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New Data: Direct Care Workers Face Significant Racial and Gender Disparities

November 8, 2017

NEW YORK — Women of color make up nearly one in two direct care workers in the U.S. yet face higher poverty rates than their counterparts, according to research released today by PHI, a national research and consulting organization widely considered the leading expert on the direct care workforce. Direct care workers—home care workers and nursing assistants—support older people and people with disabilities with living in their homes, communities, and a wide array of residential settings.

“Women of color face significant, additional obstacles as part of an important workforce that already struggles with low compensation, minimal benefits, and limited advancement opportunities,” said PHI President Jodi M. Sturgeon. “We need to draw attention to these persistent racial and gender disparities, and ensure that our field strengthens the full direct care workforce in all its diversity.”

Women of color in the labor force are expected to grow by 6.3 million between 2016 and 2026, making them an essential part of the labor supply needed to meet growing demand for direct care. As millions of Americans reach later life and require support at home, the demand for direct care workers will multiply—yet this workforce continues to be saddled by a growing workforce shortage.

Key findings include:

  • Men of all races and women of color are large and growing segments of the direct care workforce. The number of male home care workers tripled from 60,000 in 2005 to 182,000 in 2015.
  • Women in direct care generally have lower levels of formal education than men, and white direct care workers generally have higher levels of formal education than direct care workers of color. Fifty-three percent of women of color and 45 percent of white women in the direct care workforce have a high school education or less, compared to 43 percent of men of color and 37 percent of white men.
  • Women of color in direct care are more likely to live in poverty and rely on public assistance than their counterparts in the direct care workforce. The poverty rate for women of color in direct care (22 percent) is higher than the poverty rate for white women (17 percent), white men (14 percent), and men of color (12 percent).
  • Men and people of color in direct care have higher personal earnings than women and white workers, and white workers have higher family incomes than people of color. Median personal earnings are $20,000 for men of color and $17,500 for white men, whereas median personal earnings for women of color are $17,300, compared to $16,000 for white women.

“Women of color are an essential part of the direct care workforce, now and in the future, and they deserve high quality jobs that can provide optimal care,” said Robert Espinoza, vice president of policy at PHI. “We also need targeted solutions that explicitly address racial and gender inequality, or we’ll continue to threaten the pipeline of workers needed for this critical occupation.”

The study notes that the state of direct care jobs might be making it more difficult to attract new candidates to this occupation. The study argues for strategies that strengthen this occupation and attract more workers into this workforce, including men, who are less common yet growing in size in direct care.

This research was released as part of PHI’s #60CaregiverIssues campaign, a two-year public education campaign aiming to solve the growing workforce shortage in home care. Since February 2017, the campaign has reached half a million people online, generated widespread media coverage, and released the first 23 issues, available at


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