Not Enough Workers for the Job
An epochal change has almost silently swept over the American workplace, accelerating in the last five years. This trend affects workers and customers alike and can, in part, explain a whole array of elements that have made American life increasingly chaotic—long lines, messy grocery aisles, organized theft, high hotel costs, frequent flight cancellations, deadly medication errors at pharmacies, increased use of medical restraints in nursing homes, and, more generally, a palpable and rising dissatisfaction with work. It is quite simple: At many American workplaces, there is widespread, persistent understaffing.
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It is not always clear to management, staff, clients, and customers what the proper level of staffing should be. And it is not always clear why a business is understaffed: Can the firm not find enough qualified workers, or is management deliberately trying to cut costs by heaping more work on fewer people? But in recent years, both the extent and impact of understaffing have emerged, and it is not just disgruntled workers making the case.
A 2024 Kennedy School survey of 14,000 workers found 53 percent believe their workplace is “always” or “often” understaffed. Surely, workers will often agitate for adequate staffing, while bosses will push employees to do more with less. But researchers looked into public-health agencies and found many need to hire 80 percent more workers to be fully staffed. Mt. Sinai Health System in New York was ordered to pay $2 million in 2024 due to critical understaffing in emergency departments, labor and delivery units, and oncology. A Journal of the American Medical Directors Association article correlated low levels of staffing at nursing homes (especially in poor neighborhoods) with increased use of antipsychotic medications.
A 2024 survey of 14,000 workers found 53 percent believe their workplace is “always” or “often” understaffed.
The Department of Transportation’s inspector general determined that 77 percent of “critical facilities” for air traffic controllers are staffed below the required 85 percent threshold, with New York and Miami at 54 percent and 66 percent, respectively. State officials in Texas reduced the capacity of the county jail serving the Houston area due to chronic understaffing. In countless news reports of unionization campaigns and strike threats, from Starbucks to major hospitals to railroad workers, you will see “understaffing” mentioned as a key concern. The trend affects white-collar workers, too; 83 percent of millennials report that they take on up to six tasks beyond their job description due to turnover.
Understaffing is so common that it is even part of the plot of the recent novel Help Wanted, by Adelle Waldman, whose characters work at a fictionalized Target and never seem to have enough staff to clear out the warehouse and properly stock the shelves.
WHY ARE STAFFING LEVELS SO LOW across the American workplace? It’s common to note that, in the post-COVID world, we operate in a tight labor market in which workers are scarce and have better-paying options. But as professor Daniel Schneider of Harvard’s Kennedy School notes, surveys he has conducted about understaffing indicate the problem was just as bad before the pandemic. Firms are choosing to understaff their workplaces consistently over time. “[It’s] a really good way to control personnel costs,” Schneider says, akin to paying low wages and shaving hours to the bare minimum.
Further highlighting the fact that understaffing is a managerial choice is that workers at different firms in the same sector report radically different levels of staffing over time, like fast-food workers at In-N-Out Burger (who report little understaffing) versus McDonald’s (who report high levels of understaffing). “This is a business decision being made here,” Schneider says.
The government doesn’t mandate minimum staffing, except in certain industries and often only in specific states. One of the few examples of federal intervention on understaffing, the so-called “safe staffing rule” for nursing homes implemented by the Biden administration, was formally revoked by Congress in the One Big Beautiful Bill Act. Private equity firms have cut staff at nursing homes to a bare minimum, all while they withdrew cash out of the business, as an NPR investigation found.
One of the only ways to ensure firms hire the right number of people is for workers to have some agency. But with union representation near an all-time low, few workers can push back against understaffing without fear of retaliation.
The changing nature of business ownership may contribute to the trend, as owners are increasingly removed from day-to-day realities. Regulators have found systemic understaffing by large corporate chains, for example, leading to unprecedented enforcement action. In 2021, the Ohio Board of Pharmacy discovered CVS pharmacies with barricaded walk-up windows that diverted all customers to the drive-through, because there was only one pharmacist on duty to deal with customers. Unopened boxes and deliveries littered pharmacist workstations, while the heat in the building rose above safe levels. Some patients had to wait over a month to have their prescriptions filled. “Pharmacy staff asked for assistance from a pharmacist and pharmacy technician to fill prescriptions after hours to get caught up,” the board’s report reads. “They were denied, stating there is no staffing available to do so.” Investigators first visited one CVS store in March, and when they returned in October, they noted that every worker interviewed in the first report just months earlier was gone. In 2024, the board settled a $1.5 million fine against the chain.
