The U.S. labor market has struggled since 2022, when hiring and job growth began to plummet from their post-pandemic peak.

Arguably the only thing keeping it from falling into complete disarray? The healthcare sector.

Despite making up only about 15% of the overall U.S. workforce, job gains in healthcare have accounted for a disproportionate share of overall monthly growth – often upward of 50%. And in many cases, it was job growth in healthcare and related social assistance professions that kept the monthly jobs report from falling into the red.

That steady demand has translated into equal stability for promo distributors working in the healthcare sector – both in terms of consistent orders throughout the calendar year and minimal spending pullback on print and promo essentials.

Eric Mapes – a brand consultant at Counselor Top 40 distributor Proforma (asi/300094) affiliate Baymare Promotional Group – for example, works with several large hospital systems in the San Antonio, TX, area. He notes his healthcare customers bring stability throughout the year with their order timing, as well as steady performance during times of economic uncertainty.

“There’s not as much up and down as there is with other clients,” Mapes says.

Still, that leveling out doesn’t mean that the healthcare promo market – the second-largest vertical, accounting for $2.2 billion in North American promo sales in 2024 – is immune to many of the challenges distributors have faced over the past year. Slashed budgets, increased spending scrutiny and pressure to do more with less all mean that distributors have to be smart sellers, even in a more resilient market segment.

Healthcare Holds Steady as Other Sectors Slip

According to a recent Gallup poll, more workers have reported “struggling” in their lives than “thriving” for the first time since Gallup began tracking the metric in 2022. Nearly three-quarters of those surveyed reported that it’s currently a “bad time” to find a job in the U.S.

Recent job reports reinforce that negative sentiment, with the Bureau of Labor Statistics (BLS) reporting job losses in five separate months since January 2024. (Prior to that, the last time the BLS reported monthly job losses was in 2020. Before that, it was during the Great Recession.)

In the same timeframe, there would have been 15 months with job losses if healthcare job growth were removed. The sector has consistently grown by roughly 60,000 to 80,000 jobs per month, regardless of conditions in the broader labor market.

Notably, the healthcare sector’s only month of job loss since the pandemic – February 2026, a particularly tough month for the labor market overall with 133,000 jobs lost – came as a result of a massive nurses’ strike around the country. Over 32,000 nurses from the Kaiser Permanente network went on strike for much of the month over staffing shortages, safety and wages. Because BLS job growth metrics are calculated based on payroll data, those nurses were excluded from February data, but re-added in March following the conclusion of the strike.

And healthcare was right back to being the driving force in labor growth – in March, the U.S. added 91,000 healthcare positions, more than 50% of the 178,000 estimated overall jobs created.

Healthcare job growth is broad-based, spanning the entire market rather than being concentrated in a few areas. Employment in physicians’ offices – including doctors, nurses and other medical techs – grew by 60,000 in 2025. Hospitals, which employ the largest share of healthcare workers, added roughly 135,000 jobs, according to BLS data. By comparison, the overall U.S. labor force – factoring in sectors that experienced job losses last year – added just 181,000 jobs in 2025.

The trend is similar when it comes to healthcare job postings, which indicate organizations are hiring. At Indeed’s Hiring Lab, the number of open positions for pharmacy and medical techs is about 25% higher than it was in 2020. For personal care and home health positions, it’s nearly 35% more. And postings for high-level healthcare professionals like physicians and surgeons are close to double 2020 levels. (Current healthcare openings are down from their 2022 peak, however.)

“Healthcare just seems to sometimes be able to ride it a little bit better than other [industries] during economic upheavals,” said Tyler Fitz, an account executive at Counselor Top 40 distributor ASB (asi/120075). “People continue to care about their health. People want GLP-1s. People need heart valves.”

In other words, healthcare is essential in a way that many other top promo verticals are not. High-end client gifts, lavish parties at tech firms or even trade show handouts can all be among the first to go when marketing budgets get cut.

But people are always sick and injured, says Fitz. In addition to churning out orders for thousands of lip balms and hand sanitizers for his healthcare clients to hand out, he also does significant business on the print side. Just as one example, he prints tens of thousands of labels for hospital blood bags every year – and that need isn’t going anywhere.

“There’s not as much up and down in healthcare as there is with other clients.” Eric Mapes, Baymare Promotional Group, an affiliate of Proforma(asi/300094)

In fact, demand for healthcare services is increasing in many cases. A study from Peterson-KFF found that there has been a 31% increase in the number of annual hospital outpatient visits since 2000. Mental health-related emergency room visits, specifically for young people, have nearly doubled over the past decade. And the Census Bureau reports that the number of Americans aged 65 and older is predicted to jump from 58 million to 82 million over the next two decades – meaning more demand for home health services and residential care facilities, among other services catered to older adults.

