Study Finds Few COVID-Displaced Workers Re-Employed in Direct Care

October 13, 2021

CONTACT: Robert Espinoza
PHI Vice President of Policy
Phone: 718-928-2085
Email: [email protected]


Study Finds Few COVID-Displaced Workers Re-Employed in Direct Care

A new report finds that few workers displaced by COVID-19 from occupations with similar skills as required in direct care jobs filled job openings in direct care.

NEW YORK — A new study by PHI and the Health Workforce Research Center on Long-Term Care at the University of California, San Francisco finds that many COVID-displaced workers were in occupations with similar entry-level requirements as direct care, but that few took jobs in direct care, where there continues to be a worsening staffing shortage.

These results are detailed in a new report, Workforce Displacement and Re-Employment During the COVID-19 Pandemic: Implications for Direct Care Workforce Recruitment and Retention, which examines workforce displacement and re-entry during the COVID-19 pandemic among direct care workers and workers from similar entry-level occupations, such as food preparation and serving, office and administrative support, and others.

The purpose of this study was to understand whether and how new workers were recruited into direct care jobs during this crisis, which has implications for how the long-term care field could fill job openings in the future.

Direct care workers, defined as home care workers, residential care aides, and nursing assistants, ensure that older adults and people with disabilities have the support they need across care settings. These jobs often have inadequate compensation, limited training and advancement opportunities, long-standing gender and racial inequities, and a general lack of recognition and support.

According to PHI, the nation’s leading expert on the direct care workforce, long-term care employers will need to fill 7.4 million job openings in direct care from 2019 to 2029, including 1.3 million new jobs to meet rising demand, and another 6.1 million job openings to replace workers who leave the labor force or transfer to new occupations, often in search of higher wages or safer working conditions.

“This research provides new insights on a long-standing question that has become even more urgent in the last two years: how do we recruit more workers into the direct care workforce to meet growing demand and avoid future tragedies?” said Jodi M. Sturgeon, president of PHI.

Joanne Spetz, associate director for research at the Health Workforce Research Center on Long-Term Care at the University of California, San Francisco and one of the three co-authors of this report, added, “The fact that few workers who lost jobs during the pandemic moved into open direct care jobs highlights the need to improve direct care jobs so they attract well-skilled and dedicated people to care for people who need their services.”


The study examines three primary questions, starting with: How many direct care workers and workers from other occupations with similar entry-level requirements became unemployed during the first three months of the COVID-19 pandemic?

The second question explored the extent the which the knowledge, skills, work activities, and work context of displaced workers’ previous occupations were aligned with those of the three direct care occupations.

And, the third question asked: How many displaced workers re-entered the workforce (including into direct care jobs) within the following year, and from which previous occupations?

Data from the U.S. Census Bureau’s Current Population Survey and the Occupational Information Network [O*NET] were used to address these questions.

According to Workforce Displacement and Re-Employment During the COVID-19 Pandemic:

  • 13.7 million U.S. workers were displaced from occupations with similar entry-level requirements to direct care during the first three months of COVID-19 in 2020.
  • Sixty-seven percent of COVID-displaced workers (9.2 million workers) were displaced from five major occupational groups: food preparation and serving-related occupations (3.1 million workers), office and administrative support occupations (2 million workers), sales and related occupations (1.6 million workers), transportation and material moving occupations (1.6 million workers), and production occupations (1 million workers).
  • One year later, in early 2021, 66 percent of those COVID-displaced workers (9.1 million workers) had re-entered the workforce, leaving 4.6 million displaced workers still out of work.
  • Two occupational groups similar to direct care had large numbers of displaced workers who did not re-enter the workforce: food service and serving occupations (1.9 million long-term displaced workers) and office and administrative occupations (1.2 million long-term displaced workers).
  • Across these occupational groups, women and people of color were more likely to be displaced and less likely to re-enter the workforce.
  • Four percent of direct care workers were displaced during the second quarter of 2020, and an immeasurably small number of displaced workers (from direct care or any other occupation) were re-employed into direct care.
  • Overall, re-employed workers tended to earn higher wages and were more likely to work full time than direct care workers.

"It's clear from this study that the direct care job should be made more attractive to workers, and we all must find new ways to recruit specific populations into these jobs," said Stephen McCall, data and policy analyst at PHI and a co-author of the report.


The report lays out various opportunities to strengthen the direct care workforce during and beyond the COVID-19 pandemic, including raising compensation for direct care workers and improving the overall quality of these jobs. According to the report’s authors, poor job quality in direct care helps explain why so few COVID-displaced workers chose to enter this workforce.

Other recommendations from the report include developing tailored recruitment strategies that reach job candidates from occupations similar to direct care, creating workforce supports specific to people of color and people with family caregiving responsibilities, and better supporting new hires as they transition into direct care roles, to address the problem that many direct care workers leave their jobs within the first few months of employment.

"The overarching lesson from this report is our country’s leaders will need to transform the direct care workforce to ensure that employers can fill these jobs—now and in the decade ahead," said Kezia Scales, director of policy research at PHI and one of the report’s co-authors.

Read the full report.