New Report Finds Care Infrastructure Critical for Equitable Economic Recovery

Contact: Ja-Rei Wang, Caring Across Generations,, 631-338-2567

Investing in Care Sector Could Generate Twice as Many Jobs Per Dollar as in the Physical Infrastructure

WASHINGTON—As unemployment rises to record levels ahead of Labor Day and negotiations over economic recovery measures stagnate, a new report from Caring Across Generations and 70 partners identifies public investments in the care sector that will address the health and economic crises exacerbated by the COVID-19 pandemic. Expanding access to quality childcare and community- and home-based care will create jobs quickly, spur job growth in other sectors, and ensure financial stability for Black and immigrant women who disproportionately fulfill family care responsibilities, according to the leading care advocates backing the paper. 

“The U.S. has never built a sustainable system that treated care as a public good, effectively solved for how to both work and care for kids or other family members, or valued care work the way it deserves to be valued,” said Julie Kashen, report co-author and senior policy advisor at National Domestic Workers Alliance (NDWA). “We need to build a robust care infrastructure and support the nannies, childcare workers and home care workers that make all other work possible.”

For the first time, caregivers, sandwich generation parents, labor leaders and advocates for paid leave, child care, disability justice and long-term care have come together to back a unified and comprehensive set of policies and programs that ensure all people can access and receive care across the full lifespan while generating millions of jobs: 

  • Universal child care, including expansion of home-based child care options to compensate for reduced capacity of child care centers; grants and other financial support for child care business owners; and fair pay and personal protective equipment (PPE) for child care workers.
  • Paid family and medical leave for all, including paid sick days and paid time off to attend to a critical safety need, such as domestic violence or sexual assault recovery.    
  • Universal long-term support services (LTSS) by expanding and improving Medicaid and Medicare to incentivize and fully cover home- and community-based care options and improving quality and pay for home care workers.
  • Support for family and sandwich generation caregivers, including training, financial compensation and health assistance to family caregivers. 
  • Fair pay and protections for care workers, such as lifting the federal minimum wage to $15.  

The report pointed to recent research showing how the unaffordability of child care and long-term care for adults hampers families, employers, and the wider economy. For example, parents were already forgoing approximately $30-35 billion in income before the pandemic as a result of quitting their jobs or reducing paid work hours to care for children. That lost income costs the U.S. $4.2 billion in tax revenue annually. Similarly, caregivers who leave paid work or retire early due to caregiving responsibilities lose on average over $300,000 in wages, Social Security benefits and pensions over their lifetimes, which translates to a loss of $25 billion per year. The financial strain is even higher for Black caregivers who often have lower household earnings and emergency funds than their white counterparts as a result of longstanding racial disparities in generational wealth. Medicare and Medicaid cover some home- and community-based care for aging adults and people with disabilities, but not in most cases.  

“Our policies rely on an antiquated and inequitable system of unpaid or undervalued labor—performed disproportionately by Black, Latinx and immigrant women,” said Josephine Kalipeni, policy director at Caring Across Generations. “We need a strong foundation of care that centers equity and addresses the impacts of multigenerational systemic racism. In doing so, we can ensure true economic opportunity for Black and Latinx families.” 

Care workers currently only make $15,100 on average per year, even though home health aides and personal care assistants are the third and fourth fastest growing occupations in the U.S. Expanding the care sector and ensuring fair pay and health protections could raise living standards for this critical workforce as well as boost the economy. According to the study, investment in the caregiving sector can generate twice as many jobs per dollar as physical infrastructure construction can due to the caregiving sector’s high labor intensity.  

“Like transportation, energy, and public health, we need a robust care ‘infrastructure’—policies, services and workforces that allow us to provide for our families and contribute to the economy,” said Ai-jen Poo, director of Caring Across Generations and executive director of NDWA. “We have a unique opportunity to bring these policies into the 21st century and rebuild our economy in a way that meets the growing needs of the oncoming demographic shift and creates good paying jobs.” 

The report recommends the federal administration work with Congress to pass a set of care infrastructure bills that address urgent caregiving needs and lay the foundation for a safety net that guarantees dignified care at every stage of life. 

