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Care work is the work that makes all other work possible. Whether caring for children, disabled people or the elderly, care workers provide vital services that allow people to enter the labor force while knowing their loved ones are being taken care of. This benefits not only individual families, but our country overall by growing our economy. But we’re based in a paradigm where care is largely treated as an individual responsibility, expecting families or individuals to figure out how to acquire and pay for care on their own.

Like most long-standing frameworks in the U.S., our conceptions of caregiving are rooted in sexism, racism and ableism. Enslaved Black women were made to care for white families while being forcibly separated from their own, and care work is still often dismissed as “women’s work” that is disproportionately provided by Black, Latina, AANHPI, immigrant, older and disabled women. Even though they are essential workers, paid care jobs are not “good jobs” – that is they generally pay low wages and don’t have benefits such as access to healthcare, paid sick days, paid leave, union protections or retirement benefits. At the same time, family pocketbooks are increasingly squeezed by care priced like it’s a luxury and not a necessity. This leaves both families and workers struggling to make ends meet, while businesses often operate on small margins.

The three care industries – nursing and residential care facilities, child care, and home health care – have not experienced the same level of job growth as the rest of the economy in the COVID-19 recovery. While the growth in home health care jobs compared to the pre-pandemic baseline surpassed total nonfarm job growth in 2023, both child care jobs and nursing and residential care jobs are lagging behind. Meanwhile the need for care remains immense; almost 700,000 people were on Medicaid Home- and Community-Based Services waiting lists last year, more than 20 percent of states have waiting lists for child care assistance and home health and personal care aides are projected to account for more than 1 out of 6 new jobs created in the next decade. In order to keep up with the demand for paid care workers, these jobs must increase their pay to reflect the true value of the work they’re providing and compete with other professions for workers – and they must do so without increasing the burden for families.

Over the past few years, wage growth picked up for workers being paid low wages, including care workers, and outpaced overall wage growth likely due to the tight labor market and state minimum wage increases. The American Rescue Plan stabilized the child care industry with $24 billion from April 2021-September 2023, which likely helped wage growth for child care workers keep pace with the economy as a whole and bring back lost jobs. But these higher wages could not be considered a living wage for anyone with a child anywhere in the country, and wage gains have been uneven for paid caregivers across sectors over the pandemic years.

Unfortunately wages for these paid caregivers still remain far below the wages that all workers are taking home. While some are citing the nominal wage gains as a win for care workers, after accounting for inflation the real wage gains aren’t helping care workers as much as they should. In fact, National Partnership analysis of the Bureau of Labor Statistics’ Occupational Employment and Wage Estimates median hourly wages in 2019 for Nursing Assistants, Childcare Workers, and Home Health and Personal Care Aides were 25 percent, 39 percent and 37 percent lower than the median hourly wages across all occupations. In 2023, that gap only closed slightly to 21 percent, 37 percent and 30 percent respectively. And even though wages for paid caregivers aren’t high enough for these invaluable workers, individuals and families who need these services are being priced out by ever increasing costs, with costs for the three care industries having outstripped overall inflation for the past decade while still not capturing the true value of this work.

As Treasury Secretary Janet Yellen says, care is a market failure, with all of society enjoying the benefits of care, but only some individuals paying the costs while relying on a workforce that isn’t fully compensated for their labor. This failure especially impacts women, who are disproportionately pushed out of the workforce over childcare and eldercare costs. And while this could be contributing to women feeling worse about the economy than men, we know that investing in care leads to women returning to the workforce, gaining economic power, and contributing tax revenue. In fact, if the women in the U.S. worked at the same levels as women in other countries with stronger caregiving policies, the economy would add another $775 billion in activity each year.

We know that care can’t wait, and it will require big, federal investments to create high quality care jobs and ensure that families aren’t overburdened by the cost of care. Like other investments, these will pay dividends, not just for all of us who will require care in our lives and for the economy at large, but also for the millions of workers providing this care. Continuing this unstable and unsustainable business model of care will force more women out of the workforce at the cost of their own careers, retirements, and ambitions, hampering our economy along the way.

Thank you to Kate Gallagher Robbins, Molly Kozlowski, Jessica Mason, Gail Zuagar, Mettabel Law and Sharita Gruberg for their significant contributions to this piece.