DIRECT CARE WORKFORCE IN THE US BEFORE AND DURING COVID-19

Abstract

Abstract Purpose This study describes the changes in the direct care workforce between 2019 and 2020. Design and Methods Data were from the 1% Public Use Microdata Sample (PUMS) of the 2019 and 2020 American Community Survey (ACS). Logistic regression was used to compare demographic and employment characteristics of direct care workers (DCWs) in 2019 and 2020. Results While the total number of DCWs increased by 0.08% and the number employed in home care increased by 3.45%, the number of DCWs employed in hospitals decreased by 3.73% and the number employed in residential care facilities decreased by 4.01% from 2019 to 2020. Compared to 2019, DCWs in 2020 were more likely to be nonmedical aides, under 25, over 65, non-white, to purchase health insurance directly, and to receive health insurance from Medicaid. DCWs in 2020 were less likely to be widowed, to be recently married, to be non-English speaking, to work year-round and full-time, to have moved in the last year, and to be below poverty than they were in the previous year. Implications: By the end of 2020, the early effects of the COVID-19 pandemic on the direct care workforce could be seen. While the total number of DCWs increased slightly, this was due to the accelerated growth of DCWs in home care, as the decline in the number of DCWs in hospitals and residential care facilities also accelerated. The direct care workforce in 2020 was more nonmedical, part-time, entry-level or exit-level and non-white than in the previous year.