Did You Know:
- Home care services are one of the fastest-growing industries in the United States.
- By 2050, the number of adults older than 65 years is expected to nearly double from 48 million to 88 million.
- According to one AARP study, 87% of adults 65 years and older prefer to stay in their current home and community.
- The home health care workforce (HHCW) will grow by 36% by 2029, nearly four times the rate of total employment growth.
- The majority of HCWs are women (89%) and/or people of color (58%), and immigrants (26%).
- Nearly one-quarter of HCWs live below the federal poverty line and more than half rely on some sort of public assistance.
- The number of children living in poverty in the United States more than doubled in 2022, (US Census).
- Recruiting, training, and maintaining staff in the Health Care Industry is the number one priority.
Impact
Despite the high demand for direct care workers overall, their wages remain low—the median hourly wage for this workforce was $13.56 in 2020. While “successfully employed”, these workers are underemployed, which means their positions do not meet their abilities and daily living needs. Low wages combined with a high rate of part-time work make it challenging for direct care workers to financially support themselves and their families. Median annual earnings are $20,200. 44 percent of direct care workers live in low-income households, and 45 percent rely on public assistance such as Medicaid, nutrition assistance, or cash assistance. (Ruggles, et al, 2021). Given the focus on long-term care and the direct care workforce generated by the pandemic, it’s imperative to refine direct care jobs and strengthen and stabilize the workforce. If you want to increase employee performance and productivity, retain the right team members, and have an employer brand that helps you attract more of the right talent. You need to understand your employees.
Understanding The Workforce
Individuals who experience childhood poverty are more likely to experience poverty into adulthood, which contributes to generational cycles of poverty. In addition to the lasting effects of childhood poverty, adults living in poverty are at a higher risk of adverse health effects from obesity, smoking, substance use, and chronic stress. Nine out of ten home care workers are women, 25% are African American, and 25% are immigrants, many undocumented. These immigrants come from extremely poor countries like Haiti and Guyana and are desperate to work to be financially independent and raise their families. They are an undervalued and underpaid population who will work themselves to death trying to provide a meaningful subsistence for themselves and their families while receiving little formal education or training, low pay, and a lack of respect for the skills required for the job expectations. (McGhee-Ryan, et al, 2011).
Most of these workers are or have grown up in poverty and display the results of that in their cognition and behavior, yet they do not claim to be poor. Whether generational, lasting more than two generations, or situational, caused by divorce, illness, or death, these workers want to work and support their families, most being single parents with more than one child at home. Black, Hispanic, and Indigenous children are overrepresented among children below the age of 18 living below the poverty line. (35.5% Black; 40.7% Hispanic; 29.1% Native American; 21% White). Furthermore, families with a female head of household are twice as likely to live in poverty compared to a male head of household. Both personal responsibility and structural pressures can lead to poverty, but some factors outside of the control of the individual —being a woman, black, Hispanic, a child, or a disabled person — are indicators of poverty. This was compounded by the economic impacts of the pandemic in 2020 (USB, 2020).
Poverty is hard for people to see – mostly because those who are poor try to hide it while others don’t want to see it. However, understanding poverty can help create discussions and guide communities toward solutions. It makes us more sympathetic to drive us to do better to help our most vulnerable. To better understand individuals from poverty, a working definition of poverty is “the extent to which an individual does without resources.” These resources are financial, emotional, mental, spiritual, physical, support systems, relationships/mentors, and knowledge of hidden rules. Typically, poverty is thought of in terms of financial resources only; however, while it is extremely important, the ability of an individual to leave poverty is more dependent on other resources beyond financial. Each of the resources listed is critical to individual growth and leaving poverty (Payne, R., 2019).
Despite their circumstance, most home care workers find meaning and purpose in their work. They are compassionate, caring individuals who have cared for their families, some since childhood, and feel comfortable in these caregiving roles. They lack education/advanced skills, have never been encouraged to be a leader, have low self-esteem, and lack the emotional, mental, spiritual, and physical support systems and knowledge of the hidden rules to break their cycle of poverty. However, they want to work, be recognized, be heard, be supported, be trained, and be compensated for the valuable service they provide. Their primary focus is to make a living for their families.
