WASHINGTON — The CEOs of America's largest companies do not expect employment to significantly improve in the next six months.

A quarterly survey from the Business Roundtable released Tuesday found that 19 percent of companies expect to grow their work forces, while 31 percent predict a decrease in the next six months. That's slightly better than the 13 percent who saw increased hiring three months earlier, when 40 percent forecast cuts.

The CEOs also expect the overall U.S. economy to grow by 1.9 percent in 2010. That would mark a slowdown from the 2.8 percent pace in the third quarter of 2009. Still, that growth broke a record string of four straight quarterly declines and was the strongest signal that a recovery from the recession had started.

In more positive news, the number of CEOs expecting to increase capital spending nearly doubled, to 40 from 21 percent. The number forecasting an increase in sales grew to 68 from 51 percent.

A new question on the survey asked CEOs to identify their greatest cost pressures. The largest group — about one-third — cited health care.

The Roundtable has emerged as an aggressive voice in the debate over the Obama administration's overhaul of the health care system. The group has applauded some measures it says would keep costs down, but criticized provisions like a government-run plan for those who can't get other insurance.

"The economy is in the throes of a long transition back to health; recovery will be long, extending beyond 2010," Ivan Seidenberg, CEO of Verizon Communications and chairman of the Roundtable, said in a statement. "The outlook of our CEOs reflects that reality: we see noticeable gains in sales and capital spending but employment growth continues to lag."