One of the country’s fastest-growing jobs — home health and personal care aides — is also among its lowest-paying.
About 4 million people were employed in the field in 2024. Like many other workers in the most common occupations, they earned below-average wages, earning just $16.78 per hour — about $2 more than fast-food workers — for a role that can involve bathing elderly or disabled clients and helping them use the bathroom, among other daily living tasks.
But the need for direct care workers is more intense than their wages suggest, and that demand isn’t going anywhere. The home health aide field, already the country’s single-largest occupation, is expected to grow by 17% over the next decade, adding nearly 740,000 workers as the population ages. That growth far outpaces roles that similarly do not require a college education but typically pay better, including customer service representatives, secretaries, and construction laborers.
In fact, as the economy barely managed to eke out any job gains last year, employment in the subsector largely made up of home care aides grew by 8.8% from the year prior, or more than double the pace of the next-fastest-growing category, according to the Indeed Hiring Lab.
These factors encapsulate a core vulnerability of the current job market, where AI is reshaping many fields and threatening to gut higher-paid, white-collar roles.
“I think it is notable to point out that the sectors that are losing jobs, many of them are higher-wage sectors than this subsector,” Laura Ullrich, the director of economic research in North America at the Indeed Hiring Lab, told Yahoo Finance.
“All of them are, actually.”
Read more: Worried about job security? Take these 5 steps now to protect your finances.
Even as demand for home health aides is expected to grow, however, the supply of workers might not keep pace.
Home care workers are largely women, and about 1 in 3 are immigrants, according to data from PHI, a research and advocacy group. Because the jobs are difficult and wages are low, turnover is high. For health insurance, many aides also rely on the same government program that predominantly funds their employment: Medicaid.
States have the option to use Medicaid to cover home- and community-based services, versus the services Medicaid must cover, like hospital and nursing home care. That discrepancy leaves funding for home-based care vulnerable when budget constraints arise. At the same time, Medicaid’s reimbursement rates to providers are low compared to other types of insurers, which helps depress pay.
That in turn makes it difficult to recruit workers despite a rising need.
“In just about every state, direct care workers’ wages are lower than other entry-level jobs like hospitality and retail,” said Amanda Rae Kreider, a health economist at the University of Pittsburgh. “They also often have no paid time off or insurance benefits.”
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The One Big Beautiful Bill Act’s cuts to Medicaid, combined with a Trump administration proposal to reverse basic minimum wage and overtime protections for direct care workers, could worsen the problem, with direct care jobs simply unable to compete with higher-paid work, advocates and experts say. Declining immigration may also reduce the pool of available workers.
“There’s a long history of exploitation of care workers in this country,” said Leslie Frane, executive vice president at the SEIU, a labor union representing 2 million workers, about half of whom are in healthcare. “Some of the history has to do with racism and sexism — the fact that this work is done overwhelmingly by women, majority by women of color, with a significant percentage done by immigrants.”
Home care workers have been pushing state by state for collective bargaining rights to raise wages, since “domestic work” was historically excluded from federal labor laws surrounding workplace organizing. Just this month, the Virginia legislature passed a law enabling public sector collective bargaining, putting an estimated 28,000 home care workers on the cusp of winning the right to form a union and negotiate for higher wages, according to the SEIU.
But as it stands right now, home care workers typically take the job because open roles are readily available or because they’re passionate about the field. And passion can only contribute so much to job growth.
“Frankly, workers can’t afford to keep doing this work for long,” Frane said.
The challenges in recruiting more home care workers could have knock-on effects for the broader labor force, said Matthew Nestler, senior economist at KPMG.
“It will mean more informal, unpaid caregiving by family members, which will then mean that adult children, grandchildren, relatives will pass up career opportunities, they may reduce hours, and ultimately — as a last resort if they can’t make it work any longer — they will have to leave the labor force for some period,” Nestler said.
Emma Ockerman is a reporter covering the economy and labor for Yahoo Finance. You can reach her at emma.ockerman@yahooinc.com.
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