The September jobs report was a disappointment on its face. Employers added 29,000 jobs, well below forecasts, and the two months before it were revised down by 60,000. Read across the past year, the report says something more structural about where American jobs are coming from.
In the 12 months to September, total payroll employment rose by 496,000, according to the Bureau of Labor Statistics. One sector, health care and social assistance, added 520,000. Every other industry put together lost about 24,000 jobs.
That is not a one-month quirk. Measured over a rolling 12 months, the sector's gain has been larger than the gain for the economy as a whole in every month since June 2025. September was the 16th in a row.
How unusual that is
The sector has outgrown total employment before, in the payroll data that begin in 1990. It did so through the recession of the early 1990s, from 2001 to early 2004 and from 2008 to 2010. In each case the reason was the same. Health care kept hiring while the rest of the economy shed jobs, so its gain exceeded a total that was shrinking or barely positive.
Runs while the economy as a whole was still adding jobs have been short. The longest before this one lasted three months, in the spring of 1992. The current run has lasted 16 months, and in all of them total employment was growing.
So the American labour market of the past year and a half has had the shape of a recession labour market, in which one sector does all the net hiring, without a recession's job losses. Employment overall has grown, slowly. The unemployment rate was 4.2 per cent in September.
Where the jobs came from
Within the sector, health care added 372,000 jobs over the year. The largest part, 213,000, was in ambulatory services such as doctors' offices, outpatient centres and home health care. Hospitals added 108,000 and nursing and residential care facilities 50,000.
Social assistance added 149,000. Almost all of that, 153,000, came in individual and family services, the BLS category that includes in-home care for elderly and disabled people. Other parts of social assistance shrank slightly.
On the other side of the ledger, the biggest single loss was in the federal government, down 232,000 over the year and 328,000 since January 2025. Information, the industry that includes publishing, telecoms and data processing, lost 120,000. Financial activities lost 107,000, a decline that includes the insurance job losses this publication reported on Friday.
Private employers outside health care and social assistance did add jobs, but not many: 192,000 over the year, or about 16,000 a month. Construction added 109,000, professional and technical services 83,000, leisure and hospitality 62,000 and manufacturing 40,000.
A little wider lately
The 12-month figure flatters the concentration somewhat, because it still includes the large federal job losses of late 2025, among them 166,000 in October alone. Over the past six months, the picture is broader. From March to September, total employment rose by 394,000 and health care and social assistance by 202,000, about half. Manufacturing added 54,000, construction 53,000, transportation and warehousing 51,000 and retail 44,000. Federal employment was unchanged.
Half is still a lot. The sector employs 15.1 per cent of the country's payroll workers. At the end of 2019 it employed 13.6 per cent, and in January 2000, 9.7 per cent.
In September itself, health care and social assistance added 23,000 of the 29,000 total. Average hourly earnings rose 0.1 per cent in the month and 3.0 per cent over the year, the slowest annual pace since May 2021, CNBC reported. "Americans are frustrated by the lack of opportunities right now," Heather Long, chief economist at Navy Federal Credit Union, told CNBC, though she described the labour market as stable.
Why it matters which sector
A labour market that depends on one sector is exposed to whatever happens to that sector. Health care's demand comes largely from an ageing population and from insurance, public and private, rather than from the business cycle, which is why its payrolls kept growing through every recession in the series except the pandemic. That has made it a reliable source of jobs. It also means its hiring depends heavily on what Medicare, Medicaid and private insurers pay.
For workers outside health care, the past year has looked different from the headline numbers. This publication reported on Wednesday that the rate at which employers hire has been stuck in a narrow, low range for 30 months. Combine that with flat employment outside one sector, and a worker who loses a job in finance, publishing or the federal government is looking for work in an economy that, outside health care, has added almost no jobs over the year.
The October jobs report is due on 6 November.
All employment figures are seasonally adjusted payroll counts from the Bureau of Labor Statistics' Current Employment Statistics survey, retrieved through the BLS public data API on 4 October 2026 and including the September 2026 Employment Situation release of 2 October. August and September figures are preliminary and subject to revision. The 12-month and six-month changes, the comparison of the health care and social assistance sector with total nonfarm employment in every month since January 1991, the identification of earlier runs, the employment shares and the calculation for all other industries are this publication's. Industry series used: total nonfarm, total private, health care and social assistance, health care, ambulatory health care services, hospitals, nursing and residential care facilities, social assistance, individual and family services, federal, state and local government, manufacturing, construction, information, financial activities, professional and technical services, transportation and warehousing, retail trade, and leisure and hospitality. The September headline, revisions, wage figures, household survey figures and the quotation from Heather Long are from CNBC's report of 2 October 2026. Accurate to 1pm ET on 4 October 2026.
Topics businessjobs reportlabor markethealth careemploymentbureau of labor statisticsfederal workforce
