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bureau of labor statistics
America Runs on Care Work, and I’m Tired of Pretending Otherwise
The labor that sustains human life gets pushed to the margins, while the labor that scales software gets paraded on magazine covers.
Mar 08, 2026
A few days ago, I stared at a federal bar chart on my laptop and felt my stomach drop. I started asking people a party-trick question: What’s the biggest occupation in America? Almost everyone guessed something visible: teachers, retail, fast food, office work. That’s what our culture trains us to notice.
Then I pulled up the Bureau of Labor Statistics’ (BLS) “largest occupations” data, and the answer was sitting there in plain English: Home Health and Personal Care Aides, 3,988,140 people.
I’m not reading that as an abstract statistic but something I see daily through my work in running CareYaya, a social enterprise that helps families find affordable in-home care support. I hear the voices behind those numbers every day: the exhausted daughter trying to keep her job, the older man determined to stay in his own house, the care aide who shows up anyway even when her own life is fraying.
What hit me wasn’t just the size of the workforce, but the silence with which society treats caregivers.
Care work sits at the intersection of everything America avoids looking at directly: aging, disability, dependence, death, and the truth that every “independent” adult is one accident, cancer, or dementia diagnosis away from needing help.
In a country that can’t stop talking about “the economy,” I rarely see the economy described the way it actually functions at street level. I see caregivers keeping older adults safe so that family members can work, so the bills get paid, so other industries keep humming. I see care work acting like the hidden scaffolding under everything else.
And, I see how quickly that scaffolding gets treated as disposable labor.
When I talk to families, they often whisper about their difficulties getting care support almost like they’re confessing a moral failure. “We’re trying,” they tell me, as if the need for help is some private weakness instead of a predictable part of aging or serious illness. When I talk to care aides, they talk about the stress from the care work. They talk about rushing between clients. They talk about loving the work and sometimes still not being able to make rent.
PHI’s snapshot of the direct care workforce puts numbers to what I keep hearing, that median annual earnings for direct care workers were just $25,015. I read that figure and think about what it really means in 2026 America: The largest job category in the nation is, effectively, a low-wage backbone.
I also think about who gets stuck holding the bag. Care work is still treated as “women’s work” in the cultural imagination, and that bias leaks into policy, pay, and prestige. I watch the same pattern repeat: The labor that sustains human life gets pushed to the margins, while the labor that scales software gets paraded on magazine covers.
What makes me angrier is that this isn’t a small sector we can ignore until later. The BLS projects 17% growth from 2024 to 2034 for home health and personal care aides, with about 765,800 openings each year on average. This is not a “future” problem but rather a present problem that is going to grow much worse, faster.
And yet I keep watching public conversations drift toward fantasy. I hear endless speculation about AI replacing workers, while the largest workforce in America can’t even get a stable ladder, a living wage, or basic respect. I hear investors pitch “aging tech” like it’s a consumer gadget category, while the core issue is whether a real human being can afford to do this work and stay in it.
I don’t think this is an accident, but rather, a choice embedded in our system.
Care work sits at the intersection of everything America avoids looking at directly: aging, disability, dependence, death, and the truth that every “independent” adult is one accident, cancer, or dementia diagnosis away from needing help. So we do what societies often do with uncomfortable truths. We outsource them, we underpay them, and we call them “personal responsibility.”
Even the funding structure says it all. Medicaid is the main payer of long-term services and supports in the US, and a recent Centers for Medicaid and Medicare Services brief says so plainly: “Medicaid is the largest payer for long-term services and supports (LTSS) in the United States.” I read that line and think about the whiplash families face when they confront a vast public health need paired with political rhetoric that treats caregivers and recipients like line items to be squeezed.
So when I’m asked what to do, I start with a moral stance and then I get practical.
I want a country that pays the people who keep elders safe, like they truly matter. I want Medicaid rates and payment models that stop forcing providers into churn, and stop forcing workers into poverty. I want training and advancement pathways for care workers, and I want the caregiving workforce to have real power: bargaining power, scheduling power, and dignity at work.
I also want us to stop acting surprised when the care workforce pipeline breaks. If the biggest job in America is care, then the “care crisis” isn’t a niche issue, but a core labor rights issue; a public investment issue; and an economic issue that’s as critical as housing, wages, and healthcare.
When I look back at that BLS bar chart, I don’t see a pop-quiz type question anymore. I see millions of workers holding up millions of families. I see the work that makes the rest of American life possible.
And I can’t unsee the insult of how little we talk about it.
If I want anything from readers, it’s this: I want you to say the name of the job out loud, and then demand that we build an economy that treats it as essential, because it is.
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'Dismal' Employment Report Shows Trump Economy Lost 92,000 Jobs in February
“Month after month, the data shows Donald Trump’s economy is failing American families.”
Mar 06, 2026
President Donald Trump's self-proclaimed "greatest" economy in history took another major blow on Friday as the US Bureau of Labor Statistics revealed that the American economy lost 92,000 jobs in February.
Heather Long, chief economist at Navy Federal Credit Union, described the report as "dismal," while noting that the US economy as a whole has actually lost jobs since Trump announced his "liberation day" global tariffs in April 2025.
"Total job gains since from May 2025 to February 2026 are now -19,000," she wrote. "Companies are not hiring in the face of all of these headwinds and uncertainty. And even healthcare is starting to slow down."
University of Michigan economist Justin Wolfers argued that "the economic story just changed dramatically" because of the jobs report, which also showed downward revisions to the estimated jobs created in December and January.
"Recession questions are back on the menu," he said.