Poverty Impacts Child Brain Development
Poverty is associated with substandard housing, hunger, homelessness, inadequate childcare, unsafe neighborhoods, and under-resourced schools. The first three years of a child’s life are a period of rapid brain development. Too little energy, protein, and nutrients during this sensitive period can lead to lasting deficits in cognitive, social, and emotional development. School-age children who experience severe hunger are at increased risk for poor mental health and lower academic performance and often lag behind their peers in social and emotional skills. Children living in poverty generally perform poorly in school, with markedly lower standardized test scores and lower educational attainment. The longer children live in poverty, the greater their academic deficits. These patterns persist to adulthood, contributing to lifetime-reduced occupational attainment (APA, 2022).
Impoverished children have less access to medical care, increased exposure to toxins, violence, poor schools, and income inequality. “The stress of living in poverty affects children’s brains like trauma and abuse,” said Seth Pollak, an expert on child development at Duke University. He and others found that poverty affects brain growth, and the difference can be seen as early as infancy. Infants living in poverty showed a different trajectory of development as early as age 2, suggesting that the longer the child is exposed to an impoverished environment, the greater the difference in brain development (Chaudry, 2016). Without effective interventions, society is facing a cost: fewer people with good qualifications, lower productivity, poor health education, high risk of unemployment and dependence on social benefits, and loss of community connection.
What can you do to help your employees?
“You really never understand a person until you consider things from their point of view.” Atticus Finch in Harper Lee’s To Kill a Mockingbird
There are many ways that you can help those who are in poverty and struggling to make ends meet, the first of which is to honor and respect them as valued members of your team. Give them your ear and listen to their thoughts. Teach them how to share their concerns in clear meaningful ways. Understand their culture and what they value. Then help them grow and develop through training and mentorship. Giving your employees opportunities to share their challenges in a respectful, caring, understanding way; allowing their voices to be heard; and creating opportunities for shared decision-making regarding processes and practices that benefit the organization’s clientele, builds self-esteem, and creates lasting relationships. Relationships are the key to growth. This will create positive change not only for the worker but the organization. Begin here and put processes and policies in place that support their overall well-being under extremely stressful work conditions. Take care of your employees and they will take care of you.
References:
(2022, October 9). Mental health effects of poverty, hunger, and homelessness on children and teens. American Psychological Association. https://www.apa.org/topics/socioeconomic-status/poverty-hunger-homelessness-children
Chaudry A, Wimer C. Poverty is Not Just an Indicator: The Relationship Between Income, Poverty, and Child Well-Being. Acad Pediatr. 2016 Apr;16(3 Suppl):S23-9. doi: 10.1016/j.acap.2015.12.010. PMID:
Mason, A. (2021, July 22). Ruby Payne: Understanding the “Why” Behind Behaviors. NAESP.org. https://www.naesp.org/blog/ruby-payne-understanding-the-why-behind-behaviors/
McKee-Ryan, F. M., & Harvey, J. (2011). “I Have a Job, But . . .”: A Review of Underemployment. Journal of Management, 37(4), 962-996. https://doi.org/10.1177/0149206311398134
Payne, R. K., PhD (2019). A Framework for Understanding Poverty (6th ed.). AHA Process, Inc.
PHI. (2019). U.S. home care workers: Key facts. https://phinational.org/wp-content/uploads/2019/08/US-Home-Care-Workers-2019-PHI.pdf
Steven Ruggles, Sarah Flood, Sophia Foster, Ronald Goeken, Jose Pacas, Megan Schouweiler and Matthew Sobek. IPUMS USA: Version 11.0 [dataset]. Minneapolis, MN: IPUMS, 2021. https://doi.org/10.18128/D010.V11.0
U.S. Bureau of Labor Statistics. (2019). Home health aides and personal care aides. Retrieved from https://www.bls.gov/ooh/healthcare/home-health-aides-and-personal-care-aides.htm#tab-2U.S. Bureau of Labor Statistics. (2020). Employment projection. https://data.bls.gov/projections/nationalMatrix?queryParams=621600&ioType=i