A study published in Health Affairs found that Black women are “more overrepresented in health care and more concentrated in the lowest-wage direct care jobs” than any other racial or ethnic group of women and of all men. An analysis of American Community Survey data from 2019 revealed that almost 23% of Black women in the workforce are employed in the health care sector, with a majority (64.7%) working as licensed practical nurses or nurse aides, and 40% working in long-term care.
The authors of the study contend that structural racism in the nation’s labor market created this stratification. Furthermore, the study argues, the intersection of gender and race advanced a culturally constructed division of care. According to the authors, Black women and women of color have historically, through a legacy of slavery, been relegated to more physically demanding direct care work, along with jobs that were more strenuous and were thought to require “little or no skill.” Carried over to today’s workforce, direct care workers “face difficult and dangerous working conditions.” With heath care workers having the “highest rates of workplace injuries of any industry in the United States.”
Policy considerations proposed by the authors to combat and improve racial equity include:
- Raising wages of direct care workers, starting with a federal minimum wage increase for all workers.
- Building career ladders in health care organizations by creating meaningful pathways to opportunities such as training programs, building avenues to higher education, and providing flexible scheduling to accommodate coursework.
- Addressing racism through training programs for health care leaders and managers, along with creating workforce equity and inclusion plans.
The authors conclude that “investing in Black women through targeted investment in care infrastructure could begin to undermine some of the ideological constructions and structural barriers” that have devalued both Black women and care work.
February 23. 2022 – C. St. John
 Dill, J., & Duffy, M. Structural Racism and Black Women’s Employment In The US Health Care Sector. Health Affairs. (February 2022). Available at: https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01400
 US Census Bureau. About the American Community Survey. Census.gov. (January 6, 2022). Available at: https://www.census.gov/programs-surveys/acs/about.html