Investing in the provision of care: a social, public health and economic issue

An working daughter, I recently entered a new uncertain phase of my career: taking paid leave for my critically ill mother. Without my own children, I never needed to consider paid time off. This new role in caregiving makes me a square of the cultural norms and values ​​ingrained in me as a second generation South Asian immigrant and as an only child with my leadership role in American businesses.

Although I have juggled responsibilities for years, this one is different. The pandemic has sharpened my attention to the importance of home care. Providing home care reinforced the lessons learned from my public health training on health fragility. Balancing this work became a tedious exercise and prompted an important decision: My mom had looked after me all her life, and now was the time for me to take care of her.

In the United States, 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, regardless of their status. ‘use. Caring for a loved one is hard enough without the added mental and emotional strain of knowing that you are expected to do so without complaining or asking for help from others.


I am one of the lucky ones. Alone 20% of workers in the private sector have access to paid holidays; it is only 5% among low-wage workers. Unpaid leave is granted to eligible workers through the Family and medical leave law, but exclusions in the law leave out about 44% of workers – disproportionately women, people of color and single parents. Only nine states and the District of Columbia have innovative state programs.

For working girls, the need to care for an aging parent can come at a high cost.


Jennifer Olsen, a friend of mine who is CEO of Rosalynn Carter Institute for Caregivers, where I sit on the board, told me that “caregiving and work often collide. Without paid time off or flexible work policies, too many of us have no choice but to reduce our work or exit the workforce altogether. ” A recent poll of full-time caregivers conducted for the institute by Public Opinion Strategies showed that a minority of respondents have access to paid leave. Two in ten said they had to quit their jobs to care for a loved one.

The result? Every adult over 50 who leaves work to provide care loses over $ 300,000 in income and retirement savings. For women, especially women of color, the costs are higher and the negative effects on their economic security are even more substantial.

It is not just a personal or domestic matter. It is also a health problem And one economic problem. The AARP estimates that the gross domestic product of the United States could increase by 5.5% – or $ 1.7 trillion – by 2030 if caregivers were better supported at work and able to stay in the workforce .

Universal access to paid family and medical leave is an intervention that would make a difference. A national program of paid family and medical leave, like that of the House of Representatives now considering, would offer up to 12 weeks of paid leave for workers who have to care for a loved one, as well as those who need time for their own serious health problem or to care for a new child . A national standard on paid time off would create the same opportunity for workers who currently do not receive paid time off through their employers, while helping to normalize a culture where unpaid family care is properly valued.

Another part of the solution is to improve access to paid care for sick children and for the elderly like my mother by increasing wages and improving the training of paid caregivers through new public investments – and reducing the cost of care. cost of care for families. Congress is also considering historic funding increases for home and community services in order to achieve these two objectives. In the USA, 2.4 million workers, disproportionately women and women of color, provide home and community care that serves the elderly 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 better paid, more experienced workforce.

Working children like me have struggled with a patchwork of options to ensure that our parents receive care, that we provide that care at a cost to ourselves and our careers, or that we depend on the work of caregivers. professionals. As Congress considers policies to “build back better”, investments in care for the elderly and young must be high on the priority list and remain so during the period of intense negotiations ahead. Policies that support care, caregiving, and caregivers aren’t just “nice to have” and they shouldn’t be delayed for another minute.

A unique opportunity in a generation where political winds and a new pandemic-fueled understanding of the importance of investments in care are upon us. Investing in elderly care, child care, and paid family and medical leave is an economic imperative for the United States and, just as important, it is the right thing to do for the people who need it. care and workers, mostly girls like me, who care. for them.

Paurvi Bhatt is an American healthcare executive and a board member of the Rosalynn Carter Institute for Caregivers.

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