested funds to begin implementation of the comparable worth concept. However, he went out of office and the new administration questioned the study. The union then turned to the courts, and in 1983 a judge ruled that the state had illegallymaintained a system of compensation that discriminated on the basis of sex and ordered the state to pay persons in female-dominated jobs a rate reflecting full evaluated worth. The state decided to appeal the case, and it will probably eventually be decided by the Supreme Court. Gunther was a divided decision, so a change of one person on the Supreme Court could tip the balance the other way. To the extent that the announced position of the Civil Rights Commission reflects the administration's thought, there is legitimate worry about possible new appointments to the court. There is also concern about the negative climate of opinion in Washington, D.C. Yet the concept of comparable worth is still logical, and it is still important to nurses. The negative report by the Civil Rights Commission can be used by us as an impetus to write a letter to the president, the Commission, and members of Congress. Legal decisions are also political decisions, and this decision is worth fighting for.

BONNIE BULLOUGH, RN, PHD

Dean, School o/Nursing State University of New York~Buffalo References 1. Pear R: U.S. panel on civil rights rejects pay equity theory. New York Times, April 12, 1985 2. Blumtosen RG: Wage d~riminarion, job segregation, and Title VII of the 1964 Civil Rights Act. University of MichiganJ Law Reform 12:397-502, 1979 3. Killingsworth V: Labor: what's a job ~ t t h ? Atlantic Monthly, February 1984, pp 14-18 4. Remick H: Beyond equal pay for equal work: comparable worth in the State of Washington, in Rarner RS (ed): Equal Employment Policy for Women: Strategies for Implementation in the United States, Canada and Western Europe. Philadelphia, Temple University Press, 1980 5. Barnes CS: Denver: a case study, in Bullough B (ed): The Law and the Ex. panding Nursing Role. New York, Appleton.Century-Crofts, 1980 6. Bullough B: The struggle for women's tights in Denver:. a personal account. Nuts Outlook 26:566--67, 1978 7. Bullough B: Legislative update: Alaska public health nurses lose sex discrimination grievance. Pediatr Nuts (in press), 1985 8. Feldberg RL: Comparable worth: toward theory and practice in the United States. Signs 10:311-28, 1984 9. Moskowitz S: Pay equity and American nurses: a legal analysis. Saint Louis University Law J 27:801-55, 1983 10. Hershey RE): Women's pay fight shifts to comparable worth. New YorkTimes, Novembes 1. 1983