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School's Out: Childcare Needs among Essential Health Care Workers and First Responders
- Across the United States, we estimate about 2.6 million essential health care workers and first responders1 need childcare. For brevity, we refer to them as essential workers. They include 905,000 single-parent workers or workers where both adults in the household work in such an occupation. These workers are affected by statewide school and childcare center closures, but they are essential to combat the COVID-19 pandemic.
- We estimate childcare needs are particularly great among workers in several frontline health care occupations, including registered nurses (776,000 need childcare for their children), nursing assistants (312,000), physicians and surgeons (209,000), and licensed practical nurses (182,000). These numbers reflect the number of workers who need care for their children, not the number of children who need care.
- The need for childcare among essential workers varies widely among states and metro areas. The need ranges among states from 27.2 percent of essential health care workers and first responders in Minnesota (61,000 workers need childcare), to just 8.5 percent in Vermont (2,000 workers need childcare). This issue also affects these workers in current virus hot spots such as the New York metro area (18.4 percent; 155,000 workers need childcare), Seattle (18.9 percent; 24,000 workers need childcare), and New Orleans (17 percent; 9,000 workers need childcare).
- Various U.S. states and local governments have adopted measures to tackle this issue, including easing regulatory restrictions on childcare centers, opening designated childcare centers for essential workers, providing free childcare for these workers, or utilizing their public school infrastructure to provide care.
In an unprecedented situation, almost all states and the District of Columbia have, as of this writing, enacted statewide school closures to reduce the spread of the COVID-19 virus.2 Many have also opted to close childcare centers. However, these closures place a burden on workers in essential occupations, who need to ensure appropriate care for their children. The CDC expects this will lead to a decrease in the available health care workforce, as these workers stay home with their children. In the event of nationwide school closures, one estimate places reductions in key health care personnel between 6 percent and 19 percent.
Many essential workers now face a dilemma of caring for their children or working in increasingly busy and important jobs. This situation jeopardizes the readiness and effectiveness of a share of workers essential to combating the current public health and economic crisis. The CARES stimulus package includes $3.5 billion in Child Care and Development Block Grant funding. Designated within the authorizing language is the intent to support essential workers. In this article, we provide estimates of the number of essential workers with children below the age of 14 for states and metro areas across the country, and we highlight examples of states that have taken steps to address this issue. As states plan for the best and most appropriate use of the CARES childcare funding, these data provide insight on the workforce in need of childcare assistance.
What are the childcare needs among workers in essential occupations?
About 12 million U.S. workers are employed in essential health care occupations or as first responders (hereafter referred to as essential workers).3 About 2.6 million of these workers, 23 percent, need childcare for children under the age of 14.4 Approximately 905,000 workers, about 7.5 percent, are part of a single-parent household or live in households where both adults work in these occupations.5
Across the country, we estimate childcare needs are particularly great among workers in several frontline health care occupations, including registered nurses (776,000 need childcare), nursing assistants (312,000), physicians and surgeons (209,000), and licensed practical nurses (182,000).
Of the 2.6 million essential workers who need childcare, 52 percent need care for children between 5 and 13 years of age; 28 percent need care for children younger than age 5, and 20 percent need both types of care. As states make policy to address childcare needs among essential workers, considerations for both types of care are warranted.
Our estimates show significant variation in essential worker childcare needs between states and regions across the country. For instance, the share of essential health care workers and first responders who need childcare ranges from 27.2 percent of essential health care workers and first responders in Minnesota (or 61,000 workers who need childcare), to just 5.8 percent in Washington DC (or 18,000 of these workers who need childcare). In metro areas across the country, Minneapolis-St. Paul (24.7 percent, or 33,000 of these workers need childcare) and Kansas City (24.2 percent, or 22,000 workers) appear to have particularly great childcare needs among their health care and first responder workforce. This issue also affects current virus hot spots like New York (18.4 percent, or 155,000 workers); Seattle (18.9 percent, or 24,000 workers); and New Orleans (17 percent or 9,000 workers).
Readers can use the tool embedded in this article to explore childcare needs among essential health care workers and first responders in states or metro areas. However, data on individual occupations are not displayed if not enough observations were available. In practice, this means that for smaller metropolitan statistical areas (MSAs), not enough observations were available to provide estimates on childcare needs for workers in most or all individual occupations.
