NCPA - National Center for Policy Analysis

Caregiving For Love Or Money -- Or Both?

January 22, 2001

Unpaid household and family work -- called nonmarket activities -- still account for between 40 and 60 percent of the total value of all U.S. output, based on the equivalent market value of the labor involved. But as women have moved increasingly into the world of paid work, many tasks formerly performed by family members or intimates have become market activities -- such as child care and nursing care for the elderly.

  • In 1900, only 4 percent of the population was employed in professional care services.
  • By 1998, nearly one-fifth of the paid labor force was engaged in a professional care industry.

The shift of caring activity from family to markets represents an enormous social change. On the positive side, women have greater freedom to choose their employment. However, markets on their own are unlikely to provide the particular volume and quality of "real" care that society desires for children, the sick and the elderly. For instance, according to Consumer Reports, about 40 percent of nursing homes repeatedly fail to pass the most basic health and safety inspections. And turnover rates among nursing home aides is high, amounting to almost 100 percent within the first 3 months.

A major concern is that markets may increase freedom of choice regarding whether or not to become a caregiver primarily for middle-class, white, U.S.-born women, while worsening, or at least not improving, the lot of the other groups.

  • Even today, women are concentrated in the professional care industries -- of all women in paid employment, 31.3 percent were employed in these industries in 1998.
  • And about 30 percent of all women workers are still involved in homemaking.

Source: Nancy Folbre and Julie A. Nelson, "For Love or Money - or Both?" Journal of Economic Perspectives, Fall 2000.


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