When it comes to jobs, health care is the leader in metro St. Louis. Often we can overlook the importance and impact of health care to the economy.The St. Louis Business Journal has listed the largest employers in St. Louis in the number of local employees and three hospitals are in the top five employers. BJC Health Care is the No. 1 employer with 28,351 local employees. Next comes Wal-Mart Inc. with 22,290 on its payroll. Ranked No. 3 is Washington University with 15,818 employees. No. 4 is SSM Health, with a payroll of 14,926 workers. Mercy ranks No. 5 with 14,125 employees.Hospitals operate 24 hours a day, every day. They never close and it takes a large staff to handle the delivery of health care.The largest employer in this area is Mercy Hospital Washington with about 1,800 employees. That includes Mercy clinic and its other facilities that provide health care in this area.The top 10 other companies are Boeing Defense, Space and Security, with 14,000 employees, followed by Scott Air Force Base, 13,000; Schnuck Markets Inc., 9,956; AT&T, 9,000; and the Archdiocese of St. Louis, 8,780.In the listing of the number of local employees, the St. Louis mertro area takes in counties on both sides of the Mississippi River. Franklin and Warren counties are included in the metro area.It is significant that health care plays such a major role in economic development in the metro area. St. Louis is considered a leader in the field of health care.Mercy Hospital Washington’s total economic impact on this area is tremendous.With three of the top five employers in St. Louis being hospitals and their other facilities, the total economic impact is such that it points out how important they are to the entire region.