Labor
Construction employment hits a record 8.33M
Construction employment reached a record 8.36 million as job openings rebounded and quits remained subdued.
Construction employment reached a record 8.36 million in August 2026, with unemployment at 3.1% (Q2 average 4.2%; not seasonally adjusted). Job openings averaged 287,000 a month in Q2 (+32% YoY) while quits remained subdued at 134,000 (-12%) — employers are actively trying to hire workers who are not showing indication to change jobs. ABC estimates additional recruitment needs of 349,000 workers in 2026 and 456,000 in 2027. The shortage is most acute in certified MEP trades.
Source: BLS CES, through August 2026 (September 4 release); annual and quarterly averages, July–August monthly levels. JOLTS, Q2 2026 (August 4 vintage); ABC, January 15, 2026.
San Francisco has the highest median wages in the five occupations shown - up to 66% above national medians - while Miami has the lowest in four of five.
San Francisco has the highest medians in all five occupations shown, electricians at $44.63 an hour, 47% above the $30.38 national median. Miami has the lowest medians in four of the five occupations; Richmond has the lowest sheet-metal wage ($23.08/hour versus Miami’s $24.86). These wage medians do not measure installed labor costs. Healthcare requirements narrow the pool further: medical-gas installers need ASSE 6010, controls techs need vendor certifications, and everyone on an active campus needs ICRA training. Each additional requirement reduces the number of eligible workers and can extend mobilization time.
Source: BLS OEWS, May 2025. Controls/BAS proxy: SOC 49-2094, Electrical and Electronics Repairers, Commercial and Industrial Equipment. The 66% premium is for sheet-metal workers.
Figure 14:
Regional labor availability and certification pipeline by MSA
Source: Turner & Townsend assessments (shortage ratings); NCCER; ASSE International. National recruitment forecast: ABC Workforce Shortage Analysis, January 15, 2026; BLS JOLTS.
Physician shortfall projected at 13,500 to 86,000 by 2036; projected RN shortages are greater outside metropolitan areas
AAMC projects a physician shortfall of 13,500-86,000 by 2036, with primary care (up to 40,400) as a major gap. HRSA predicts a 108,960-FTE RN shortage by 2038, concentrated outside metro areas (11% outside vs 2% inside metropolitan areas). The geography is mapped by federal designations: California (689) and Texas (451) top the list, and national designations rose to 9,003 covering 108.6m people as of June 30, 2026, an increase of 214 designations from the previous quarter. Workforce gaps reshape what gets built. There is greater demand for more ambulatory sites and telehealth-ready spaces where clinicians are scarce. HPSA designations inform workforce support; they do not directly measure facility needs or guarantee construction funding.
Source: AAMC Physician Workforce Projections, March 2024. Nursing narrative: HRSA Nursing Projections, December 2025 (2038 RN FTE shortfall).
Source: HRSA, Designated Health Professional Shortage Areas Statistics, Q3 FY2026 (as of June 30, 2026).
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