More than the whole economy
In the twelve months to September 2026, health care and social assistance added 520,400 jobs; American payrolls as a whole added 496,000. The Bureau of Labor Statistics published the September figures on 2 October 2026, and September itself added 29,000.
Every other sector put together therefore lost 24,400 jobs over the year. That is the desk’s arithmetic: the twelve sectors of the payroll survey add up to the total, to within rounding, so the rest is the total minus the one sector.
Health care alone added 371,800 of the 520,400, three quarters of the whole economy’s gain, and social assistance added 148,600. Within health care, ambulatory services, such as doctors’ offices and home health care, added 213,300, hospitals 108,100 and nursing and residential care 50,400.
| Sector | September 2025 | September 2026 | Change, jobs | Change, % |
|---|---|---|---|---|
| All payrolls (total nonfarm) | 158,548,000 | 159,044,000 | +496,000 | +0.31% |
| Health care and social assistance | 23,438,200 | 23,958,600 | +520,400 | +2.22% |
| Professional and business services | 22,359,000 | 22,482,000 | +123,000 | +0.55% |
| Construction | 8,255,000 | 8,364,000 | +109,000 | +1.32% |
| Leisure and hospitality | 16,907,000 | 16,969,000 | +62,000 | +0.37% |
| Trade, transportation and utilities | 28,725,000 | 28,778,000 | +53,000 | +0.18% |
| Manufacturing | 12,612,000 | 12,652,000 | +40,000 | +0.32% |
| Other services | 6,005,000 | 6,039,000 | +34,000 | +0.57% |
| Mining and logging | 605,000 | 607,000 | +2,000 | +0.33% |
| Private educational services | 4,050,300 | 4,046,400 | -3,900 | -0.10% |
| Financial activities | 9,189,000 | 9,082,000 | -107,000 | -1.16% |
| Information | 2,859,000 | 2,739,000 | -120,000 | -4.20% |
| Government | 23,543,000 | 23,327,000 | -216,000 | -0.92% |
Where the rest went
Outside health care and social assistance, private employers added 191,600 jobs and government lost 216,000. Federal employment fell by 232,000 and state government by 25,000, while local government added 41,000.
Professional and business services added 123,000 jobs and construction 109,000; information lost 120,000 and financial activities 107,000. Leisure and hospitality added 62,000, trade, transportation and utilities 53,000 and manufacturing 40,000.
Payrolls fell in four of the twelve months: October and December 2025, February and July 2026. The year’s gain came from the other eight.
What the payroll survey counts
It counts positions, not people. The survey asks employers how many people are on their payroll, so a person with two jobs counts twice and nobody is followed from one job to another.
It sorts them by the employer’s industry, not by what the job is. A receptionist at a hospital counts in health care; a nurse placed by a staffing agency counts in professional and business services.
And its latest months are first estimates. The BLS revises each month twice in the following reports and benchmarks the March level to tax records once a year.
- JOBS, NOT PEOPLE: the payroll survey asks employers how many people are on their payroll, so a person with two jobs counts twice, and nobody is followed from one job to the next.
- THE EMPLOYER’S INDUSTRY, NOT THE OCCUPATION: a receptionist or a cook employed by a hospital counts in health care; a nurse employed by a staffing agency counts in professional and business services.
- A FIRST ESTIMATE: the latest two months are revised in the next two reports, and every March level is benchmarked once a year to tax records. September 2026 is preliminary.
So 520,400 does not say that half a million more people work as nurses or carers: it says that employers in health care and social assistance had 520,400 more positions on their payrolls in September 2026 than a year earlier, whatever those positions are.
One survey of employers, counting positions by the employer’s industry, and a reading that forgets either says what the source does not.
What these figures do not say
They name no cause. An ageing population, immigration, federal policy, tariffs, interest rates and artificial intelligence have all been offered to explain American jobs, and none of them is measured here.
They do not say that anyone lost a job or found one. A sector with fewer positions may have people who moved to another sector, retired or are looking, and this survey cannot tell which.
They are not the unemployment rate, which comes from a different survey of households, and they say nothing about pay or hours. None of this is a forecast.
