Black women are overrepresented in the toughest health care jobs, study finds

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As co-author Janette Dill, an associate professor in the division of health policy and management at the University of Minnesota, put it: “They take care of people’s bodies, feed them, bathe them, and take the people in the bathroom – it’s very hard physical work.

Shantonia Jackson, a 52-year-old certified practical nurse at City View Multicare Center in Cicero, Ill., is responsible for caring for 30 to 60 residents at a time, she said. As a result, “there’s not enough time in the day” to give them all the care they deserve, said Jackson, who is black.

“It’s like nobody cares about people. … It’s like I’m a number,” said Jackson, who is also a member of the SEIU Health Union and a member of the advisory board of the Center for Equitya national advocacy organization for long-term care workers.

City View administrators did not respond to requests for comment.

Dill undertook the study with Mignon Duffy, an associate professor of sociology at the University of Massachusetts Lowell. To conduct the study, Dill and Duffy used data from 2019 American Community Survey – an annual national survey conducted by the US Census Bureau – to analyze the likelihood of employment of black women in different occupations and sectors of the health care industry. They controlled for a variety of factors that might otherwise explain career choice, including education, marital status, age or immigration status, the study notes.

Their analysis found that black women have a higher likelihood of working in healthcare – 23% – than all other groups: white, Hispanic and Asian women, as well as women who identify with another race or ethnicity, have a predicted probability of 16 years. to 17% chance of working in the sector, and men of all racial and ethnic groups have a much lower chance of working in health care, ranging from 4 to 8%.

While white women make up a higher overall proportion of the health workforce – at 46% of the workforce – than black women, they have a lower overrepresentation rate than black women. in the sector relative to their overall labor force participation, the study notes. According to the study, white women are also more evenly distributed across different health care settings and are slightly underrepresented among the lowest paid nursing assistants and orderlies compared to their overall representation in the industry. .

According to the study, working in the healthcare sector involves many risks: healthcare workers have the highest overall rates work-related injuries of any private industry in the country, and nurses and nurses aides are more likely to experience stress and injury in the workplace than other healthcare workers, other studies have shown.

And for black women, the risks are even higher: “Black women are more likely to work in nursing homes and other long-term care facilities that are most understaffed and under-resourced, resulting in a increased risk and exposure to injury or infection,” the study notes.

But while black women do some of the hardest work in health care, their paychecks don’t reflect it, according to the study, which cites research from the Paraprofessional Healthcare Institute – an advocacy and policy research organization focused on direct care workers – showing that home care workers earned an average hourly wage of $12.12 in 2019, while residential care aides earned an average hourly wage of $12.69 and orderlies in nursing homes earned $13.90 hourly.

This research also notes that 1 in 6 home healthcare workers live below the federal poverty line and nearly half live in low-income households. And about half of black and Hispanic direct care workers earn less than $15 an hour, according to a 2019 article. published in the American Journal of Public Health. (While the American Community Survey tracks income, Dill and Duffy did not include it in their article to focus on “the representation and location of black women in health care,” Dill said.)

Jackson earns $16.90 an hour. Before the pandemic, she earned less than $15 per hourbringing him and hundreds of other Chicago nursing home workers to go on strike in November 2020.

But his higher salary still doesn’t reflect the rising cost of living, Jackson said: “The rent is going up, the [cost of] the food increases, but the wages do not increase.

Tracy Mills Jones agrees. Mills Jones, a 57-year-old long-term care worker in Palmdale, Calif., earns $16 an hour thanks to the state home support services program to take care of two clients, one of whom is her brother, she said.

“I change all the sheets, I change the diapers, I do all the work as an in-home care provider, and they only pay us super cheap,” said Mills Jones, who is black.

Sometimes her low salary means “I have to choose whether I’m going to eat or pay a bill,” she added.

Mills Jones Syndicate, SEIU Local 2015East campaign raise the wages of California caregivers by up to $20 an hour. For Mills Jones, this increase would be transformative, she said: “$20 [an hour] would make me a member of society. … I literally live from check to check.

A spokesperson for the Los Angeles County Department of Public Human Services said the agency “cannot release any personal information as to whether or not it is a provider.” (The Washington Post reviewed the state’s Mills Jones pay stubs.)

According to the study, higher-paying roles in health care are hard to come by for black women: they are less likely to be registered nurses than white and Asian women and women from other racial and ethnic groups, and they only have a 1-2% predicted probability of working as physicians, advanced practitioners, therapists, or technicians.

In their article, Dill and Duffy argue that these realities are a product of the legacy of slavery, when white people forced black women to work as unpaid servants in their homes.

From this story came a distinction between “spiritual” and “menial” household chores, law professor Dorothy Roberts argued in an article that Dill and Duffy cite: Privileged white women performed household chores – including serving as hostesses and role models for children – which were considered superior to other tasks, while black women were tasked with more labor-intensive tasks, including scrubbing floors, doing laundry, and preparing meals.

Some of those assumptions about who does what kind of housework still haven’t changed, helping to keep black women locked into low-wage, dangerous health care work, according to Dill: “We have a cultural assumption that women of color will provide care for us and they will do it inexpensively and that is their role.

Jackson also sees the historical connection in his work: “People act like, since we did it in slavery, we can do it again, and we still don’t have to get paid…but it should be about be happy with your work. , to be proud to be able to help take care of a loved one,” she said.

The solutions to rectifying the disparities faced by black women in health care, argue Dill and Duffy in their article, lie in raising wages, creating more opportunities for career advancement, and tackling the racism in the workforce. They recommend raising the federal minimum wage to $15, citing a recent study this showed that it would reduce household poverty rates among female health workers by up to 27%.

Building better career paths could include top brass in healthcare organizations facilitating workers’ participation in training programs that will help them advance in their careers, they write. And tackling racism in the pipeline would require challenging “the feminization of care and the racialized association of some jobs with ‘menial’ – and therefore less valuable – work,” they write, adding that this should start in schools and that health officials and managers should spearhead equity and inclusion plans.

For Jackson, health care reform is essential for the future of the workforce: “I want this industry to change so that our young people can be there to take care of us, because the way the industry go now, no one will be there. ”