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Demand for Home Care Workers Outpacing Labor Pool Supply, PHI Reports

March 7, 2013

— Improving Quality of Direct-Care Jobs Is Essential for Building a Quality Workforce —

The demand for direct-care workers — particularly those employed in home and community-based settings — will continue to outpace supply through this decade, warns PHI (Paraprofessional Healthcare Institute), the nation's leading authority on the direct-care workforce.

As many as 3.3 million direct-care workers — including nursing home aides, home health aides, and personal care aides — were employed in 2010, and 1.6 million new positions are projected by 2020, PHI reports in its updated Facts 1: Occupational Projections for Direct-Care Workers 2010-2020 (pdf).

The direct-care workforce is projected to be the nation's largest occupational grouping by 2020. Direct-care occupations will outnumber all retail sales workers as well as all teachers from kindergarten through high school.

"Pressure is building to improve the quality of direct-care jobs," says PHI Policy Research Director Dorie Seavey, Ph.D. "The economy's booming demand for direct-care workers — particularly home health aides and personal care aides — means that it is now more essential than ever to attract workers to these jobs by making them competitive with other occupations. This is especially true at this time when fewer women are entering the labor force."

While demand for direct-care workers is projected to increase by 48 percent during this decade, the main labor pool from which this workforce is drawn — women aged 25-54 — is expected to grow by only 1 percent, the PHI analysis shows. This compares to a 14 percent increase in the number of women in this age group from 1988-1998.

Personal care aides and home health aides are projected to be the fastest-growing occupations in the nation between 2010 and 2020, increasing by 71 percent and 69 percent, respectively. Personal care aides and home health aides rank third and fourth, respectively, on the list of top ten occupations projected to generate the most jobs. This outsized growth will result in home and community-based direct-care workers outnumbering facility workers by two to one by the end of this decade.

The growing demand for direct-care workers has had little impact on wages, which remain among the lowest in the nation. In 2011, the median hourly wage (pdf) for all direct-care workers averaged $10.59. The nation's fastest-growing occupations — personal care aides and home health aides–earned under $10 per hour ($9.49 and $9.91, respectively).


Since public funding accounts for about 70 percent of spending on long-term services and supports, PHI recommends that federal and state policymakers take action to ensure that the workers who provide these services receive decent wages and benefits along with high-quality training.

PHI also recommends that particular attention be paid to the quality of aides' jobs in the rapidly growing home and community-based sector, since these aides tend to earn lower wages and have fewer benefits than in facility based settings.

State Data on the Direct-Care Workforce

For state-by-state information on the direct-care workforce size, employment projections, wages, benefits, and more, visit the PHI State Data Center.

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PHI, the Paraprofessional Healthcare Institute, works to transform eldercare and disability services, fostering dignity, respect, and independence — for all who receive care, and all who provide it. The nation's leading authority on the direct-care workforce, PHI promotes quality direct-care jobs as the foundation for quality care.

Deane Beebe, PHI Media Relations Director


Caring for the Future

Our new policy report takes an extensive look at today's direct care workforce—in five installments.

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.