Report says low-paid care work relic of racism, sexism
Research center says child, elder care undervalued
BEFORE THE Industrial Revolution, the work of caregiving fell almost exclusively to women – wives, mothers, daughters, and sisters. White women were seen as nurturing and domestic, and acted as hostesses and supervisors. Enslaved Black women and poor and immigrant women worked in more physically demanding domestic work – nursing, washing floors, and doing laundry. After Emancipation, many of the jobs available to Black women remained in domestic labor.
The COVID-19 pandemic and a national reckoning on race have called renewed attention to the essential work done by caregivers – childcare workers, home care workers, and workers in long-term care facilities. A new report by Boston Indicators, the research center at the Boston Foundation, and SkillWorks, which does workforce development, looks at the chronic underpayment and undervaluing of caregivers. The report traces the root of the problem to systemic racism and sexism dating back hundreds of years. It makes the case that it will take conscious work to improve the system and, as a society, provide the care that children and increasingly seniors will need.
“It’s not easy to overcome 400 years of systemic oppression and, given the nature of the market for the care economy, it will require both private and public sector commitments,” wrote Andre Green, executive director of SkillWorks, in the report’s preface. “But if we’re serious about racial, gender, or economic justice it’s a task we must take up together.”
Luc Schuster, executive director of Boston Indicators, said the report, released before Labor Day, makes clear that those workers who provide critical support for people in infancy, illness, disability, or old age “are too often excluded from our image of high-value labor.”
Demographically, care workers tend to be female, non-white, and foreign born. While just under half of Massachusetts workers are female, women make up 85 percent of home care and long-term care facility workers, and 92 percent of childcare workers. While 7 percent of workers are Black, Blacks comprise 43 percent of workers in long-term care facilities. Latinos are 11 percent of the total workforce but 27 percent of home care workers.
The report says care work had a median wage between $13 and $16 an hour depending on the type of work between 2016 and 2020, though the pay increased as the state minimum wage increased and federal funding offered wage bumps during the pandemic. The report says the low pay is not reflective of skill or education level. It compares several jobs that do not require a high school degree and finds those that are predominantly female (like health care and childcare) have lower wages than those that are predominantly male (electricians, firefighters, and carpenters).
Care workers are less likely than other workers to receive employer-provided health insurance and retirement benefits. As a result, many depend on public assistance. Almost one-third of Massachusetts home care workers receive food stamps.
The result is an industry plagued by high turnover and burnout, an increasing problem as Baby Boomers age. The Massachusetts Office of Labor and Workforce Development predicted that between 2018 and 2028, the need for home health aides and personal care aides will rise by about 20 percent in an industry that already has staffing shortages.The report makes several policy suggestions, including continued minimum wage increases, increased Medicaid and Medicare reimbursement rates, a licensing process for home care agencies, and improved career training. Advocates have been pushing an expansion of the earned income tax credit to cover unpaid caregivers, so a stay-at-home parent of a young child or someone caring for a disabled family member could get the tax credit.
Schuster said there are models to look to, like a public home care authority in Washington state that lets home care workers at different agencies bargain collectively.