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Massage Today
January, 2005, Vol. 05, Issue 01

Massage Therapist Densitites

By John Fred Spack, LMT

Editor's note: The following data is based on the author's nonscientific research methods; caution should be used in generalizing the results.

In 2003, Massage Today published my review of data that suggested that massage therapists are more available to the public in licensing states (

As of July 2004, the trend continued with some diminishment.

In 2003 and 2004, 26 states and the District of Columbia mandated massage therapy regulation. Three states (Connecticut, Wisconsin and Virginia) offered voluntary certification. Regulation was pending in four states as of July 31, 2004: New Jersey (certification), Illinois, Arizona and Kentucky. Aside from everything else in this article, it will be interesting to follow the numbers as these states build their registration lists.

The July 2004 edition of Massage Today was distributed to 72,245 massage therapists in all 50 states and the District of Columbia, according to its published circulation data. Using the July 2003 U.S. census data (the 2004 estimates were not available at this writing), the subscribers of Massage Today represent a density of about 25 massage therapists per 100,000 people in the United States. One way of looking at that is to figure that there are 4,000 potential clients per massage therapist, without discounting infants, prisoners and troops abroad.

About half the U.S. population lives in the 26 licensing states and Washington, D.C. The density of massage therapists is approximately 35 therapists per 100,000 in licensing states - above the national average. Nonlicensing states have an average density of only 15 massage therapists. To the extent that these numbers represent availability of massage services, availability is over twice as much in licensing states.

The numbers change a bit when the three certification states, Connecticut, Wisconsin and Virginia, are shifted into the credentialing column, joining the licensing jurisdictions. Credentialing states average 34 therapists per 100,000 people and non-credentialing states average 14 therapists. Measured this way, availability in credentialing states is still more than double other states, but in 2003 it was nearly triple.

This year, the state with the largest number of massage therapists per capita is Utah, with 82 per 100,000 (down from 101 a year ago). The 14 highest state densities occur in credentialing states, and these are the same states as last year. Montana, ranked 15th overall, is the nonlicensing state with the highest density, at 30 massage therapists per 100,000. The trend favoring licensing is mitigated by the three states with the lowest densities, which are all licensing states: North Carolina (7.5), Mississippi (6.4) and at the bottom, Maryland (5.5).

Individual state numbers must be viewed with caution. North Carolina, for example, has far more therapists than the 633 recipients of Massage Today in that state; the number of recipients in Ohio is 3,902, about half of the 7,820 reported by the state medical board in June 2004. Massage Magazine's online listing showed 7,334 Ohio licensees. There is no authoritative count in any nonlicensing state.

Expanding this report, I investigated numbers from the U.S. Department of Labor for the year 2000 of employed massage therapists only, excluding massage therapists who are self-employed, including independent contractors. (The data on average wages is interesting but not my focus.) Numbers are not available from seven states and Washington, D.C. Of the remaining 44 states, 20 were licensing states and 23 were nonlicensing states (Mississippi did not yet license in 2000.) A total of 25,890 massage therapists were reported as employed in the 44 states. According to an AMTA membership survey, 16 percent of therapists are employed. A calculation with that percentage gives a 44 state total of about 155,000 massage therapists where Massage Today lists 66,152, suggesting that the massage densities I have shown might be about 60 percent short of the actual numbers.

Using just the Department of Labor numbers, the average density for employed therapists is 10 per 100,000 people over all states and is also 10 in either the licensing states or nonlicensing states taken as groups. This data shows near equality between licensing and nonlicensing states as to the density of massage therapists working for employers.

Economists conjecture that licensing deters employment, but these figures do not support that. This Department of Labor data would be an excellent source of information for a massage school student researching a well-balanced approach to the theoretical economic effects of licensing.

We may conclude, as we did a year ago, that these data do not document that state licensing depresses the availability of professional touch to the public. One explanation may be that the very negative affects of local regulation are overcome by state licensing. In theory, state licensing imposed on a free market should dampen entry to the profession. When compared to local patchworks of regulation in the nonlicensing states, massage therapy licensing at the state level uniquely liberates the massage market and affords better opportunities for clients and practitioners.



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