Why We Need a Care Infrastructure that Works

Caregiver and patient

(Photo: National Domestic Workers Alliance)

September 1, 2021

  • Women's Political Power and Leadership
  • Gender and Reproductive Equity
  • Care Work
  • Women's Economic Power

This post was updated on March 18, 2022.

Over the course of the COVID-19 pandemic, workers across the country have faced unprecedented health risks, continued to adapt to new workspaces and technologies and navigated unstable employment. Some have also faced the added burden of making the difficult choice between employment and caring for their children and families during school closures as many care options were unavailable or unsafe.  

Navigating these challenges is disproportionately more difficult for low-paid workers as inequitable labor practices continue to exist in nearly every sector of the American workforce. Many fields—particularly fields overwhelmingly populated by women, and particularly by women of color and immigrant women—receive less protection from policymakers and less attention from the American public. Among the most overlooked sectors of workers is one we have relied on most for services and called most essential during the pandemic: care work.

As care work increasingly becomes part of our legislative conversations and as organizations continue their indispensable work pushing for protections, we see exciting progress in this sector. The American Rescue Plan and American Families Plan introduced by the Biden administration established federal support for our kids, families and caregivers in the wake of the pandemic, and Vice President Kamala Harris partnered with the Care Can’t Wait Coalition in a national summit on care infrastructure. A National Domestic Workers' Bill of Rights was also introduced on Capitol Hill this summer in partnership with the National Domestic Workers Alliance.

If we are to keep moving forward, and build on the progress made, we must consider the historical context that led us to a care infrastructure that needs to be fixed.

The History of Care Work

Care work encompasses the range of services provided by paid or unpaid caregivers that support needs related to age, disability and illness—services that have grown exponentially in demand since the start of the pandemic. While care work is essential to our society, those currently providing care are rarely afforded the rights, protections and pay we see in other vital labor sectors. This undervaluation of care is distinctly rooted in the systems of discrimination undergirding American society.

Historically, employment options for women of all races were limited and circumscribed. These positions were often designated as unpaid household labor or were accompanied by meager enough compensation to ensure women were not in competition with men in the work force. Following the end of American slavery, Black women's contributions were further relegated as less valuable than the service of white women in comparable roles as they continued to serve white families through caregiving and domestic work. And as immigrants increasingly arrived from across the globe in the 19th and 20th centuries, even more women of color filled these roles perceived as the least valuable to the American public.

Today, while women of all backgrounds continue to occupy the majority of caregiving roles, Black and Latina women alone currently make up 41% of paid caregivers. Moreover, currently 20% of care workers live in poverty and 40% rely on public assistance . Unpaid caregiving also falls disproportionately on women, contributing to concerning economic trends such as the wealth gap (the difference in overall net worth between men and women) and retirement gap (the difference in retirement savings and age of retirement between genders). This historical precedent set over generations of American living has only been exacerbated by the COVID-19 pandemic. Almost 1.1 million women have left the workforce since the start of the pandemic, and one in 16 Black women and one in 20 Latinas were still unemployed as of February 2022.

By failing to adequately compensate and provide labor protections for care workers and those relying on care, our current systems are further marginalizing underserved members of our communities. This is a cycle we can only end when we recognize that care work is essential to our society and is in fact the essential infrastructure of our communities. Policies that can strengthen our care infrastructure include paid family and medical leave, accessible and affordable childcare, well supported home and community-based services and fair pay and labor protections for care workers.

Investing in a Robust Care Infrastructure

A robust care infrastructure supports families’ economic security and stability across the economic spectrum by creating a thriving sustainable economy for us all. With the COVID-19 pandemic exposing the failings of our current system, building a comprehensive care infrastructure is an immediate need.

By investing in creating a strong care infrastructure, we can:

  • Ensure labor and health protections for caregivers;
  • Increase the quantity and quality of job opportunities in the paid care sector in which employees are afforded the rights and protections they deserve;
  • Challenge outdated gender norms and historical precedents that assign caregiving to women, particularly women of color;
  • Reinforce that care is essential infrastructure for our families and our economy. At some point, we will all need or provide care in some capacity.

To support an effective care infrastructure that meets these needs, we were among eight funders who joined together to create the Care for All with Respect and Equity (CARE) Fund . This ambitious initiative is investing $50 million over the course of five years in universally supported care infrastructure to expand and align resources addressing a wide range of critical issues, from workers’ rights to early childhood care to greater economic equity. Importantly, this fund is committed to supporting the work that organizers are already driving across a wide variety of care-related issues.

Many of these leaders are grantees in Schusterman’s Gender and Reproductive Equity portfolio. These include:

  • Family Values @ Work: A network of grassroots groups helping state coalitions educate the public and policymakers about the importance of Earned Sick Days and Family and Medical Leave Insurance.
  • Paid Leave for All: A national campaign of organizations fighting to win paid family and medical leave for all people through policy expertise and research, communications partnerships and grassroots memberships in the field.
  • National Women's Law Center: A leading organization fighting for gender justice across issues that are central to the lives of women and girls, especially women of color, LGBTQ people and low-income women and families.
  • MomsRising: A network accelerating change in national policy and holding corporations accountable for fair treatment of women and mothers.
  • National Domestic Workers Alliance: An organization advocating for the respect, recognition and rights for the nearly 2.5 million nannies, housecleaners and home care workers who do the essential work of caring for our loved ones and our homes.

In addition to making individual contributions to the fight for care infrastructure, these organizations are also forming collaborations across multiple facets of the care economy. One example is the Care Can't Wait Coalition. Formed earlier this year, the Coalition lobbies Congress to address the most pressing needs facing our current care economy. These include:

  • Passing paid family and medical leave so people know they can care for their loved ones without losing their income;
  • Supporting affordable, quality childcare programs, particularly for low- and middle-income families;
  • Expanding home and community-based services for older adults and people with disabilities; and
  • Creating millions of jobs in the care sector.

These organizations have already made significant headway in the pursuit of progress to combat the historic undervaluation of care in American society. Now is the moment for philanthropy to align resources at the pace and scale needed to support them and emerge from this crisis with a care infrastructure that works for everyone.

We have the opportunity now to make good on our nation’s promise to build a system that supports workers and families. Changing our policies and business practices to support caregivers, care workers and those that rely on care is essential to our economic recovery and to achieving racial, gender and economic equality—the fact is, a win for care work is a win for us all.