The health care industry has played an outsized role in the nation's economic recovery and is fueling rapid job growth in the Twin Cities and the nation, according to a report released Monday by the Brookings Institution.

Jobs in the health care field now account for more than one in 10 jobs on average among the nation's largest 100 metropolitan areas, outstripping overall employment growth by a wide margin.

"There's a long-term trend of job growth in the health care industry that you don't see in other sectors of the economy," said Martha Ross, lead researcher on the report by Brookings' Metropolitan Policy Program. "They're now taking up a bigger share of the employment pie, and that's happening in some cases because other parts of the pie are shrinking."

In the past decade, the health care industry has added 2.6 million jobs nationwide. That translates to a hefty employment growth rate of 22.7 percent, compared with 2.1 percent among all other industries.

About 9.3 percent of the jobs in the Twin Cities were in the health industry before the financial crisis of 2008. Today, about 10.8 percent of the area's jobs are in the health field, the Brookings' research found.

Health care accounted for almost 15 percent of the job growth in the recovery in the Minneapolis-St. Paul area.

Statewide, health care was the only employment sector that kept expanding through the recession, according to the Minnesota Department of Employment and Economic Development.

In the past decade, about 104, 100 new jobs in Minnesota have come in the fields of health care and social assistance, which includes those who work in hospitals and clinics as well as nursing homes.

Bolstered by the growth in health care, the state has almost recovered all of the jobs lost during the recession, said Dave Senf, a state labor market analyst. But it came amid job losses in manufacturing and construction, industries that are nowhere near their peak, Senf said.

The Brookings study also found that not all health care jobs are equal. Doctors, nurses and dentists earn nearly double the average worker salary in major cities, while support workers, such as nursing ­assistants and home health aides, are paid about 37 percent less.

"I worry about that group of workers because they have limited career mobility and limited earnings," Ross said. "The only way they get career mobility is to go back to school and get another certificate or degree."

But Ross said opportunities may arise as the Affordable Care Act and other reform efforts seek to lower costs by reducing expensive hospital stays and other specialty care.

"Those jobs are going to become more important," she said.

Jackie Crosby • 612-673-7335