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Title: The Growing Need for Home Care Workers: Improving a Low-Paid, Female-Dominated Occupation and the Conditions of its Immigrant Workers

Citation Type: Journal Article

Publication Year: 2017

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Abstract: Direct care workers who provide assistance in clients’ homes, also known as home care workers, are a large and growing share of the U.S. labor force. In 2015, 1.7 million workers provided in-home, personal assistance to the elderly, the chronically ill, and individuals with disabilities, and this number was almost double the number working as home care workers in 2005. While this is still a female-dominated occupation—88% of the workers providing in-home care were female in 2015—the share has fallen somewhat from 92% female in 2005. Home care workers are included in two occupational categories, personal and home care aides and nursing, psychiatric, and home health aides, used to describe direct care workers in federal data sets; there were about 4.4 million direct care workers in both occupations in 2015. Here, we further identify direct care workers in these two occupations who work in the industries of home health care services or individual and family services as home care workers: about 38% of the total direct care workforce in the two occupations identified. Home care workers are also growing as a share of direct care workers. Among all personal and home care aides, those working in homes grew from 43% to 51% of the total between 2005 and 2015, and among all nursing, psychiatric, and home health aides, the share working in homes grew from 20 to 30% of the total across the same 10 years (see Appendix). The direct care occupations of personal and home care aides and nursing, psychiatric, and home health aides have much in common with other low-wage, female-dominated occupations. A 2016 study by researchers from the Institute for Women’s Policy Research (IWPR) working with Oxfam America identified the 22 largest, growing, female-dominated occupations (here defined as having 60% or more female incumbents) with median pay of less than $15 per hour in 2014 (Shaw, Hegewisch, Williams-Baron, & Gault, 2016). Personal and home care aides are the eighth largest of these occupations and nursing, psychiatric, and home health aides are the fourth largest. Among those 22, personal and home care aides constitute the single occupation with the highest growth rate projected through 2024 by the U.S. Bureau of Labor Statistics (BLS), at 25.9% from 2014–2024, while the growth rate for nursing, psychiatric, and home health aides is not far behind at 24.5%. The growth rate projected for all 22 low-paid, female-dominated occupations is 9.5% across the same period and 6.5% for all occupations (total employment). Aides in these two direct care occupations are older (median age 45 and 41 respectively) than the average workers in these 22 low-wage occupations (median age 36). Female personal and home care aides earn about $1.00 per hour less than female workers across all 22 low-wage, female-dominated occupations ($10.16 and $11.18 per hour, respectively) while female nursing, psychiatric, and home health aides earn just above the median for all 22 occupations at $11.83 per hour. In 2014, 78.8% of female personal and home care aides earned less than $15 per hour compared with 71.3% of all female workers in the 22 largest occupations; female nursing, psychiatric, and home health aides fare just slightly worse than all female workers with 72.0% earning less than $15 per hour (Shaw et al., 2016). Almost half of both groups of female direct care workers have education beyond high school; nevertheless, more than half have family incomes below the poverty or near-poverty level, faring somewhat worse than women in the 22 occupations as a whole and much worse than all women workers. Female direct care workers are disproportionately women of color and disproportionately foreign-born (only the occupations of personal appearance workers and maids and housekeeping cleaners have higher shares of foreign-born workers among the 22 occupations).

Url: https://academic.oup.com/ppar/article-abstract/27/3/88/4085586?redirectedFrom=fulltext

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Authors: Hartmann, Heidi; Hayes, Jeffrey

Periodical (Full): Public Policy & Aging Report

Issue: 3

Volume: 27

Pages: 8

Data Collections: IPUMS USA

Topics: Aging and Retirement, Gender, Labor Force and Occupational Structure, Migration and Immigration

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