Report on the 1999 Membership Database of the American Dietetic Association.(Statistical Data Included)

This report presents the major findings of the 1999 membership database update of the American Dietetic Association (ADA). The update is designed to provide an accurate profile of the characteristics of the membership at a single point in time. This information is vital because it allows ADA's member leaders and staff to better understand the members they serve.

The membership database was initiated in 1990 and has been updated biannually since 1991. The questionnaire is designed to capture current demographic, educational, professional, and employment characteristics of members. A core set of questions and response categories have been kept constant, allowing comparisons overtime. Members have been responsive to the database update process and consistently high response rates contribute to the reliability of the information.

In the ten years since the membership database has been available, it has fulfilled many needs. Ongoing analyses and reports are used to enable member leaders and staff to select tactics designed to implement ADA's strategic plan effectively, facilitate long-range planning, and target programs and marketing efforts efficiently. Individual members and students use the information to explore changes among the practice areas, employment settings, and salaries reported by members. Government agencies, educational institutions, and others use the information to aid their research and planning efforts.

Because of the interest in employment trends in dietetics, as indicated by member inquiries, this report highlights employment data from 1991, 1993,1995,1997, and 1999. Our analyses record the growth of employment within dietetics and the diverse practice areas and employment settings in which members deliver food and nutrition services.

Trends within the membership have been presented in a series of reports published in the Journal that document previous membership database updates (1-5). Readers should consult all of these reports in order to obtain a comprehensive understanding of changes within the membership in the last decade.

The membership database provides general information useful in answering a number of questions about members. The response categories that are used paint a broad picture of dietetics practitioners, but do not provide answers to special questions about dietetics practice. ADA conducts a number of special studies that are designed to answer these questions, e.g. member needs assessment/satisfaction studies and, in conjunction with the Commission on Dietetic Registration (CDR), a periodic practice audit of member and nonmember registered dietitians (RDs) and dietetic technicians registered (DTRs).

METHOD

Design

The 1999 membership database update was conducted in conjunction with the 1999 membership renewal process. During the membership renewal and processing period (April to August), ADA mails all new and renewing members a membership card after they have paid their dues. In 1999, a form was created that allowed the database questionnaire to be attached to the membership card. Beginning in April and continuing throughout the membership renewal period, the form was sent to all members in the Active and Retired member classes with their membership cards. [1] All eligible members who paid their ADA membership dues by the end of August received the questionnaire.

A request for participation describing the importance of the membership database update was included in the mailing.

J.A. Bryk (corresponding author) is director of Association Research American Dietetic Association, 216 W Jackson Blvd, Chicago, IL 60606-6995. T. K Soto is a consultant in Chicago, Ill.

Members were asked to remove and keep their membership card and to complete and return the questionnaire in the postage-paid return envelope. All eligible members who had not returned a completed questionnaire by October 1999 were sent a second mailing. All questionnaires received by the end of December 1999 were included in the 1999 database update.

Questionnaire

The questionnaire consisted of 22 fixed-alternative questions organized into 4 sections: (a) demographics, including year of birth, gender, and race/ethnic origin; (b) professional information, including number of years employed in dietetics after registration and licensure status; (c) educational information including degrees received, year and major of degrees received, and degrees in progress; and (d) employment information, including employment status, number of positions in dietetics, employment setting, type of employer, size of community employed in, amount of budget controlled, number of employees supervised, annual gross income, practice area, number of years worked in current position, and number of paid hours worked per week. Respondents who held one or more dietetics positions were given the opportunity to provide the employment information for their primary and, if applicable, their secondary position in dietetics.

Data Collection, Capture, and Retrieval

Data collection for the membership database update was accomplished under the direction of ADA's Association Research and Management Information Services teams. Questionnaires were returned directly to Data Shop Inc., a data collection and capture firm in Janesville, Wis. Responses that violated the instructions within the questionnaire were coded as missing. Information from the 1999 membership database update is based on self-report of members, with the exception of membership and registration status, which are based on ADA and CDR records.

ADA guidelines require that confidential information (eg, age and salary) be retrieved in accordance with standards that prevent identification of the information from individual members, In effect, confidential information is aggregated and used in statistical reports only.

Respondents

Of the 59,198 eligible members who were sent questionnaires, 45,741 respondents returned usable forms by the end of December 1999. The response rate of 77.3% compares favorably to the response rates of 70.9% achieved in 1997 and 77.9% achieved in 1995.

Results of the 1999 update are presented separately for RDs and DTRs with relevant comparisons to previous updates. All data reflect member RDs and DTRs only and exclude nonmember RDs and DTRs, The report focuses on employment information, including employment status, employment settings, practice areas, and gross annual income from full-time employment in dietetics.

RESULTS

Demographic and Educational Characteristics

The 1999 membership database survey repeated a series of questions asked in previous updates regarding demographic characteristics and the educational attainment of members. Table 1 presents the answers to these questions for RDs and DTRs. RDs and DTRs continue to be predominantly women although slightly more DTRs are men compared to RDs. RDs and DTRs continue to be primarily white, and DTRs are more diverse as a group than RDs. However, among both RDs and DTRs there were slightly more minority respondents in 1999 than in 1997. The estimated median age of member RDs was 42.2 years in comparison to 41.3 years in 1997 and of member DTRs was 42.6 years in comparison to 40.6 years in 1997. The increase in age among both RDs and DTRs mirrors, in part, the aging of the US population.

