Dr. King’s Most Persistent Question—and the 5.4 Million Workers Who Answer It
On this day, as we honor the life and legacy of Dr. Martin Luther King Jr., we reflect on what he called “the most persistent and urgent question”: What are you doing for others?
Across the nation, nearly 5.4 million direct care workers answer that question every day. They are home care workers who help older adults and people with disabilities maintain their health and wellbeing in their own homes and communities. They are direct support professionals, who support individuals with intellectual and developmental disabilities to live full, independent lives. They are residential care aides and nursing assistants, who bring comfort and dignity to those in assisted living and skilled nursing homes.
The direct care workforce exemplifies one of our nation’s greatest strengths—vibrant diversity. These workers are overwhelmingly women (85 percent). They are disproportionately people of color (64 percent). And they include a vital population of immigrants (29 percent nationwide, and far higher in many states). Together, direct care workers strengthen families, communities, and the economy overall in every U.S. state.
A Legacy of Exclusion
Direct care workers have long faced systemic barriers to fair treatment—barriers rooted in the same racism and sexism that Dr. King spent his life confronting.
When Congress passed the Fair Labor Standards Act in 1938, establishing minimum wage and overtime protections, domestic workers—including home care workers—were deliberately excluded. This exclusion was a compromise with legislators who opposed extending labor rights to a workforce that was, at the time, predominantly Black women and men.
That exclusion went unchecked for decades. It was not until 1974 that domestic workers gained coverage under federal wage law—but home care workers were carved out completely. Only in 2015 did home care workers finally gain full federal minimum wage and overtime protections. Yet, today, as the identity of our nation faces grave and significant tests, those protections are once again under imminent threat.
The Current Moment
We observe this holiday amid intensifying debate over American identity, and as a changing federal policy landscape brings increasing disruption to our nation’s care infrastructure. We are witnessing a surge in harmful rhetoric that questions the belonging of immigrants, and appears intended to divide communities based on origin and background.
Current rhetoric, which deals in abstractions and fear, ignores the reality of care in this country. The real experience inside American homes is so often one of trust and connection. Every day, families across the political spectrum entrust their loved ones to direct care workers from different backgrounds, cultures, and countries of origin. In these intimate moments of care and compassion, our shared humanity outweighs our differences.
Rhetoric has consequences. When the contributions of the immigrants and women of color who so often provide our nation’s care are devalued in the public sphere, such narratives threaten the economic stability and safety of these essential workers. Simply put: They demean the humanity of the people we entrust to care for our loved ones.
As a recent example of where rhetoric and policy intersect to challenge care: A proposed Department of Homeland Security rule on public charge would treat immigrants’ use of legally available safety-net programs, like Medicaid and SNAP, as evidence against their admissibility. Nearly half of direct care workers rely on some form of public assistance. This rule would force immigrant caregivers to choose between feeding their families and maintaining their immigration status—destabilizing a workforce already stretched to its limits.
A Call for Action
Dr. King understood that economic justice and civil rights are inseparable. He called for dignity and fair treatment for all workers.
According to PHI’s research, between 2024 and 2034, there will be 9.7 million job openings in direct care, more than any other occupation in the country. Meeting this demand requires a stable, supported, respected, and well-compensated workforce that reflects the diversity of the nation it serves. We cannot build a strong care economy by alienating the very workers who sustain it.
PHI calls on policymakers safeguard and strengthen labor protections for direct care workers. In turn, we call on employers to invest in wages, training, and career pathways. And we call on all Americans to recognize the contributions of a workforce that provides care to our most vulnerable neighbors—and makes all other work possible.
“Direct care workers have long been excluded from the professional recognition and basic protections that most Americans take for granted,” said Jodi M. Sturgeon, President and CEO of PHI. “As we honor Dr. King’s legacy, we also honor the millions of workers—overwhelmingly women and people of color, and many of whom are immigrants—who care for our families and communities. Their work is essential. Their contributions deserve recognition. And their rights and dignity must be protected.”
