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Who Cares? Now, All of Us Must

Ai-jen Poo
I came to realize in a series of waves the enormous impact this pandemic would have on the domestic workforce.

Lauren A. Little/MediaNews Group/Reading Eagle via Getty Images

ManorCare workers gathering as people parade past the retirement facility where they work to thank them, West Reading, Pennsylvania, May 5, 2020

I came to realize in a series of waves the enormous impact this pandemic would have on the domestic workforce. The first was quite early on, before the travel ban, school closures, and state shutdowns. One of my colleagues at the National Domestic Workers Alliance (NDWA), of which I am the director, was in one of our regular meetings with house cleaners where we discuss organizational strategies and hear directly from our members. One by one, workers began describing clients’ cancelling jobs due to the coronavirus, leaving cleaners with no idea if, or when, those clients might resume their hiring. Shortly after, another colleague told me she’d heard similar reports in a meeting with domestic workers who find work in the gig economy. One worker held her phone up to her computer screen to show everyone on the Zoom call her bank balance: one cent.

As we listened to our members, our team quickly realized that the public health crisis had caused an unprecedented wave of job and income loss, with enormous implications for America’s workforce, especially its most precarious and vulnerable workers. For the 2.2 million domestic workers in the United States, work—by definition—takes place in someone else’s home. “Working from home” is not an option.

This labor force comprises over 90 percent women, and is disproportionately made up of women of color and immigrants. The wages for such work are poverty-level: 16.8 percent of domestic workers live below the federal poverty line—the threshold commonly used by researchers to measure what it takes a family to actually make ends meet—and 44.3 percent of domestic workers live below double the federal poverty line, compared with 16.9 percent of all other workers. Domestic workers already struggle to make a livable wage—most do not—and as the catastrophic losses for this insecure workforce rose, I began to feel the weight of the financial burden that NDWA’s members would only continue to shoulder. In response to the need, we launched the Coronavirus Care Fund, to provide $400 in emergency cash assistance to domestic workers affected by the pandemic.

The second wave of realization came two weeks after we launched our fund. Like so many millions of parents across the country, I was homeschooling a child—in our case, my step-daughter—and my husband and I were considering whether to bring his mother to live with us, to ensure her safety. We discussed the logistics involved with this change and how we might manage: my husband and I both work full-time, we were already homeschooling a third-grader, and his mother would make for a fourth family member, and third generation, in the home.

I knew we weren’t alone. All across the country, millions of families have been struggling with similar questions: How do we take care of our families when schools are closed and care facilities are facing a heightened risk and being evacuated? How would we manage our families, our homes, and our jobs all under one roof? Suddenly, the focus of every family in the nation had shifted to the home. Amid this combined health and economic crisis, we are all struggling to take care of our families in new and unfamiliar ways.

That is when it dawned on me that the pandemic had created something that we at the NDWA have sought to create for decades: mass public awareness about the importance of care work. We had not, as a nation, recognized how essential caregivers are—whether family members or professional workers—to the very fabric of our society and the infrastructure of our economy. That is, until now.

Care, which we use to broadly mean the time, energy, and labor required to care for children, older people, and people with disabilities, is a universal need: no matter who you are, you have needed and probably will need or rely on care at some point in your life—whether as a child, a new parent, in sickness, or in old age. And yet America’s care infrastructure is fragile at best, unable to meet the growing demands. Families struggle to afford care while the underpaid care workforce has no safety net. And as the demographics of our population shift and our family structures evolve, our reliance on the care economy has only increased, and will continue to do so.

Every day, some 10,000 people turn sixty-five in the United States. As more people prefer to “age in place,” rather than move to a nursing home, we rely on homecare workers and house cleaners to help our older loved ones (ditto for family members with disabilities living independently in their own homes). At the same time, more families today have two working parents, and fewer families have a full-time caregiver, leaving people to rely on professional care workers and house cleaners to do the work in the home while the working parents go out to earn a living. For the “sandwich generation,” those currently managing the needs of both aging parents and their own young families, the cost of care, both financial and emotional, can be extremely onerous. Nearly 70 percent of working Americans earn less than $50,000 per year, while the average cost of childcare is more than $9,000 per year, and the average cost of home care is $50,000 per year. It’s not surprising, then, that people caring for their own family members spend on average nearly thirty-six hours caregiving each week, according to a survey released late last year by Caring Across Generations and the Women’s Alzheimer’s Movement. More than half of those surveyed were expending this effort on top of holding down a full-time job.


