Why Direct Care Worker Wages Are Key to Closing the Gender Wage Gap

Despite decades of advocacy by dedicated direct care workers and other visionary leaders, care work is still seen by too many Americans as somehow "less than" other forms of work.
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The wage gap is about more than just equal pay for equal work; it is also about the near-poverty wages we pay for some predominantly female professions.

March is Women's History Month, a time to pay tribute to female leaders and visionaries from previous generations by recognizing their contributions to the effort for women's equality. This March, let's take it a step further by working to become a society where women's equality is truly universal and secure, no matter who you are, where you're born or what you do for a living. Let's commit to finally closing the gender wage gap that leaves women earning 77 cents for every dollar earned by a man.

In his February 1980 proclamation declaring National Women's History Week, President Jimmy Carter said:

From the first settlers who came to our shores, from the first American Indian families who befriended them, men and women have worked together to build this nation. Too often the women were unsung and sometimes their contributions went unnoticed. But the achievements, leadership, courage, strength and love of the women who built America was as vital as that of the men whose names we know so well.

This provides a perfect backdrop as we look at where we are in the fight for women's equality and think about how to reach our goal. If we are going to close the gender wage gap, we can't only make sure that women who do the same job as men get paid the same wages. We must also improve wages for the millions of women who are paid less than men because they do work that has traditionally been done by women -- and paid at a much lower rate than work traditionally done by men. Millions of these women are direct care workers -- the nursing assistants, home health and home care aides, personal care attendants, direct support professionals and other frontline workers who make up one of our largest and fastest-growing workforces.

Many men provide care and support, either professionally as direct care workers or personally in their families, and that trend is growing, especially among family caregivers. But women have historically provided most of the care for children, parents and others, and they still make up 89% of the direct care workforce. Direct care workers, who provide the bulk of the paid hands-on personal assistance and long-term care to older adults and people with disabilities, are among those unsung heroes President Carter was talking about. They are often taken for granted even though their work, which requires specialized knowledge and skills, patience, dedication and compassion, is vitally important to the millions of Americans who use direct care services.

Despite decades of advocacy by dedicated direct care workers and other visionary leaders, care work is still seen by too many Americans as somehow "less than" other forms of work. It may no longer be socially acceptable to refer to these jobs as "women's work," but it's still status quo to treat them dismissively. As home care worker and Direct Care Alliance Board Chair Tracy Dudzinski puts it: "Direct care work is expected but not respected."

That lack of respect is reflected in the near-poverty wages that most direct care workers earn; in 2012, the median hourly wage for direct care workers was $10.63. Direct care workers also have few opportunities for advancement and the higher wages that often accompany it. As a result of these low wages, direct care workers and their families are frequently forced to depend on public benefits like Medicaid and food stamps (in 2011, 49% of direct care workers lived in households that relied on public benefits). They have also been far more likely than the average worker to be without benefits like paid sick days, paid family and medical leave, or health insurance. In 2011, 30% of direct care workers were uninsured. Granted, that was before the Affordable Care Act went into effect, and many direct care workers are now finding affordable coverage under the new law, but many are still struggling to pay the monthly premiums or finding themselves trapped in the health care coverage gap in states that refuse to expand their Medicaid programs.

The low wages assigned to these "pink-collar" workers are a significant part of the reason why women earn so much less than men on average -- and the problem will only get worse if we don't raise their wages soon. Demand for quality long-term care, services and supports is booming, due in large part to aging baby boomers, and most people want to receive those supports in their homes. That makes two subsets of the direct care profession--personal care and home care workers -- the fastest-growing job categories in the nation. If we don't do more to improve direct care workers' wages over the next few years, there will be more than five million direct care workers -- the vast majority of them women -- swelling the ranks of this country's working poor by 2020.

So where do we go from here? The path forward is ambitious, given all of the areas in which improvements are needed, but it is not ambiguous. Let's increase direct care worker wages and access to health care and other benefits, so people who love and excel at this job don't have to leave it in order to raise a family and make ends meet. Let's also create career paths within the profession, so direct care workers can commit to the field and know they have options to increase their pay and responsibility. (For more on how we can strengthen the direct care workforce, see The New Face of Our Economy.)

By prompting us to look back at where we've been, Women's History Month gives us an opportunity to think about where we're headed and how we can alter our course to ensure a better, more just and prosperous future. We need visionary leaders like the famous women being honored this month, but at least as important, if not more so, are the unsung heroes of which President Carter spoke. Women and their allies everywhere need to draw attention to this issue and demand change, using our voices, our votes, our social media pages and every other tool at our disposal.

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