The history of racism and structural racism in the United States has resulted in the devaluing of direct care workers and therefore in their low wages. Direct care workers are majority people of color and women and are paid very low wages and live in disadvantaged communities. According to the California Employment Development Department, the mean hourly wage for home health and personal care aides (called home care workers for short) was $16.27 in the first quarter of 2022. According to PHI, 49% of homecare workers in California rely on Medicare, Medicaid, or other public coverage, and 48% earn less than 200% of the federal poverty guideline levels.

Direct care is the occupation creating the most jobs in the state and in the nation and represents the largest industry in California for growth in terms of worker numbers and the largest employer of low wage workers and of women. In 2021, 717,220 home and personal health aides and 94,450 nursing assistants comprised the direct care workforce in California. 80% of direct care workers are women, 78% are people of color, and 48% are immigrants, according to PHI. According to the Bureau of Labor Statistics and Employment Projections, between 2018 and 2028, Home Health Aide and Personal Care Aide are projected as the 3rd and 4th fastest-growing jobs nationally, respectively. California’s population is expected to double between now and 2030 with the coming senior boom as the post-war generation grows into old age,  and PHI projects that an additional 232,500 direct care workers will be needed in the state by 2030. California is already currently experiencing a shortage of 500,000 healthcare workers to meet the needs of the state’s current senior population.  

Throughout California, 40,000 family child care providers (FCCPs) take care of children in their homes. They serve families who receive childcare subsidies from the state and low-income families in the communities where they live who are majority black indigenous and people of color (BIPOC). FCCPs educate the children in their care, from infant to kindergarten children and older, including children who are in their care before or after their TK or pre-K program or elementary school.

Family child care providers offer a critical service to working parents in under-resourced communities who often work irregular schedules and must drop off their children early in the morning or pick them up late. These parents are not able to both take their children to school and pick them up. 

In order to be able to transport these children, family child care providers are required to have a certified assistant so that one of them can stay with the other children at the provider's home while the other conducts the transportation. However, family child care providers are finding it more difficult now to hire and retain assistants because since they serve low-income families, they do not have sufficient funds to pay a living wage to their assistants.