Blog | Health Care

Nursing Home Initiative to Right America’s Injustices

The worst of the pandemic appears to be over but make no mistake: Our country is still dealing with the loss of life and disability left in its wake as millions of families are still recovering from this tragedy. It also revealed a truth about the inequitable economic treatment of women and workers of color. 

Women dominate caregiving occupations, which are undervalued and underfunded. Women are paid less and lack access to child care and paid sick leave, even though they are often the ones who need it most. Women regularly face pay discrimination, yet they are the majority of workers in occupations that are not covered by the Fair Labor Standards Act, the federal labor law that ensures a minimum wage. Women are the most likely to be vaccinated against COVID-19, affording protection to others. But many lack a union, a voice at work to protect their own health, safety and economic interests.

Nursing home worker holding someone's hand

Nowhere is this more true than in the nursing home sector, which is dominated by low-wage women of color: 87% of these workers are women, 61% are people of color and 27% are immigrants. The median hourly wage for nursing home workers is $13.56, and the median annual salary is only $20,200. As a result, 44% of this workforce live at or near poverty and 45% rely on some kind of public assistance. No worker should have to live under such miserable economic conditions; it’s especially egregious because caretaking is so grueling. We should be rewarding those whose work is caring for the most vulnerable among us. The poor economic conditions endured by this sector reflects our country’s institutional misogyny and racism.

Care work in homes and in institutions has a direct historical connection to slavery. Enslaved black women worked as servants in private households performing the most strenuous and unpleasant tasks. After slavery was abolished, black women continued to work as domestic workers in private households while earning very little. It’s past time we recognize and right these wrongs and compensate these workers fairly. 

In 2021, President Biden announced a new initiative to establish a national minimum staffing  standard for nursing home workers, improve compensation and make it easier for these workers to join a union. This is surely one of the single biggest ongoing initiatives to address the inequities facing women and workers of color; it is also one of the best solutions for addressing the emotionally difficult and physically dangerous working conditions these workers face.

The labor movement is already a movement for working women. Union women know the best way to combat injustice is with a union. Union members have greater access to paid sick days and parental leave. Nearly all union members (94%) have health insurance through our employers, compared with 69% for nonunion workers. Women covered by union contracts lost fewer jobs between 2019 and 2020 than women who were not in unions.

As the numbers show, it’s time to organize more nursing home workers. Numerous states, including Arkansas, New York and others, have acted during the pandemic to improve working conditions in this sector—creating pilot programs to pay nursing home workers more and increase staffing levels to improve working conditions. 

But we know that having a union is the best way to make sure workers continue to get a fair shake, even after state legislatures have moved on to other issues. 

The Biden administration’s initiative would improve the quality of care for nursing home residents and their families. Far too many are willing to overlook the working conditions that women and workers of color face. All of us will age, and many of us will come to need some kind of assistance or elder care. Many workers are already struggling to care for aging loved ones. We may overcome serious medical conditions, yet face a lifetime of ability challenges. We want older and disabled people living in a facility to get the best possible care and live out their final years in engaging and supportive environments. That can’t happen unless workers there are paid fairly, treated right and are able to thrive.

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