Paid adult care work jobs are expected to increase substantially in the coming years, due to both an aging population and a comparatively low risk of automation for many of these jobs. These jobs, however, are among the lowest quality occupations in the U.S. labor market, with paid adult care workers facing low earnings, limited access to benefits, high rates of injury on the job, and scheduling unpredictability. Improving the quality of paid adult care work jobs is essential to ensuring high quality care and promoting the economic security and well-being of care workers, who are predominantly women, especially women of color. Strengthening the quality of paid care jobs, however, represents a significant challenge that would require increasing society’s valuation of care work and raising wages in a persistently underfunded industry.

Researchers and advocates are exploring many strategies for improving the quality of paid care jobs, including unionizing care workers and developing career ladders, among others. In addition to these well-developed strategies, some are exploring how technological advancements might transform the paid care industry in both positive and negative ways—by opening up new opportunities for improving the quality of paid care jobs as well as potentially creating challenges to increasing job quality among the care workforce.

This report examines the potential impact of changes in job distribution and the growth of paid adult care work on women’s employment quality in the future. It analyzes the paid adult care workforce focusing on three care occupations—home health care aides and personal care aides (jointly referred to as “home care aides” and certified nursing assistants (CNAs), who work in institutional settings such as nursing homes and hospitals. It then explores key markers of job quality, considers how the low quality of care jobs affects care recipients and workers, and examines the potential effects of technology on care jobs in the future. Drawing on a literature review, expert interviews, and analysis of data from the U.S. Census Bureau and National Health Interview Survey, the report outlines the findings below.