REPORT

Essential but undervalued: Millions of health care workers aren’t getting the pay or respect they deserve in the COVID-19 pandemic

Molly Kinder Thursday, May 28, 2020


Editor's Note:

This is the second post in a series on COVID-19 frontline workers. Read the stories of the workers profiled here.

Contents:
Introduction
Underpaid, undervalued, and essential
A policy agenda for essential, low-wage health workers:
Keep all health workers safe
Introduce hazard pay
Raise pay to a permanent living wage
Expand paid leave
Give workers the respect they deserve

INTRODUCTION

The COVID-19 pandemic has inspired an outpouring of public appreciation for the country’s frontline heroes, from television ads to firefighter salutes to essential worker toys. But while doctors and nurses deserve our praise, they are not the only ones risking their lives during the pandemic—in fact, they represent less than 20% of all essential health workers.

Too often, we overlook the heroism and dignity of millions of low-paid, undervalued, and essential health workers like Sabrina Hopps, a 46-year-old housekeeping aide in an acute nursing facility in Washington, D.C.

“If we don’t clean the rooms correctly, the pandemic will get worse,” said Hopps. She cares deeply about the patients she works with, and knows that the value of her job goes well beyond cleaning. “It’s me and the other housekeepers who sit and talk with [patients] to brighten up their day, because they can’t have family members visiting.”

Despite her contributions, she doesn’t feel recognized. “Housekeeping has never been respected,” she told me recently. “When you think about health care work, the first people you think about are the doctors and the nurses. They don’t think about housekeeping, maintenance, dietary, nursing assistants, patient care techs, and administration.”



Hopps is one of millions of low-wage essential health workers on the COVID-19 front lines. Like the higher-paid doctors and nurses they work alongside, these essential workers are risking their lives during the pandemic—but with far less prestige and recognition, very low pay, and less access to the protective equipment that could save their lives. They are nursing assistants, phlebotomists, home health aides, housekeepers, medical assistants, cooks, and more. The vast majority of these workers are women, and they are disproportionately people of color. Median pay is just $13.48 an hour.

Over the last several weeks, I interviewed nearly a dozen low-wage health workers on the front lines of COVID-19. (You can read their stories here.) Despite being declared “essential,” the workers I interviewed described feeling overlooked and deprioritized, even expendable. They spoke with pride about their work, but few felt respected, even as they put their lives on the line. Many expressed frustration—and sometimes anger—over their lack of life-saving protective equipment.

It is long past time that these workers are treated as truly essential. This starts with simply recognizing the value of workers like Hopps—but we can and must do more. The policy recommendations in this report aim to keep these workers safe on the job, compensate them with a living wage, support them if they fall ill, and give them the respect and appreciation they deserve.

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UNDERPAID, UNDERVALUED, AND ESSENTIAL

The underpaid but essential health care workforce in America comprises nearly 7 million people in low-paid health jobs in these three categories:

Health care support workers assist health care providers such as doctors and nurses in providing patient care. Roles include orderlies, medical assistants, phlebotomists, and pharmacy aides.

Direct care workers such as home health workers, nursing assistants, and personal care aides provide care to individuals with physical, cognitive, or other needs.

Health care service workers include housekeepers, janitors, and food preparation and serving workers employed in health care settings such as hospitals and nursing homes.

More people are employed in health care support, service, and direct care jobs than in all health care practitioner and technician jobs (doctors, nurses, EMTs, lab technicians, etc.). In fact, more people work in hospitals as housekeepers and janitors—like Sabrina Hopps—than as physicians and surgeons. The size of this low-wage health workforce exceeds the size of most other occupational groups of essential workers. It employs more people than the entire transportation and warehousing industry and more than twice as many people as the grocery industry.

Median wages in health care support, service, and direct care jobs were just $13.48 an hour in 2019—well short of a living wage and far lower than the median pay of doctors (over $100 per hour) and nurses ($35.17 per hour). Home health and personal care workers earn even less, with a median hourly wage of only $11.57. The wages are so low that nearly 20% of care workers live in poverty and more than 40% rely on some form of public assistance. These fields are some of the fastest-growing of all occupations, with more than a million new jobs projected by 2028.

READ THE REST HERE Essential but undervalued: Millions of health care workers aren’t getting the pay or respect they deserve in the COVID-19 pandemic (brookings.edu)

Molly Kinder
David M. Rubenstein Fellow - Metropolitan Policy Program