Care Work in the United States

Project Date:
Jun 2009
Award Amount:
Project Programs:
Future of Work

Second Supplemental Appropriation: $200,000 (February 2011)

Project Completed: June 2013

As women have moved into the formal labor force in large numbers over the last forty years, care work—traditionally provided primarily by women—has also shifted increasingly from the family arena into the formal economy. Child care, elder care, care for the disabled, and home care now account for a growing segment of low-wage work in the United States, and there is every reason to expect this trend to continue if we consider the aging of the baby boom generation and the reality that care work cannot easily be automated or off-shored. But as care work gravitates from the family to the market, an increase in the number of those taken care of at any one time decreases opportunities for personal connection, which can have detrimental consequences for the quality of care. Many theoretical and practical questions emerge about how well care can be delivered by market exchange, including: how do we measure the quality of care? What is the likely future demand and supply of care work? Why does care work remain low paid with sparse or nonexistent benefits when the quality of care is so highly valued and the demand has increased? And what is the impact of immigration on the provision and price of care work?  

With support from the Foundation, economist Nancy Folbre of University of Massachusetts and ten other leading social scientists have formed a working group to study the social organization of care work in the United States. The working group will tackle the difficult policy problems that arise from the fact that market care is not a perfect substitute for family care. Drawing on diverse disciplines, areas of expertise, and methodological orientations, the working group aims to develop an innovative research agenda that provides a theoretically unified and empirically substantive analysis of care provision in the United States.

Care Working Group

Suzanne Bianchi, University of California, Los Angeles
Catherine Eckel, Texas A&M University
Paula England, NYU
Nancy Folbre, University of Massachusetts, Amherst
Janet Gornick, Graduate Center, CUNY
Candace Howes, Connecticut College
Carrie Leana, University of Pittsburgh
Shelly Lundberg, University of California, Santa Barbara
Kristin Smith, Carsey Institute at the University of New Hampshire
Douglas Wolf, Syracuse University
Erik Olin Wright, University of Wisconsin, Madison

For Love and Money

Folbre and her colleagues spent the first year of the project writing a book, For Love and Money, published in August 2012. The volume provides an overview of care provision in the United States and develops a framework for the analysis of existing care policies. The book also considers the distinctive features and the looming problems of a care sector that crosses the traditional boundaries between the market and the family.

The authors used available literature and data to offer a big picture account of care work – tracing changes in care labor over time, identifying key definitional, measurement and accounting issues, providing a rough estimate of the size of the workforce and of the care gap, and describing what we know about the effects of turnover on quality of care and the particular problems of low- and middle-income families. The book also outlines potential next steps in a care policy and research agenda.

Click here to download the introduction or puchase a copy of For Love and Money.


During its first year, the group also undertook five smaller projects, both policy-related and empirical. The first of the smaller projects involved developing a set of policy briefs based on existing research. The first brief, by Shawn Fremstad of the Center for Economic Policy Research, looks at ways to target federal fiscal stimulus funds to benefit direct care workers. Another brief, written by Peggie Smith of the University of Iowa College of Law, addresses potential regulatory reforms that would extend Fair Labor Standards Act protections to direct care workers The third brief, by Candace Howes, examines fiscal federalism and variations in state funding arrangements for direct care workers.

A second policy project involved field work to gather information on an innovative community-level system of care provision (child care and elderly home care) in Quebec, Canada. Working group member Eric Olin Wright, University of Wisconsin, Madison, conducted preliminary field work, involving interviews, participant observation, and analysis of archival data.

Three empirical projects complement the book and policy projects. Suzanne Bianchi (UCLA) is using the Health and Retirement Study (HRS) to examine the co-residence and geographic proximity of older mothers and their adult children. The study will assess the supply of unpaid family assistance to the elderly and its variation by race/ethnicity, whether parent-child ties are biological or not, and the mother’s health status.

Another project, by Douglas Wolf (Syracuse University), uses HRS data to examine the consequences of caring for an elderly parent. The project shows that the stress attributed to caregiving may in fact be a function of having a parent who is ill, as even ‘non-caregiver’ adult children of the frail elderly exhibit elevated stress levels.

A third empirical project, headed by Catherine Eckle (The University of Texas at Dallas) and Paula England (New York University), combines experimental and survey methods to test whether monetary or financial incentives “crowd out” the provision of unpaid care or reduce the quality of paid care. They also ask whether those who enter “caring” occupations differ in systematic ways – for example, are they more altruistic? – from those in other occupations.

Additional Research

With a 2011 supplemental award from the Foundation, the working group’s future research examined:

  • the work careers of adult- and child-care workers;
  • the impact of residential mobility on inter-generational care provision;
  • the role of training or credentialing and job crafting in job quality;
  • lessons learned from the distinctive features of care work in other countries and their implications for quality of care;
  • the task time allocation of home- and community-based workers during their work day;
  • the determinants of staying, leaving or switching jobs among paid care workers;
  • the potential role of bio-markers to determine whether variability in response to stress helps explain why some family members are more willing than others to take on responsibility for the care of an elderly parent;
  • the economic penalties of paid and unpaid care work throughout the life-course; an experimental analysis of the causal relationship between cooperative preferences and care provision.


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