With respect to educational attainment, Table 1 reflects the fact that receipt of a baccalaureate degree is the minimum educational requirement for registration as a dietitian and receipt of an associate degree is the minimum educational requirement for registration as a dietetic technician. However, more than 52% of RDs report they have received or are pursuing a graduate degree and more than 30% of DTRs report they have received or are pursuing a baccalaureate degree.

These proportions have remained stable throughout the decade [1-5].

Employment: RDs

Table 2 presents the employment status of RDs reported between 1991 and 1999. These findings permit a number of generalizations:

* The percent of RDs reporting being employed in dietetics or both in and outside dietetics has been consistent and high (about 82%) throughout the 1990s.

* The unemployment rate reported by RDs--those RDs currently unemployed and seeking employment either in dietetics or outside dietetics--has been below the unemployment rate reported by the US Bureau of Labor Statistics (BLS) for all professional-specialty occupations in each year of the membership database update [6].

* The level of employment outside dietetics reported by RDs has been consistent and low (less than 1.7%) between 1991 and 1999.

* The proportion of RDs who report being unemployed and not currently seeking employment has been stable (approximately 10%) between 1991 and 1999.

Table 2 also presents the employment settings, type of employers, and number of paid hours worked per week reported by RDs for their primary position between 1991 and 1999. Regarding employment setting, employment in hospitals has declined 8.4%, but employment in other health-related settings (clinics or ambulatory care centers; extended care facilities; HMO, physician, or other care providers) has increased 5.3% and employment in community/public health programs has increased 2.5%. Regarding type of employer, government (all levels) has decreased 2.7% between 1991 and 1999, nevertheless government (all levels) accounts for nearly one quarter of all jobs held by RDs. Regarding number of paid hours worked per week, the ratio of part-time ([less than or equal to]30 hours/week) and full-time ([greater than] or equal to]31 hours/week) employment has remained virtually unchanged from 1991 to 1999.

While the findings regarding employment of member RDs demonstrate continuing strong demand for their services, the data do not provide a projection of future demand for food and nutrition services provided by dietetics professionals. However, BLS provides a projection of future job growth for dietitians and nutritionists as part of its projections for employment in all occupations. Unfortunately, BLS does not report a specific projection for RDs or DTRs.

In its latest published projections, BLS projects growth in total US employment for all occupations between 1998 and 2008 of 20.3 million new jobs or an increase of 14.4%. The projected growth in employment for dietitians and nutritionists between 1998 and 2008 is 10,300 new jobs or an increase of 19.1%. However, the growth rate of jobs for dietitians and nutritionists is less than the overall projected growth rate of 23.5% between 1998 and 2008 for all health assessment and treating occupations [7].

Finally, since 1993 the practice areas used to define dietetics practice within the membership database update have been consistent and permit comparison. Among member RDs, the distribution of practice areas reported for primary positions in dietetics have changed between 1993 and 1999.

Clinical nutrition has increased from 45% to 50%; commnunity nutrition has increased from 14% to 15%; food and nutrition management has decreased from 20% to 16%; consultation and business has declined from 13% to 11%; and, education and research remain unchanged at 8%. Clinical nutrition and community nutrition together have increased 6%, while food and nutrition management and consultation and business together have decreased 6%. Services provided by member RDs have shifted toward clinical and community services in comparison to management and consultation services.

Employment: DTRs

Table 3 presents employment information reported by member DTRs in 1995, 1997, and 1999. Although the data provide evidence of the demand for services provided by DTRs, there are noteworthy differences between DTRs and RDs:

* The percent of DTRs reporting being employed in dietetics or both in and outside of dietetics has been consistent and higher than that reported by RDs.

* The unemployment rate reported by DTRs--those currently unemployed and seeking employment in dietetics or outside dietetics--has been consistently higher than the unemployment rate reported by RDs.

* The proportion of DTRs who report being employed outside dietetics only is consistently higher than the proportion of RDs who report being employed outside dietetics only.

* The proportion of DTRs who report being unemployed and not currently seeking employment is consistently lower than the proportion of RDs who report being unemployed and not currently seeking employment.

Regarding future demand for dietetic technicians, BLS does not provide an employment projection specifically for dietetic technicians. However, it does project a 25,2% increase in jobs for all health technicians and technologists between 1998 and 2008 [7].

Finally, the practice areas (primary position) reported by DTRs have remained stable between 1993 and 1999. Clinical nutrition accounts for 58% of jobs (59% in 1993); food and nutrition management accounts for 30% of jobs (31% in 1993); and community nutrition, consultation and business, and education and research, together account for 12% of jobs (10% in 1993). Almost 9 out of 10 jobs performed by DTRs involve clinical or management services.

Annual Gross Income: RDs and DTRs

Consistent with previous membership database updates, members were asked to give the annual gross income for …