Below are additional endorsements of the report from leading advocates in the elder care, disability justice, and child care communities. 

“Our society would collapse without caregiving,” said Indivar Dutta-Gupta, co-executive director of the Georgetown Center on Poverty and Inequality Economic Security and Opportunity Initiative. “Yet, we’ve never built the solid foundation to ensure that our care needs are met, instead leaving families to fend for themselves. Why is that? We’ve depended on some of the most marginalized people—immigrant and Black and brown women—to provide this care, unpaid and underpaid. But now is the time for a reckoning with reality. We must act and we must do so in a way that’s durable, for generations to come. We must be guided by the simple and radical idea that care is infrastructure. It is during this pandemic—and it always has been.”

“For our economic recovery, it is essential that we invest in the systems that support women workers across our economy. We are in a defining moment in this country,” said Ankita Kanakadandila, policy analyst at the TIME’S UP Foundation. “Now more than ever, we have a responsibility to broaden our understanding of what caregiving means, to invest in creative and innovative policies, and to finally provide caregivers with the support and resources they need to thrive.”

“Our families and our economy are hurting,” said Cherita Ellens, president and chief executive officer of Women Employed. “Women predominate in caregiving professions and family caregiving roles. For far too long, we have under-invested in and undervalued our caregiving infrastructure, and now we are suffering the consequences. We need strong and healthy caregiving systems to relieve the pressure on those who are caring for children, parents, family members with disabilities. Our families, communities, and our economy cannot thrive until we make that investment.” 

“We must create a care infrastructure that meets the needs of those providing and receiving care,” said Nzingha Hooker, staff attorney at the National Employment Labor Project. “Our existing caregiving system has relied upon the undervalued labor of women of color who for decades have been fighting to create a better system for workers and the people they care for. It is crucial that we invest in quality care through good, quality jobs. And through a robust and comprehensive infrastructure, all working people can access the care they need for their families.” 

“Building Our Care Infrastructure for Equity, Economic Recovery and Beyond makes a vitally important contribution to the work to make our country more equitable, safe and successful,” said Kristin Rowe-Finkbeiner, executive director and chief executive officer of MomsRising. “The policy solutions it recommends – universal child care, paid family and medical leave including paid sick days, and universal long-term support services – will lift moms, families, essential workers, businesses, and our economy. They are especially important to moms of color, who suffer the most because our policies are painfully outdated and systemic discrimination remains largely unchecked. It’s past time lawmakers adopt these policies.”

The pandemic has made clear the interdependent nature of our lives,” said Wendy Chun-Hoon, executive director of Family Values @ Work. “In this new economy, we need systems that ensure everyone is included in our nation’s prosperity and every working person’s contribution to that prosperity is given due respect and properly valued. We demand a government response that guarantees the shared prosperity we have earned, including living wages, access to healthcare and child care, and paid sick days and family and medical leave that allow us to heal, take care of our loved ones, and protect public health.

“Right now, families across America are being overwhelmed by a deadly pandemic, a devastating economic recession, and a caregiving crisis which have revealed and exacerbated deep inequities in our society,” said Katie Bethell, founder and executive director of Paid Leave for the U.S. “As we work to rebuild, we have an opportunity and a responsibility to enact policies like high-quality paid family and medical leave, centering working families and ultimately building greater resilience into our economy. We are so proud to be a part of this campaign to support millions of working families and win lasting, transformational change.”

“The COVID-19 pandemic has laid bare the inadequacy of a fragmented and underinvested care infrastructure that is failing older adults and perpetuating long standing racial and gender inequities. ‘Building Our Care Infrastructure’ establishes why it is so imperative that we design and invest in an equitable and universal system of care that ensures that we all can age in dignity,” said Kevin Prindiville, executive director of Justice in Aging

“Caregivers will be the largest occupation by 2040,” said Natalie Foster, co-chair and co-founder of the Economic Security Project. “To make caregiving a well paid career, and keep it affordable for families — public investment will have to be made.” 

“Creating a comprehensive care infrastructure ultimately comes down to this question: Who do we see as deserving and worthy?” said Jhumpa Bhattacharya, vice president of programs and strategy at the Insight Center for Community Economic Development. “If we believe that everyone and all forms of work should be valued, there is no question on whether or not we should support this agenda.” 

