New Research Shows Unions Elevate Direct Care Worker Wages and Overall Job Quality

Over 5 million direct care workers in the United States provide long-term services and supports to older adults and people with disabilities across a range of settings, including in home care, residential care, and nursing homes. When accounting for growing demand, this workforce is projected to add more than 860,000 new jobs between 2022 and 2032. However, these workers contend with persistently low wages, few benefits, and often hazardous working conditions.

One mechanism to improve job quality is unionization. Across industries, union coverage is associated with improved wages, benefits, worker health and safety, and workforce retention. However, due to historical and current barriers to organizing, direct care worker union density is low overall and uneven across settings and states.

A new research brief from PHI, The Union Effect for Direct Care Workers, provides a comprehensive analysis of how unionization can impact the direct care sector.

Our findings show that unionized direct care workers earn higher wages across all settings. Overall, median hourly wages for unionized direct care workers are $1.39 higher than for their non-union peers. After controlling for demographic, geographic, and job-specific factors, our analysis found that union coverage is associated with a six percent increase in hourly wages. The study also finds that state context matters; direct care worker median hourly wages are $1.22 higher on average in states that are more supportive of unions compared to so-called “right-to-work” states that undermine them.

These findings reveal that where unions are stronger, they raise standards for all workers—including those not covered by a union contract. This is likely because a stronger union presence strengthens the collective voice of workers in calling for better working conditions. Considering the myriad benefits to direct care workers, employers, and local economies, policymakers should consider how to support worker participation and organizing initiatives. This can include promoting policies that remove barriers to worker organizing, such as repealing right-to-work laws at the state level, and encouraging employers to support quality jobs through voluntary recognition of unions.

To delve deeper into the data and analysis, view the full report here: https://www.phinational.org/resource/the-union-effect-for-direct-care-workers/