Hiring in the U.S. health care sector is looking increasingly shaky, raising a warning flag for the economy given its importance as a key driver of job growth over the last three years.

Health care and social assistance companies added about 47,000 employees to payrolls in August, according to a Bureau of Labor Statistics report published Friday. While it remained the largest contributor to job growth in the month, it also marked the sector’s marking the smallest increase since January 2022.

The report also showed excluding health care, the U.S. economy has shed more than 140,000 jobs over the last four months, a rare development which underscores the critical role health care employers are playing in supporting the broader labor market.

“Health care has been recovering from a slowdown during the pandemic and was growing faster than its pre-pandemic trend, so the catch-up has been an important part of that story,” said Neale Mahoney, a Stanford University economics professor who studies health care. “It’s still propping up the economy, but it won’t go on forever.”

Friday’s numbers were the latest in a string of data in recent days showing a chilling in the labor market for health care workers. A BLS report on job openings published Wednesday showed listings for open positions fell in July to the lowest level in more than four years.

Another report, published Thursday by the private-sector payroll processing firm ADP, showed headcount in the education and health services sector contracted in August for a fifth straight month.

The discrepancy between the ADP data showing a run of declining employment and the BLS data showing ongoing hiring, even if at a slowing pace, has raised questions among analysts about which one is likely closer to reality.

The two tracked each other relatively closely in 2022 and 2023, but a gap between them began to open up last year and has widened more in 2025.

“Data from ADP raise doubts about the official BLS data on payroll growth in the health care industry,” Goldman Sachs Group Inc. economists David Mericle and Jessica Rindels said in an Aug. 17 report, before last week’s releases.

“While the BLS numbers are more consistent with trends in health care spending, employment counts from large health care companies and views from our health care sector analysts suggest that the truth might be somewhere in the middle,” they said.

Friday’s report showed outright declines in headcount in August in industries including offices of dentists, vocational rehabilitation services and outpatient care services. Offices of physicians, nursing and residential care facilities and hospitals all registered ongoing expansion.

Jon Guidi, founder of the staffing firm HealthCare Recruiters International, said some key roles appear to be increasingly suffering from a lack of qualified labor supply.

“We’re observing a noticeable slowdown in job growth for positions that require professional licensure, such as nurses, physical therapists, and mental health therapists,” Guidi said.

“This trend appears to be driven by near-full employment in these fields, coupled with a limited pipeline of newly licensed professionals entering the workforce to meet ongoing demand.”

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