Investing in caregiving

Investing in caregiving: a social, public health, and economic issue – STAT

By Paurvi Bhatt Oct. 19, 2021
As a working daughter, I recently embarked on a new and uncertain phase of my career: taking paid leave for my seriously ill mother. Without children of my own, I never needed to consider paid leave. This new role in caregiving is making me square cultural norms and values ingrained in me as a second-generation South Asian immigrant and as a female-only child with my senior leadership role in corporate America.
While I’ve juggled responsibilities for years, this one is different. The pandemic sharpened my focus on the importance of care at home. Caregiving at home reinforced lessons learned from my public health training about the fragility of health. Balancing this work became all-consuming and pushed an important decision: My mother had cared for me her entire life, and it was now time for me to care for her.
In the U.S., women, especially women of color, often feel that when faced with the opportunity to care for their loved ones, they must silently deliver exemplary results, no matter their employment status. Caregiving for a loved one is hard enough without the additional mental and emotional strain of knowing you’re expected to do so without complaint or seeking help from others.

I’m one of the fortunate ones. Only 20% of workers in the private sector have access to paid leave; it’s just 5% among lower-wage workers. Unpaid leave is provided to eligible workers through the Family and Medical Leave Act, but exclusions in the law leave out approximately 44% of workers — disproportionately women, people of color, and single parents. Just nine states and the District of Columbia have innovative state programs.
For working daughters, the need to provide care to an aging parent can come at a high cost.
Jennifer Olsen, a friend of mine who is the CEO of the Rosalynn Carter Institute for Caregivers, where I serve on the board of directors, told me that “caregiving and work often collide. Without paid leave or flexible workplace policies, too many of us have no choice but to scale back on work, or to leave the labor force entirely.” A recent survey of caregivers who work full-time conducted for the institute by Public Opinion Strategies showed that a minority of those surveyed have access to paid leave. Two in 10 said they had to quit their jobs in order to care for a loved one.
The result? Each adult over the age of 50 who leaves work to provide care loses more than $300,000 in income and retirement savings. For women, particularly women of color, the costs are higher and the negative effects on their economic security are even more substantial.
This is not only a personal or household issue. It’s also a health issue and an economic issue. AARP estimates that the U.S.’s gross domestic product could grow by 5.5% — that’s $1.7 trillion — by 2030 if caregivers were better supported at work and able to remain in the workforce.
Universal access to paid family and medical leave is an intervention that would make a difference. A national paid family and medical leave program, like the one the House of Representatives, is now considering, would provide up to 12 weeks of paid leave to workers who need to care for a loved one, as well as those who need time for their own serious health issue or to care for a new child. A national paid leave standard would create the same opportunity for workers who do not currently receive paid leave through their employers while also helping to standardize a culture where unpaid family care is valued as it should be.
Another part of the solution is improving access to paid caregiving for sick children and for older adults like my mother by raising the wages and improving the training for paid caregivers through new public investments — and reducing the cost of care to families. Congress is also considering historic funding increases for home- and community-based services to accomplish these twin objectives. In the U.S., 2.4 million workers, disproportionately women, and women of color, provide in-home and community-based care that serves older people and people with disabilities. They deserve fair wages and a career ladder, and the people who rely on them deserve more consistent care from a workforce that is better compensated and more experienced.
Working children like me have struggled with a patchwork of options to ensure that our parents receive care, whether we provide that care at a cost to ourselves and our careers or depend on the labor of professional caregivers. As Congress looks at policies meant to “build back better,” investments in care for older and younger people must be high on the list of priorities and remain that way through the period of intense negotiations to come. Policies that support care, caregiving, and caregivers are not merely “nice to have” and they should not be delayed for another minute.
This a once-in-a-generation opportunity where the political winds and a new pandemic-fueled understanding of the importance of care investments are upon us. Investing in elder care, child care, and paid family and medical leave is an economic imperative for the U.S. and, just as importantly, it is the right thing to do for people who need care and the working people, mostly daughters like me, who care for them.
Paurvi Bhatt is a U.S. health care executive and a member of the board of directors of the Rosalynn Carter Institute for Caregivers.

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