That consistent growth means that hospitals and clinics will always need pens for patients to fill out waiting room forms, or lightweight totes and folders for them to take home discharge paperwork, says Deborah Edgar, a Counselor 2025 Distributor Salesperson of the Year finalist who works exclusively with healthcare clients at distributor Brandability (asi/319940). And giveaways at community events, recruiting initiatives or after appointments can only help build a consistent baseline demand.

“People aren’t going to make their decision on where they’re going to work, or where they’re going to have their surgery or their baby solely based on the gift,” Edgar says. “But there’s that brand recognition that comes to mind.”

Appreciation Programs Drive Repeat Promo Business

Even with job growth, though, the healthcare sector is set to face major workforce shortages over the next decades – including deficits of hundreds of thousands of physicians, nurses, dentists, physical therapists and more, according to the Bureau of Health Workforce.

That’s partially due to an aging workforce, with more in the Baby Boomer generation reaching retirement age and likely needing additional health and social supports. Recent limitations on H-1B visas, which are crucial for recruiting doctors from overseas to staff rural clinics, are likely to compound the problem by reducing future supply of healthcare professionals.

Changes to federal loan limits could make the problem worse. By reclassifying some healthcare degrees like nursing and physical therapy as “graduate” instead of “professional,” the Department of Education effectively cut borrowing caps for these students in half. While it’s still too early to measure the full impact, the lower cap may reduce enrollment in these programs by increasing financial barriers.

“When healthcare organizations give employees something that they can use outside of work, that’s saying, ‘we care.’”Deborah Edgar, Brandability (asi/319940)

To help retain existing employees, hospital systems and clinics often turn to a vast array of appreciation initiatives. Doctors’ Day, celebrated March 30 each year, and Nurses Week, the second week of May, are two of the most commonly recognized within medical networks, but National Hospital Week, Radiologic Tech Week and Laboratory Professionals Week are just a few other options available for the healthcare sector to offer giveaways.

“If staff got something for Radiology Week last year, they’re sort of expecting it this year,” says Mapes. “So we get a lot of repeat orders.”

He typically sees budgets in the $10-$20 per item range for appreciation initiatives, sometimes up to $30 or $40 if the client is hoping for an apparel item. Brand-name items are rare, with Doctors’ Day being the primary exception.

Physicians have the highest appreciation budgets, typically around $60 to $100, Mapes estimates. Recently, he’s seen an uptick in requests for company stores that allow recipients to select an item of their choosing. He and his clients try to vary items year to year, but sometimes the best way to ensure a giveaway will be well-received is to give the gift of choice, he says.

That also means thinking outside the box, adds Edgar. While apparel and drinkware are certainly staples of the appreciation category, she’s seen more stipulations from clients that explicitly don’t want common giveaway items like socks, tumblers or tote bags.

Instead, she’s starting to prioritize items employees can enjoy primarily while they’re off the clock. It’s part of a larger shift toward prioritizing wellness and emphasizing life outside of the workplace, she says.

“When they give employees something that they can use outside of work,” Edgar says, “that’s saying, we care.”

Even Healthcare Faces Tighter Budgets

The desire for “out-of-the-box” product thinking isn’t just stemming from hospital systems wanting to make a good impression on their employees. It’s also a symptom of healthcare clients being smarter about their giveaways to maximize perceived value amid tighter budgets, Edgar says.

Hospitals and doctors’ offices may not have faced decreased demand in the wake of economic uncertainty like some other sectors. But they’re still facing higher costs for essentials, including tariff-driven increases on already expensive medical equipment.

$2.2 billion
Estimated value of the healthcare market in promo in 2024 – the second-largest market for distributor salesSource: ASI Research

For nearly 20 years, Edgar has worked with the same group purchasing organization that represents a variety of medical clients around the country. She’s always treated those relationships as a strategic partnership, rather than just being an order taker – and that attitude has become increasingly important when counseling clients through tougher times.

“We’re going to be good stewards, and we’re going to get them the most they can for their money,” Edgar says. “But here’s the deal – they may only be spending $10 this year when they may have spent $15 last year.”

“It doesn’t mean they’re not ordering,” she adds. “It’s just that they may be cutting their budget in half.”

Fitz has noticed a similar phenomenon. He often takes a “good, better, best” approach to pitching options, and many of his healthcare clients have started to take a step down on that ladder amid budget scrutiny. Competitive pricing has become more crucial than ever – with Fitz’s contacts consistently asking for added details, even for reorders of small items like hand sanitizers or lip balms that previously required just a quick signature.

“They’re hunting; they’re checking prices a little bit more,” he says. “Maybe they were at ‘better,’ and now they’re just looking at the ‘good’ options. And I’d say they’re being a little bit more diligent even around reorders.”

With the tariff conversation ever-continuing and global shipping set to face continued challenges due to the war with Iran, it’s likely that clients across verticals will remain budget-conscious and particularly picky about where their promo dollars land.

In that environment, healthcare stands out as one of the few verticals offering distributors a measure of consistency – even if that business now comes with tighter margins and higher expectations.