Who Cares? What's Unfair about How We Treat Our Health Care Workforce

Published jan. 12, 2017

When it comes to the frailest among us, it is most likely a woman who does the caring. According to the latest Bureau of Labor Statistics data, in 2016 women accounted for 87 percent of the nursing assistant workforce, 87 percent of home health aides, and 83 percent of all personal aides. Women of color are disproportionately employed in all of these caring occupations, as are single mothers and immigrant women. Because these occupations pay so little, most of the women in these health care support occupations remain poor, unable to support their own families even as they work full time caring for ours.

Health care support workers tend to the most intimate details of everyday life, including bathing and dressing, feeding and meal preparation, cleaning, shopping, transportation, and companionship. Whether in nursing homes, assisted living facilities, or in our own homes, they are the people that we and our family members will spend the most time with when recovering from illness or surgery and as we age and die.

Demand for their services is growing rapidly, and not just because we as a nation are getting older. Pressure to reduce health care costs while improving the quality of care and patient satisfaction has also increased demand for health care support workers. To save costs, hospitals are moving people to rehabilitation facilities or home to recuperate. And aging, frail, ill, and dying patients are increasingly seeking more care at home. But the supply of workers for these rapidly growing occupations is not keeping up with demand. Employers are having a hard time filling these positions and keeping people in them because pay is low and career advancement is lacking. Nursing assistants earn about $13 per hour, while personal assistants and home health aides earn only $11 per hour. These wages are some of the lowest in our economy: dog groomers earn $11.71 per hour, funeral attendants $12.63, and casino cashiers $13.62.

Jobs for the Future is trying to do something about the low wages and lack of career opportunities for these key frontline health care workers. In Rhode Island, we are working with the Healthcare Workforce Transformation Commission to explore how specialty nursing assistant certifications may lead to career advancement within this occupation and to higher wages. We are also exploring how the skills developed in these support fields can be leveraged for advancement into higher paying positions such as licensed or registered nursing. And in Massachusetts, we just released a report identifying strategies to expand and diversify the health care workforce and bring young people into these rapidly growing occupations.

By working to increase the skills, career opportunities, and wages of these health care support professionals, we can begin to meet the growing health care needs of the frailest among us and provide opportunities for some of the lowest-paid working poor in the labor market. At the same time, by drawing more people into the field and providing them with opportunities for higher wages and career advancement, we strengthen the frontline health care workforce and build the foundations for a health system that provides better care and greater patient satisfaction with smarter spending.

NOTE: All data referenced in this article are from Emsi.