By 2030, all Baby Boomers will be at least 65 years old and will account for 20 percent of the nation’s population. This demographic shift, along with a growing number of people who have chronic conditions, means that the demand for long-term services and supports will increase.
Direct care workers – comprised of home health aides, nursing assistants, and personal care aides – provide these essential services, and the demand for these positions is rising in correlation with the changing population. With 7.8 million direct care jobs needing to be filled by 2026, this workforce sector is projected to grow more than any single occupation in the country. For decades, however, the demand for direct care workers has outpaced the supply of people seeking to fill these jobs. Policy and lawmakers have been grappling with how to solve this challenging workforce dilemma before it is too late. During the presidential campaign, the Biden-Harris platform recommended that career ladders for direct care workers should be created to help mitigate this staffing issue. A new report by Brookings, however, suggests that those who need the career ladders the most might get left behind.
Written with the goal of helping policymakers understand, navigate, and potentially combat the challenge of career mobility (the ability to advance towards higher-paid work), “Moving up: Promoting Workers’ Economic Mobility Using Network Analysis” reports that the nation’s low-wage workforce is disproportionately female, Black, and Hispanic. Those very demographics – gender, race, and ethnicity – strongly influence a person’s mobility prospects. The report furthermore reveals a labor market landscape “riddled with mobility gaps and barriers.”
In the nursing field in particular, the report found that White workers had more upward mobility, climbing the ranks from home health aides (HHAs) to Licensed Practical Nurses (LPNs) to Registered Nurses (RNs) at a higher rate than Black and Hispanic workers. Furthermore, Black and Hispanic workers were “far more likely to transition downward” from LPNs to HHAs. The report states that:
“It is revealing that Black and Hispanic workers significantly outpace their White colleagues in only two occupational transitions: from LPN to home health aide jobs, and from home health aide to personal care aide jobs, which represent wage declines of $9.82 an hour and $1.46 an hour, respectively. By contrast, transitions into RN jobs offer median wage boosts of more than $12 an hour.”
The Brookings report also offered recommendations to “modernize the social safety net to meet workers’ needs” with an aim of helping those stuck in low-wage jobs. They include bolstering minimum wage policies, offering “wage subsidies” to targeted occupations to facilitate job transitions, and “portable benefits” that would allow workers to both acquire benefits and keep them during job transitions or times of unemployment.
June 17, 2021 – C. St. John
U.S. Census Bureau. By 2030, All Baby Boomers Will Be Age 65 or Older. (May 26, 2021). Available at: https://www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html
 U.S. Census Bureau. Nation’s Older Population to Nearly Double. (January 16, 2017). Available at: https://www.census.gov/newsroom/press-releases/2014/cb14-84.html#:~:text=%22The%20United%20States%20is%20projected,Census%20Bureau’s%20Population%20Projections%20Branch
 Campbell, S., Del Rio Drake, A., Espinoza, E., and Scales, K. Caring for the Future. (January 15, 2021). PHI. Available at: https://phinational.org/resource/caring-for-the-future-the-power-and-potential-of-americas-direct-care-workforce-executive-summary/
 Campbell, S. New Research: 7.8 Million Direct Care Jobs Will Need to Be Filled by 2026. (January 28, 2019). PHI. Available at: https://phinational.org/news/new-research-7-8-million-direct-care-jobs-will-need-to-be-filled-by-2026/
 Scales, K. It Is Time to Resolve the Direct Care Workforce Crisis in Long-Term Care. (August 27, 2020). The Gerontologist, 61(4), 497–504. Available at: https://doi.org/10.1093/geront/gnaa116
 Biden-Harris Plan to Make Nursing Homes and Long-term Care Facilities Safe. Joe Biden for President: Official Campaign Website. (October 16, 2020) Available at: https://joebiden.com/covid-nursing-homes/
 Escobari, M., & Krebs, E. The American Dream in crisis: Helping low-wage workers move up to better jobs. Brookings. (June 15, 2021). https://www.brookings.edu/blog/up-front/2021/06/14/the-american-dream-in-crisis-helping-low-wage-workers-move-up-to-better-jobs/