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On Juneteenth, We Honor Black Direct Care Workers

By Jessica King (she/her) | June 16, 2023

Juneteenth, a recently recognized federal holiday, is an important day to reflect on the historical injustices Black people have faced in this country. It’s also an opportunity to draw attention to their ongoing challenges.

Nearly one in three (30 percent) of direct care workers are Black. This Juneteenth, we highlight some key historical moments that have harmed Black direct care workers and devalued direct care jobs for decades—and look ahead to a more equitable future.


Though the Emancipation Proclamation declared chattel slavery illegal over two years prior, it was not until January 1865 that the 13th Amendment officially abolished slavery. Still, white enslavers continued a regime of racial terrorism and illegal enslavement of Black people for months after the Amendment’s passage, with Galveston, Texas as one of the last footholds of chattel slavery in the United States.

On June 19, 1865, U.S. Brigadier General Gordon Granger rode into Galveston, Texas and declared that, by executive decree, all 250,000 Black residents who were still enslaved were liberated and officially “hired labor.” Though Juneteenth has had deep roots within Black communities in the United States for many generations, its national recognition did not take place until 2021 and the history of this Black Independence Day is only recently becoming more widely known.


Occupational segregation refers to the disproportionate representation of one demographic group in a particular occupation. A long history of racist attitudes and government policies are the sources of occupational segregation, concentrating people of color in low-wage occupations with limited protections. Direct care workers share this history—as evidenced by the large percentages of direct care workers who are women and people of color.

In the pre-Civil War era in the United States, many enslaved Black women were forced to care for their enslavers’ children, as well as other family members, to the detriment of their own families and well-being.

Even after the 13th Amendment was passed and slavery was legally abolished, many Black women’s occupational prospects were restricted to domestic work. Even though this care work was physically and emotionally demanding, it was consistently devalued and considered “menial” or “unskilled.”

When the federal minimum wage and other employment protections were established as part of the New Deal, care work and other domestic labor—the sectors where Black women predominantly worked—were deliberately excluded. Even with those exclusions redressed, economic security through fair and sustainable wages has remained out of reach for many Black women care workers.


Structural racism is the system of both codified policies, like legalized slavery, and culturally adopted norms, such as medical experimentation on Black people, that have marginalized people of color—Black people, in this context—throughout the history of the United States. These institutionalized social injustices continue to undermine job quality for direct care workers, as evidenced by their low pay, limited career advancement opportunities, and inadequate training, as well as the lack of respect and recognition for direct care jobs.

Structural racism and gender inequities also contribute to striking disparities within the direct care workforce. For example, women of color in direct care are more likely to live at or below the poverty line, with Black women in the direct care workforce having the lowest family incomes. Additionally, almost half of Black direct care workers receive public benefits to supplement their low wages and meet their basic needs.


Given these disparities and the ongoing challenges facing direct care workers, policy and practice leaders must work on two fronts. First, they should transform the direct care job for everyone, benefiting Black workers and their peers within this workforce. Second, they should design race-explicit interventions that support direct care workers of color to succeed in these roles and live financially secure.

Regarding race-explicit strategies, three strategies hold promise. First, direct care employers should collect reliable data that can be disaggregated by race and ethnicity so disparities can be better identified and addressed. Secondly, employers should consider implementing workforce interventions that uniquely target systemic and racial barriers and evaluate these approaches to ensure they are achieving their intended aims. Finally, support needs to be aimed at immigrant direct care workers, who make up a substantial portion of the workforce. This support should take the form of focused research to gain a comprehensive picture of immigrant direct care workers’ challenges; culturally informed trainings and resources that meet their needs; and public policies that specifically address their employment conditions and provide pathways to citizenship.

As a nation, we have a lot of work ahead to address racial injustice. At PHI, we are dedicated to supporting and uplifting our Black direct care workers for their essential contributions to our care system, not only on Juneteenth but every day.

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