REPORT Affordable Care ActHealth and Social ProgramsUnionsWorkers

Improving Job Quality: Direct Care Workers in the U.S.


September 2011, Eileen Appelbaum and Carrie Leana

This paper looks at strategies for improving job quality in the care work sector. American and British policy makers need to stop treating care as low-paid “women’s work” that is incidental to a family’s income. Social care is a growth sector and must be considered alongside green jobs and infrastructure investment when it comes to developing industrial and economic policy. Beyond public sector investment, as this paper shows, better jobs will come from a steady focus on three priorities: improving employer practice, appropriate regulation and workforce organizing.

In 2011, a broad-based American coalition that includes unions engaged in organizing direct care workers, the National Domestic Workers Alliance, the National Employment Law Project, advocates for a higher minimum wage or for paid sick days, and numerous community groups and NGOs launched a major initiative – Caring Across Generations – to improve the quality of work for direct care workers working in people’s private households. The goal of Caring Across Generations is to pass comprehensive legislation to address the multiple disadvantages of care workers in health services and to improve clients’ access to affordable quality care. This model is one that could certainly be imported to England.

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