Beyond Bridges: Our Nation Needs a Human Infrastructure Upgrade

Whose role is it to provide care?

By framing the infrastructure plan beyond roads, bridges and ports, the Biden administration is asking our nation to pause and consider whose role it is to provide care.

The pandemic uncovered a fact that most of us have known all along: our nation is not set up to support a reality in which most citizens, particularly women, can provide care for their families and earn a living wage. In fact, over 5 million women left the workforce during the pandemic, with women of color suffering the greatest proportional job losses. But the pandemic and the needs of our nation’s aging population haven’t spared men either. Take, for example, consider Dexter’s situation.

In Dexter’s role as vice president of a shopping mall, he managed big staff and budgets. When his elderly mother started to fall repeatedly, he had no choice but to step down from his executive job to care for her. The competition for quality private caregivers was intense and expensive because the talent pool for home health aides (also called personal-care aides or certified nursing assistants) was shallow. His mother refused the option of an assisted-living facility or nursing home, and Dexter, with no spouse or siblings to turn to, paused his career and became a caregiver for a whole year.

Dexter’s story is not unfamiliar. Across the country, Americans have left work to care for their aging parents or children. And, as we look forward into the future, many more of us will soon be in Dexter’s shoes. The fact is that our nation’s aging population is expected to double in the next 20 years, with many of our elderly suffering from multiple chronic health conditions including dementia and diabetes. Harried families will carry more of the burden as health systems increasingly favoring care moving into the home. Meanwhile, even before adding on the cost of elder care, households with children use a sizable portion of their paycheck for expenses ranging from daycare costs to college debt.

This pandemic has created a care quandary many did not previously want to acknowledge. It’s time to reimagine a society in which our infrastructure does not require our able-bodied citizens to choose between their career and their families. If we want to emerge from the pandemic stronger and better positioned to take care of our young, our elderly, and our vulnerable loved ones, the nation must relook at and upgrade our human infrastructure.

How do we fix this? Biden’s plan starts the conversation. We must invite solutions that restructure the economy of healthcare — i.e., home caregivers are doing important work but being paid too little to make a decent living. On my WorkforceRx podcast, CCA Global CEO Howard Brodsky recommends leveraging worker co-ops as an economic structure to put more income into the pockets of the workers and make these critical jobs more attractive. We also need to, as a nation, facilitate more robust technology solutions. Dexter, for example, wanted an app that could let him know whether his mother had eaten or had left the house, which would give him piece of mind when he is able to return to work. Finally, an investment in education and training is paramount to ensure a quality and inclusive workforce to provide care in the home.

History has shown that investments in physical infrastructure yield gains for generations to come. We know that building roads, bridges, and dams can transform a nation and bring jobs and stability to communities. The same will be true for investment in our nation’s most precious resources — our people.

Van Ton-Quinlivan is CEO of Futuro Health, whose mission is to grow the health and wealth of communities by growing the largest network of allied health workers. Her distinguished career spans the private, public, and nonprofit sectors. Van is former executive vice chancellor of the California Community Colleges and a White House Champion of Change.

Catalyst & national #wkdev thought leader. CEO @Futuro_Health. Former Executive Vice Chancellor @CA Community Colleges. White House Champion of Change.