Domestic work and care work have historically been underpaid and overlooked, and the fact that even today this labor is often referred to as “help” rather than conceived as professional labor betrays the long devaluation of women’s work. This has material consequences for the workers who remain overwhelmingly women and disproportionately women of color: the median hourly wage for domestic workers is $12.01, compared with $19.97 for all other workers. Among the first domestic workers in the US were enslaved black women, and as a result, when workers’ rights and protections passed into law in the 1930s, domestic workers were specifically, purposefully excluded as a concession to Southern legislators who were concerned about giving rights to black workers. Because of this legacy, many domestic workers still do not have common workplace protections and rights, such as the right to overtime, paid sick days, protection from harassment and discrimination, or access to benefits.

Even before the Covid-19 crisis, the combination of this increased need for domestic work and these dismal working conditions placed enormous stress on families and workers. Dramatically high rates of staff turnover, and the loss of caregivers to other low-wage service jobs such as fast food or retail, meant that at a time of growing need, the nation could not sustain this workforce. The care industry was a house of cards on the point of collapse.

With the Covid-19 pandemic, that collapse has come. Homecare workers are faced with impossible choices—between continuing to work, potentially exposing themselves to the coronavirus, and self-isolating but losing the paycheck their families desperately need. Lydia is a homecare worker in Boston and her client is elderly, at high risk if exposed to coronavirus. Lydia takes her responsibility very seriously: “I like taking care of elderly people because they need my help,” she said, “and I take care of them like they are my own parents; I become part of their family.” And yet, with schools closed, Lydia has to leave her children—ages eight, twelve, and thirteen—at home, unsupervised, when she goes to work. Meanwhile, family caregivers like Sade, who cares both for her twenty-two-month-old daughter and her aging parents who have underlying conditions, are struggling to provide the care their families need while working from home.

When it comes to care work, America’s public policies and cultural norms do not support working people. We invest in health-care infrastructure so we can recover from being sick, transportation infrastructure so people can get to work, education infrastructure so we can learn, but we have never invested in our care infrastructure. As a result, there are costs that, as a society, we expect will be absorbed by women, who disproportionately bear the weight of our family care needs, and by domestic and other care workers, whose low wages make it difficult for them to care for their own families.

And yet, this pandemic has proven to us, the strength of our society and the resilience of our economy rely upon good care.

Two organizations that I co-founded, the National Domestic Workers Alliance and Caring Across Generations, have been working to build a more resilient care economy for many years. We have made progress; nine states and two cities have passed Domestic Worker Bills of Rights to extend common workplace rights to domestic workers. Hawai’i has created a family caregiver benefit for family members caring for loved ones at home. Washington state has created the nation’s first long-term care social insurance program. These programs offer good models, but Covid-19 has made clear that a much bolder, national vision for our care economy is urgently needed.

As we chart the road to recovery and people across the country return to work, Americans have an opportunity to rebuild the economy by investing in the fundamental infrastructure working families need. Care must be universally affordable and accessible, and we need care jobs to be good jobs. We need a strong workforce of homecare workers, nannies, and house cleaners who earn livable wages and paid time-off so they don’t have to choose between taking care of their health and earning an income. And we need family caregivers, from new mothers to adult children, to have the support they need, when they need it, to care for their own families. By investing public dollars in universal access to child care, long-term care, and paid family leave—integral to caring for our families as we work—the US can make care jobs good, family-supporting jobs with economic mobility. Good care is a virtuous cycle.


My mother-in-law is still at home, living on her own, ordering groceries online. Schools are still closed, and now we’re wondering how we will manage through the summer with camps closed too. We’ve figured out how to do a physical distance playdate outside with a friend in the neighborhood, so that my step-daughter can have some interaction with other children. Every day, I wonder how we will look back on this time and make sense of it. To match our country’s newfound recognition of care workers as essential, we must take care of them, too—by protecting and compensating them accordingly. My hope is that we find ourselves looking back from a very different world, and reflecting on this time of crisis as the time that taught us how to truly care for one another.

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