“Care work is the skeleton that supports and enables workers’ participation in economic activity,” said  Eileen Appelbaum, co-director of the Center for Economic and Policy Research. “Investments in care infrastructure will precipitate a more equitable, more just, and more productive economy.” 

“Members of our Latino community have always been an essential part of the economy of this country,” said Yadira Sánchez, Co-Executive Director, Poder Latinx. “During the COVID-19 pandemic, beneficiaries of temporary protected status, Deferred Action for Childhood Arrivals, as well as members of the immigrant community and communities of color went the extra mile to provide care and protect us, despite a long history of personal inequalities and systemic racism. Now it is up to us all to fight together to ensure that we have a care infrastructure for all.”

“For our nation’s healthy future, paid and family caregivers of all ages, including caregiving youth, are long overdue needed recognition, relief and support,” said Connie Siskowski, president and founder of the American Association of Caregiving Youth. “We can and we must take care of those who selflessly care for others.” 

“Creating a new care infrastructure, including a national policy on paid family and medical leave, is the transformational change our country requires to collectively recover and build our economy back stronger,” said Dawn Huckelbridge, director of Paid Leave for All

“In order to build the inclusive society long overdue for people with disabilities, our nation must invest in an infrastructure of supports and services that includes community-based care without long waiting lists, a robust workforce that is paid a living wage, and paid leave options for family caregivers,” said Nicole Jorwic, senior director of public policy at The Arc of the United States

“The COVID-19 pandemic, which has placed disproportionate health and economic burdens on Black and brown people should sharpen our attention toward cementing a robust and comprehensive care infrastructure that supports families bearing the inequitable strains of childcare costs, caregiving responsibilities, and working on the frontlines,” said Rodney McKenzie, Jr., executive vice president of Demos.

“For far too long South Carolina has been a place that has not valued the labor of the caregivers that give life to our economy,” said Ann Warner, chief executive officer of the Women’s Rights and Empowerment Network. “A care infrastructure will create the conditions for a state where all people can thrive.” 

Our country needs a plan — people need access to meaningful and affordable child care and long term care,” said Editha Adams, president of the United Domestic Workers | AFSCME Local 3930. “This report is a vision for a future where we all have access to the care we need at every stage of life.” 

“America’s care infrastructure is shaped by a history of racist and discriminatory policies that have undermined families’ and workers’ economic security for decades,” said Olivia Golden, executive director of the Center for Law and Social Policy. “The Center for Law and Social Policy is thrilled to join our partners in this clarion call to build an equitable system that will provide children, families, and workers the supports—including access to affordable, high-quality child care and to comprehensive and inclusive paid family and medical leave and paid sick days—they need to thrive.” 

“Working with family child care educators, we at All Our Kin see every day the burdens families bear under the current system,” said Jessica Sager, chief executive officer of All Our Kin. “A better alternative is long overdue, and this piece points to the way forward.”

“The time is now to think big and come together to build the high-quality, accessible, affordable universal care infrastructure that will not only help families and promote equity and opportunity, but will benefit us all for generations,” said Brigid Schulte, director of the Better Life Lab at New America

“What does it mean to ‘recover’ when the pre-COVID economy was built on low-paying jobs, systemic racial and economic injustice, and 40 years of flat wages?” said Bulbul Gupta, president and chief executive officer of Pacific Community Ventures. “When fewer people, especially women and workers from low-wealth communities, have living wages and little or no benefits, but need them more than ever? A true inclusive recovery needs to center the people we call ‘essential and frontline workers’ without whom we wouldn’t have food, home deliveries, and restaurants, and good Jobs–one that has to include universal childcare and mandatory sick leave and family leave.”

“COVID-19 has underscored how important long term services and supports, especially home and community-based services (HCBS), are to our care infrastructure,” said Alison Barkoff, Director of Advocacy, Center for Public Representation. “HCBS are critical to helping people with disabilities and older adults safely remain in their own homes and communities and avoid placement in congregate settings where COVID-19 infections and deaths have been highest. Expanding HCBS saves lives, benefits our economy, and protects civil rights.”