Health Advice



Fastest-growing US job failed to lift pay for Black women

By Katia Dmitrieva, Bloomberg News on

Published in Health & Fitness

WASHINGTON - A job in home-based health care, America's quickest-growing industry, felt like a step up the ladder for Shawanna Ferguson when she left her fast-food job a decade ago. But in terms of pay and security, it didn't turn out to be much of an advance.

It's taken a public-health emergency to shine a spotlight on the precarious conditions and low pay in this key corner of America's direct-care economy - a key employer for Black women, in particular - and turn it into an issue for presidential politics. Democratic candidate Joe Biden is promising a $775 billion investment in the industry, which he says will help give care workers a pay raise. Ferguson was earning $10.50 an hour when the coronavirus arrived in her town of Walterboro, South Carolina. She had to buy her own sanitizer and face masks. When her mother, who also works in home care, tested positive for COVID-19, Ferguson decided the risks were no longer worth the reward. In the middle of the worst economic crisis in generations, she quit.

"We're putting ourselves at risk," says the 30-year-old a few weeks later, as she fixes lunch for her four kids in the kitchen of her subsidized house. "We're becoming sick, and getting our family members sick, and it just goes unnoticed. They think: 'Well, they're going to come to work anyway, because they need the money.'"

Demand for home-care has surged as the population ages. Rapid hiring in the industry is one reason why South Carolina, a potential battleground in November's election, had the country's lowest unemployment rate for Black women last year.

But that went into reverse in the past six months, as Black and female unemployment skyrocketed above the overall rate. About 110,000 home-care jobs vanished in March and April, though almost half have since returned. The next update on labor markets is due on Oct. 2 when the jobs report for September will be published.

Even when they keep their jobs, Black women are likely to receive less pay and live below the poverty line. The national median pay for a home-based health aide is $12.15 an hour." It's confounding that a job that is so valuable to all of us, and all of our family members, would pay so little," says Robert Espinoza, vice president of policy at PHI, a New York-based advocacy organization for care-workers and their clients. "We don't have a properly financed long-term care system, and it creates all kinds of dysfunctions."


Ferguson's duties included feeding, bathing, grooming, and calming elderly and disabled patients for up to 12 hours a day.

Biden says his investment in the care economy will help deliver a pay raise for workers who look after the elderly and pre-school children, without specifying how much. President Donald Trump has praised health care workers, likening them to soldiers, but hasn't outlined plans for the industry in his reelection platform.

Scholars say that the prominent role of Black women in the caring professions dates back to slavery and the Jim Crow era. And the industry was historically left out of legislation to protect workers' rights, even during the 1930s New Deal era that revolutionized so many other jobs.

One result of all that history is the low wages earned by so many care workers today.


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