The impacts of CVS and other pharmacies failing to properly staff locations are dire. Medication errors, which are endemic to understaffed pharmacies, are a leading cause of death, killing 250,000 to 400,000 people a year. In a New York Times report from 2020, one 85-year-old woman discovered that she had been taking a chemotherapy drug instead of the antidepressant the doctor had prescribed. She died in the hospital. “I’m confident that I’ve had dispensing errors which have left my pharmacy, but I was working too fast in order to meet our precious metrics to notice them,” one pharmacist wrote to regulators in Missouri. Another said that they refrain from drinking water on their shifts because there is no time to use the bathroom, a choice that gave them kidney stones. “I am a danger to the public working for CVS,” a third pharmacist told regulators in Texas.
Like pharmacies, hotels are widely understaffed, which heaps stress on workers. “I sleep with pain, I wake up with pain, I go to work with pain,” said Jianci Liang, a housekeeper at the Hilton Park Plaza in Boston for seven years. “Since we returned to work after COVID, there are about 20 fewer room attendants on the regular schedule … When the rooms are sold out, we have to cover the work of the missing people.” Bureau of Labor Statistics data shows a 16 percent drop in hotel staffing from pre-pandemic levels, and a drop from about 63 workers per 100 rooms in 1995 to 42.7 in 2022.
Low staffing doesn’t just impact workers. For travelers, room cleanings become irregular and pools are closed, even as hotels report record profits and executives pull in huge pay packages. Worse care in hospitals and nursing homes is tied to understaffing as well, just as anger toward the medical system has risen to a fever pitch.
Medication errors are a leading cause of death, killing 250,000 to 400,000 people a year.
Customers at grocery stores tend to be more hostile and combative in stores that are low on staff. “We find clear evidence that workers are more frequently bullied and less likely to be treated with respect when they work in stores that are always understaffed,” Schneider and his co-author find in their Kennedy School report. The authors find that grocery stores with self-checkout machines are often understaffed beyond what they should be, possibly because of an “over-adjustment” to a lower level of staff due to the perception that self-checkout eliminates the need for workers. But as many grocery shoppers can attest to, self-checkout doesn’t always work correctly, leading to frustration. Customers often resent the implication of faulty anti-theft alerts like the omnipresent “unexpected item in the bagging area.”
Theft is also linked to understaffing, as understaffed chain stores are more vulnerable to people looking to steal. In the widely publicized theft wave that began during the pandemic, few mentioned how empty of workers chain drugstores are these days, with possibly a single cashier and a skeleton crew of pharmacists. In this light, the store’s decision to lock up many of its products—an insanely frustrating element of consumer life today—is the result of too few workers on the floor in the first place.
Increased corporate concentration plays a role in understaffing, as seen vividly in the Ohio Board of Pharmacy’s report on the business practices of CVS. CVS, the sixth-largest corporation in America and one of two major pharmacies, has a history of buying out competitor pharmacies, only to close them and divert business to their main store. This increased business does not come with additional staff, drowning pharmacists and store employees with more than they can handle.
SO WHAT IS TO BE DONE? It’s difficult to imagine legislation that could mandate staffing levels at varied workplaces: How would the government be able to determine proper staffing levels at so many different jobs? Empowering workers to challenge management when the workload becomes unmanageable makes more sense. This could be done by encouraging unions or providing more reliable unemployment benefits that would give workers more leverage.
It’s also possible that many workers are sitting out the job market because of the high cost of child care; wages are often so low that it is cheaper to stay home with the kids. (Possibly not coincidentally, day cares have been notoriously short-staffed in recent years.) In this way, some state or federal action on managing the high cost of child care could increase the number of available workers.
The rise of understaffing appears to go hand in hand with a normative shift that America underwent starting in the 1980s, when the government signaled that it would no longer side with workers. Firms no longer risked reputational damage by treating their workers and customers poorly. “In a larger sense, America’s most powerful corporations are engaged in an experiment to change the rules of the social game as it has been played in this country since the New Deal,” the legal scholar Frances Ansley wrote in 1993.
As Ansley noted, companies used to be afraid of blowback from mass layoffs, pollution, and strikebreaking. After the Carter administration broke the Teamsters and Reagan fired striking air traffic controllers, this was no longer the case. From then on, corporations were emboldened to squeeze workers for everything they had. It was a social change, in other words, not just a legal one. Work hours skyrocketed, pay stagnated, and benefits slowly disappeared. Today, the rise of “underemployed” workers from algorithmic, erratic, and short-staffed schedules may have encouraged workers to stay home.
Because the Trump administration has cozied up to large business interests and billionaires, the normative change that began in the 1980s and enabled such chaos and stress for American workers and consumers will likely only get worse.
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