Transformational responses to COVID
July 16, 2020
COVID-19 and the Caring Crisis in Canada
July 23, 2020

Race and gender stratification in the care sector

By Janette Dill and Mignon Duffy

There is a substantial body of research showing the stratification of the care workforce by gender and race. Carework is overwhelmingly performed by women – both in the unpaid and paid sector, but Black, Indigenous, and People of Color (BIPOC) and immigrants are concentrated in lower level direct care and reproductive occupations. For example, according to the authors’ calculations using the IPUMS-CPS, BIPOC women make up 45% of the direct care workforce and 30% of workers in reproductive occupations in the health care sector.

Historically we have depended on BIPOC and immigrant women to perform the “dirty work” in caring for others as slaves, servants, and low-wage workers, while nursing and other nurturant health care occupations have been the domain of white women. The labor of workers in direct care and reproductive occupations is devalued, meaning that workers earn less in these occupations as compared to occupations that require the same level of education and skill that do not involve care work, and BIPOC women experience the largest wage penalties in these carework occupations.

Calls for increasing wages in direct care and reproductive occupations have been widespread, and a number of high-profile articles have highlighted the hard work and dismal compensation received by these workers, especially in the context of COVID-19. For example, certified nursing assistants (CNAs) had median yearly earnings in 2019 was $29,640, a rate that falls well below the median rate for women across all occupations ($41,028), and most nursing assistants remain low throughout their careers.

These workers provide vital essential services, and the importance of these workers – and the risks they face – have been highlighted during COVID-19. However, most appreciation for “heroes” is focused on doctors and nurses – the visible roles. The army of invisible essential workers behind that is disproportionately people of color.

The structural and historical processes that led to the devaluation of the carework of BIPOC women also underlie the crisis of racist police violence. The lack of value of the labor or lives of BIPOC men and women has led to systemic racial inequalities in wealth, health, and opportunity.

In a recent op-ed in the New York Times, Ai-jen Poo and Palak Shay, both of the National Domestic Workers Alliance (NDWA), argue that now is our chance to change our historic devaluation of BIPOC labor. Direct care and reproductive jobs are growing rapidly in the US, due to our aging population. She writes, “The workers we need the most aren’t wearing boots and hard hats; they are wearing sneakers or scrubs. We are at a critical juncture. The future of work will be decided by how we respond to this moment. This is our moment to choose a future where we invest in the work that we now know is essential. Where care jobs become living-wage jobs with benefits, protected by a strong federal safety net. Where essential workers can support their own families through their work, even as they support ours.” Raising the wages of workers in direct care and reproductive occupations will “center on the margins” by increasing the power of BIPOC workers, their households, and their communities, making meaningful progress towards racial equity and justice.

Janette Dill is an Associate Professor in the division of Health Policy & Management at the University of Minnesota.

Mignon Duffy is an Associate Professor and chair of the Sociology Department at the University of UMass Lowell.

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