Home Health Workers Are At Risk, Vulnerable and Need Our Help

By Nathan Boucher and Emma Dries

Before COVID-19, home health aides already risked disease and injury just by going to work. Now, these individuals are on the front lines of the coronavirus pandemic with little to no job stability or employer-provided protections.

There are more than 2 million home health and personal care aides in the United States. Though the occupational titles vary, it is estimated that North Carolina has between 17,000 and 19,000 home health aides earning roughly $18,000-$23,000 annually. They provide support and health care assistance in people’s homes across America. The majority are women and people of color. Since the pandemic started, there have been disproportionate rates of COVID-19 illness and death in African American communities. This disparity is attributed to factors like housing conditions, chronic health conditions, and stress.

The median hourly wage of home health workers is about $10 per hour, and the work is inconsistent, often offering only part-time or part-year employment — and often no health insurance. This inconsistency leaves a quarter of home care workers below the federal poverty line and more than half reliant on public assistance. Many home health workers must work second jobs to make ends meet, making them more likely to encounter the coronavirus and spread it to others.

While experts have recommended that individuals avoid large crowds, stay home from work, and contact a healthcare provider if they feel unwell, many home health workers cannot afford to follow these recommendations.

Home health workers are undeniably necessary for home care as well as hospice (care at the end-of-life) in our communities. More than 10 million Americans rely on home health workers; we have been touched by their good work.

Without paid time off and adequate health insurance, direct and indirect costs of sickness and dependent care can destroy individuals’ lives. Providing greater financial and personal health security in the home healthcare sector could ensure that home health workers can safely meet our needs when we ourselves require care in our communities. This workforce needs more stability.

Nathan Boucher is an assistant professor at Duke University’s School of Medicine and Sanford School of Public Policy. Emma Dries is an undergraduate student studying public policy at Duke University.