Essentially Expendable: America’s Undervalued Front-line Heroes

The COVID-19 pandemic has inspired an outpour of appreciation towards the country’s front-line workers such as doctors to nurses, through public displays of appreciation in the forms of street parades, free coffee, and snacks for postal workers. Although doctors and nurses deserve our respect and praise, they are not the only healthcare workers who are risking their lives on the front lines. In fact, doctors and nurses only represent 20% of all essential health workers whereas health-support workers make up the remaining sector. Of these healthcare front-line workers, women comprise the majority of healthcare practitioners (75%), although the majority of doctors are men. Furthermore, women represent an even larger proportion of health-support workers (86%) and the majority of health-support workers are non-white (54%, including 25% black and 19% Hispanic).

More often than not, these underpaid and undervalued essential health workers are overlooked, even though the World Health Organization (WHO) has declared them as "the most valuable resource for health.” They work alongside high-paid doctors and nurses, all risking their lives during the pandemic — but with far less prestige and pay.

As a result, despite being declared "essential,” many front-line workers end up feeling overlooked, deprioritized, and even expendable. These 7 million low-wage essential workers can be placed into three categories:

• Health care support workers who assist health care providers such as physicians and nurses in providing patient care. These roles include medical assistants, phlebotomists, pharmacy techs, laboratory assistants, and orderlies.

• Direct care workers such as nursing assistants and at-home personal care aides who assist those with cognitive or physical disabilities (PHI).

• Health care service workers such as janitors, housekeepers, and food service workers employed in hospitals and nursing homes.

The median wage for these occupations in 2019 was $13.48 per hour — well short of the national living wage of $16.54. In addition, these wages are not even close to comparable to the median pay of doctors which is over $100 an hour, and nurses with an average of $35.17 an hour. These wages are so low that 20% of these undervalued workers live in poverty and more than 40% rely on some form of public assistance. In addition, 76% of these employees are women and these occupations are also disproportionately workers of color. Similar to other low-income jobs where women of color are concentrated, many of these occupations do not provide valuable benefits which pose an even greater risk to workers’ lives.

Despite being undervalued, these healthcare supporters play a vital role in the critical infrastructures within our communities. It is important for policymakers, employers, and the general public to understand the importance of these low-wage essential workers during COVID-19 and beyond. Policies such as providing life-saving personal protective equipment, including surgical masks, isolation gowns, gloves, face shields, and N95 respirators, must be the first priority to keep everyone, especially these overlooked essential workers, safe. Proper compensation or hazard pay should also be provided to outweigh the extremely low pay that health care support, service, and direct care workers earn. Although the House of Representatives passed the HEROES Act introduced on May 15th, which includes $200 billion for hazard pay for essential workers, U.S. lawmakers have not passed hazard pay into law.

Despite the hardships and health risks, millions of essential front-line workers continue to do their jobs. The COVID-19 pandemic exposed the systemic issues within the medical-industrial complex, ushering in a need for systemic solutions such as hazard pay or Universal Basic Income to prevent our most vulnerable from being subject to dire working and health conditions. It is up to policymakers, employees, and us to acknowledge and understand the value these unsung heroes provide to maintain stability during COVID-19 and beyond.