For a number of reasons, health care mutual funds have been struggling thus far in 2016. After outperforming the Standard & Poor’s 500 Index and most other sector mutual funds for the last five years, health care mutual funds are down 15.79% year-to-date, the most by far of any sector. By comparison, the average health care exchange-traded fund (ETF) is down just 1.61% through March 16, 2016. The gaping performance disparity can be explained in part by the fact that most health care mutual funds invest primarily for growth, looking for opportunities across the health care spectrum, including higher risk biotechnology companies and small- and mid-cap companies with high growth potential. Health care ETFs are generally invested in stocks that comprise one of the narrow indexes that track most of the larger, more stable health care companies.

That also explains why dividend yields on health care ETFs tend to be much higher than health care mutual funds. Although investors probably shouldn’t look to health care mutual funds for dividend yield, a few do offer modest yields that can act as a small buffer during market declines. Their main objective, however, is to select stocks they believe will outperform the sector and the S&P 500 Index.

Vanguard Health Care Fund

Over the years, the Vanguard Health Care Fund (“VGHCX”) has proven to be a steady performer, delivering respectable returns while outperforming the market during downturns. As of March 16, 2016, the fund has $46.3 billion in assets under management (AUM) invested in 105 holdings from across the health care spectrum. The fund tends to favor larger, more established companies with geographic diversification. After taking over the fund in 2012, fund manager Jean Hynes has made a slight tilt toward smaller, growth-oriented companies, which has expanded the number of holdings from 70 to more than 100. Its top holdings include big dividend payers such as Bristol-Myers Squibb Company (NYSE: BMY), UnitedHealth Group Inc. (NYSE: UNH), Merck & Co Inc. (MRK) and Eli Lilly and Co. (LLY). The fund’s trailing 12-month yield is 1.23%. Although the fund is down 10.01% year-to-date in 2016, it has returned 10.83% over the last 10 years and 18.85% over the last five years. The fund’s expense ratio of 0.34% is the lowest in its category.

BlackRock Health Sciences Opportunities Portfolio

At 1.40%, the BlackRock Health Sciences Opportunities Portfolio (“SHSAX”) has a slightly higher dividend yield, but its expense ratio is substantially higher at 1.15%. The $5.3 billion fund invests at least 80% of its assets in the common stock of companies in health sciences and related industries, including health care equipment, biotechnology, health care providers, biotechnology and pharmaceuticals. As of March 16, 2016, its top five holdings are UnitedHealth Group, Medtronic Plc (NYSE: MDT), Celgene Corp. (NASDAQ: CELG), Eli Lilly and Co., and Amgen Inc. (NASDAQ: AMGN). The fund has returned 11.83% over the last 10 years and 17.53% over the last five years. Year-to-date in 2016 the fund is down 11.66%. The fund only requires a $1,000 minimum investment, and it charges a 5.25% front-end sales load.

The Hartford Healthcare Fund

At 1.60%, the Hartford Healthcare Fund (“HGHAX”) has the highest dividend yield of these three funds, but it also has the highest expense ratio. The fund, which is managed by Wellington Management Company, has $1.5 billion in assets invested in common stocks of health care-related companies. As of March 16, 2016, the fund’s top five holdings are Allergan, Bristol-Myers Squibb, UnitedHealth Group, Medtronic and Gilead Sciences Inc. (NASDAQ: GILD). The fund has returned 9.68% over the last 10 years and 18.35% over the last five years. Its year-to-date return in 2016 is a negative 14.52%. The fund’s expense ratio is 1.28% and investors are charged a 5.50% front-end sales load.