Appreciating direct care workers

Let’s stop assuming there’s a relationship between low-valued work and low-paid workers

Rebecca Bryant, president and CEO of Lakes Region Community Services, a New Hampshire social services organization, penned an impressive opinion piece in the March 1-14 issue of the NH Business Review (“NH’s eroding direct care workforce”) that concretely highlighted the plight of direct support professionals, those who care for the elderly and disabled. To this cohort I would also add child care workers.

As a whole, this segment of the New Hampshire workforce is underpaid, underappreciated, disrespected and lacking in the placement of esteem they deserve as employees tasked with providing key services to needy populations.

Why is this? Unfortunately, social services have historically been viewed as somehow less urgent or worthwhile than economic pursuits resulting in manufactured goods and services supporting commercial viability. The money hasn’t flowed to caregivers.

Since money appears to be a solid metric of worth and value, the unmistakable conclusion drawn is that giving care to young children, old citizens and the disabled just doesn’t carry that much weight. Interesting. Economics is all about the production, distribution and consumption of goods and services to improve lives. How is it that the life-improving work of caregivers is different?

Many would say that the individuals who make up the direct care workforce are generally under-educated, with many also coming from low-income backgrounds. Thus, the thinking goes, they are not meritorious or qualified enough to receive living wage compensation. The time has come for us to stop assuming there is a causal relationship between low-valued work and low-paid workers in the direct care context.

In actuality, we are faced with a contrarian situation of low-paid workers toiling through high-valued work. Despite the fact that low-paid direct care services continue to attract, albeit at inadequate levels, those willing to work for low pay in order to do something they like and are good at doing, is no reason to continue the practice. It’s time to right a wrong.

Let’s first look at the root of the problem. Direct care services are historically performed by women. Presumably, they have been drawn to this work, because of the longstanding social and cultural expectations for women to nurture others. It is fair to say that women have performed laudably with direct care services for many years. The benefit to society is immeasurable.

However as we know, compensatory equity has been and continues to be elusive for women. “Women’s work” has rarely, if ever, received reparation on par with what men make. Let’s be honest — traditional views regarding remuneration say that an occupation primarily composed of women will not be seen as worth paying much for. It took men becoming teachers and nurses to spur the evolution of living wages in those fields.

Regardless, it shouldn’t take a replay of that model to boost the earnings of competent and hard working direct care service providers, whether female or male.

There are two reasons for a balancing of resources to occur. Firstly, we should recognize that high quality care directed to those among us who are not or can no longer be high producers is virtuous and enriches lives. This alone should diminish any resistance to fair pay.

That said, there is another factor to consider: Unequivocal changes already underway to reshape the nature of employment is ushering in a re-evaluation of what it means to “work.” Many jobs will be refashioned and eliminated as automation and artificial intelligence increasingly impact the economy. Labor directed to personal care may emerge as progressively appreciated employment. A paradigm shift recognition of the value added to society by direct care givers may finally remediate this excessive pay disparity.

In a state ranked third for the percentage of the population growing old, you would think New Hampshire would be intentionally reaching out to strengthen its direct care workforce. We have a chance now to show the country how fair pay for our direct care providers can be done.

Bill Ryan, who writes about career, employment and economic topics from his home in North Sutton, can be reached at

Categories: Workplace Advice