Racial Disparities in Financial Security, Work and Leisure Activities, and Quality of Life Among the Direct Care Workforce


Ulrike MuenchJoanne Spetz, Matthew Jura, and Charlene Harrington

November 20, 2020

Personal care, home health, and nursing aides provide the majority of care to chronically ill and disabled older adults. This workforce faces challenging working conditions, resulting in high turnover and workforce instability that affect the quality of care for older adults. We examined the financial security, work–life balance, and quality of life of Black, Hispanic, and workers of other race/ethnicity compared to White workers.

We hypothesized that Black and Hispanic workers experience greater financial insecurity, spend more time on work-related activities and have less time available for leisure activities, and have a lower quality of life compared to White workers. To test these hypotheses, we analyzed the American Time Use Survey using descriptive analyses and multivariable and compositional regression.

We found that Black and Hispanic individuals were 2–3 times more likely to live in poverty than White individuals. The time use analysis indicated that Black and Hispanic workers spent more time on work-related activities and less time on nonwork-related activities, including longer work commutes and less time exercising. In analyses of aggregated paid/unpaid work and leisure, Black workers were the only group that spent significantly more time working and less time on leisure activities compared to White workers. This may explain the lower quality of life that we only observed in Black workers.