Mike Konczal, senior director of policy and research at the Economic Security Project, zeroed in on the surprise loss of healthcare jobs in February as particularly concerning given that healthcare has been the lone industry to consistently add jobs in recent months.
"This is the first month in years where healthcare jobs went negative, really changing the dynamic," he said. "Cuts to Medicaid, cuts to ACA... suddenly the thing that was 187% of private jobs since liberation day, holding it together, may be giving out?"
Rep. Brendan Boyle (D-Pa.), ranking member of the House Budget Committee, said that the terrible jobs report was a direct reflection of Trump's economic mismanagement.
"Month after month, the data shows Donald Trump’s economy is failing American families," Boyle said. "The job market is weakening, costs remain high, and Trump’s illegal tariff taxes continue to hurt businesses and workers. Trump and his allies in Congress know their agenda isn’t working. Instead of helping working families, they are pushing more tariff taxes and more tax breaks for billionaires. It is clear Republicans in Washington simply do not care about working families."
Alex Jacquez, chief of policy and advocacy at Groundwork Collaborative, declared that "the deterioration in the labor market is visible from space," and pinned the blame on "Trump’s reckless economic agenda."
"As the president piles on blanket tariffs and oil prices soar," Jacquez said, "today's report confirms he's sent the economy straight into a stagflation spiral."
University of Pennsylvania economist Heather Boushey said weakness in the US economy had been evident for several months, although Friday's jobs report showed the largest job losses of any month during Trump's second term.
"Today's data should not come as a shock as there have been signs of weakening in the US labor market for quite some time," she said. "The Trump administration’s focus on undermining the US economy rather than investing in America may be coming home to roost."
Daniel Hornung, policy fellow at the Stanford Institute for Economic Policy Research, said that the bad jobs report will make things even harder for the US Federal Reserve when it comes to making interest rate cut decisions.
"This morning’s report... comes at a difficult moment, with inflation still above target and an oil price shock threatening to raise inflation further," Hornung said. "The report complicates the Fed’s efforts to keep both unemployment and inflation low, and it makes it difficult for the [Trump] administration to argue heading into the midterms that their policies are leading to the kind of growth or improvement in living standards that they’ve long promised."
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Weak US Jobs Report Shows 'Bleak Economic Reality' for Workers Under Trump
There has been "almost no hiring since April," observed one economist.
Jan 09, 2026
The US labor market appears to be running on fumes under President Donald Trump, as the latest jobs report revealed that the American economy added just 50,000 jobs in December, below economists' consensus estimate of 55,000 jobs.
The report, released on Friday by the Bureau of Labor Statistics (BLS), also found that the US economy as a whole created just 584,000 jobs in 2025, which is less than a third of the 2 million jobs created in 2024 during the last year of former President Joe Biden's term.
The 2025 figure also marked the lowest number of annual jobs created since 2020, when the economy was shut down due to the Covid-19 pandemic.
Fox Business anchor Cheryl Casone couldn't put a happy spin on the jobs report after its release, as she noted that the gains of just 37,000 private-sector jobs on the month were "much weaker than expected."
"Private sector payrolls coming in much weaker than expected" -- Maria Bartiromo and company cope with an underwhelming December jobs report (wait for Stephen Moore's bonkers commentary at the end) pic.twitter.com/C5D8qu5h8f
— Aaron Rupar (@atrupar) January 9, 2026
Digging further into the report, Bloomberg economic analyst Joe Weisenthal observed on X that manufacturing employment has been hit particularly hard in recent months, despite Trump's vow that his tariffs would lead to a manufacturing revival in the US.
"It's not just that total manufacturing employment is shrinking," he explained. "The number of manufacturing sub-sectors that are adding jobs is rapidly shrinking. Of the 72 different types of manufacturing tracked by the BLS, just 38.2% are still adding jobs. A year ago it was 47.2%."
Heather Long, chief economist at Navy Federal Credit Union, noted that the weakness in the labor market extends beyond the manufacturing sector, as there has been "almost no hiring outside of healthcare and hospitality" since the start of Trump's second term.
Richardson also observed that "there was almost no hiring since April" of last year, when Trump announced his "Liberation Day" tariffs that sent shockwaves through the global economy.
Economist Dean Baker, co-founder of the Center for Economic and Policy Research, zeroed in on downward revisions in prior jobs reports, reinforcing that the current labor market is anemic.
"With the revisions, the average for the last three months was a fall of 22,000 [jobs]," Baker explained. "The healthcare and social assistance sector added an average of 49,000 jobs over this period, which means that outside of healthcare the economy lost an average of 71,000 jobs in the last three months."
Alex Jacquez, chief economist at Groundwork Collaborative, said the jobs report reflected a "lifeless economy," and he pinned the blame on Trump and his trade policies as a top reason.
"Working families face sluggish wage growth, fewer job opportunities, and never-ending price hikes on groceries, household essentials, and utilities," said Jacquez. "Despite the president's endless attempts to deflect and distract from the bleak economic reality, workers and job seekers know their budgets feel tighter than ever thanks to Trump’s disastrous economic mismanagement."
Economist Elise Gould of the Economic Policy Institute took a look at the jobs numbers and concluded the US labor market now is far weaker than the one Biden left Trump nearly one year ago.
"The slowdown in job growth this year is stark compared to 2024," Gould wrote on Bluesky. "The average monthly gain was only 49,000 in 2025 compared to 168,000 in 2024. Over the last three months, average job growth was actually negative, meaning there are fewer jobs now than in September."
Correction: An earlier version of this story misidentified the Navy Federal Credit Union's chief economist. That error has been corrected.
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