How are some states and local governments responding?
Internationally, the challenge of addressing the childcare needs of essential workers is recognized and addressed by various national governments. Countries such as the United Kingdom and the Netherlands have implemented national policies to determine which parents are essential to combat the virus, and can therefore still make use of schools or childcare centers, despite these institutions' closure for the general public. Presently, in the United States, policy responses vary widely among states.
Some states and localities have taken a range of actions to tackle this problem. These include states and local governments utilizing the public school system infrastructure to provide care; easing licensing regulations for childcare; and/or opening specific centers designated for the children of essential workers. Below is a nonexhaustive list of implemented policies across the United States.6
Methodology for Estimating the Number of Workers with Childcare Needs
We define the need for childcare as an essential occupation worker in the labor force who has at least one child below age 14, which aligns with the federal childcare subsidy regulations. We then come up with two sets of estimates: a conservative estimate that examines households with a single parent or where both parents are employed in an essential occupation, and a “high” estimate that also includes households with multiple working adults. The latter estimate excludes households with at least one nonworking adult, making the assumption that the nonworking adult could take care of children. Other researchers have employed similar methodologies to estimate childcare needs among health care workers and provided estimates on the number of children who would need care. Our approach and analysis is focused on the number of workers who need childcare and the potential impact to this essential workforce if care needs are unmet, as opposed to estimates on the scale of the care needed.
We use the Integrated Public Use Microdata Series' (IPUMS) 2014–18 five-year American Community Survey data to estimate the (weighted) share and number of workers within an occupation who need childcare in both the high and conservative scenarios for states and metro areas where at least 100 observations on workers in an occupation are available. Further, we use these data to break down this share into workers who need: 1) care for children below age 5; 2) school-age care (children between 5 and 14); 3) and those who need both.7
- Several states have exempted children of first responders from school closings. In some cases, such as in Minnesota, New York, North Dakota, Oregon, and Vermont, public schools are directed to provide care for children of essential workers. Other states, such as Alabama, allow for more limited care. Here, school closings do not apply to the children of first responders who are ages 6 through 12. Other states, such as Delaware, New Jersey, Vermont, West Virginia, and Wyoming, have directed or allow childcare centers to remain open only for children of essential workers.
- A few states and cities have set up temporary childcare facilities for children of first responders, including Arizona's Enrichment Centers, Kentucky's Limited Duration Child Care Centers (for children age 12 or younger), and New York City's Regional Enrichment Centers. Other states like Colorado, Michigan, and Utah have set up or encourage public-private partnerships to provide childcare.
- Some states and cities provide free childcare for essential workers or offer supplemental payments to providers. These include Colorado, Maryland, North Carolina, Vermont, West Virginia, and the city of San Francisco. Several states have set up a dedicated phone number and/or website to provide information to essential workers or help them find childcare programs.
- Several states—including Maryland, Michigan, Ohio, and Texas—have eased licensing regulations to expand capacity for childcare services, particularly for children of health care workers or first responders.
Presently, not all states appear to have implemented policies to provide for the care of children in essential occupations who are affected by school and childcare center closures. Additionally, some states appear to have addressed one group of essential occupation workers with childcare needs, such as those with only school-age children, but have not addressed others, such as children younger than 5 who need care. As the burden on our states' and cities' health care services increase, and as an increasing share of health care workers fall ill due to the COVID-19 virus, ensuring that childcare needs do not inhibit these workers, and other first responders, from doing their job will become increasingly important.
By Mels de Zeeuw, senior CED analyst and Brittany Birken, principal CED adviser
1 In our analysis, we classified the following occupations or occupation groups as "essential health care workers and first responders": ambulance drivers and attendants, except emergency medical technicians; cardiovascular technologists and technicians, clinical laboratory technologists and technicians; correctional officers and jailers; detectives and criminal investigators; emergency management directors; emergency medical technicians and paramedics; firefighters; first-line supervisors of correctional officers; first-line supervisors of firefighting and prevention workers; first-line supervisors of police and detectives; health care diagnosing or treating practitioners, all other; health care social workers; licensed practical and licensed vocational nurses; medical assistants; medical and health services managers; medical records specialists; miscellaneous first-line supervisors, protective service workers; nurse anesthetists; nurse practitioners, and nurse midwives; nursing assistants; orderlies and psychiatric aides; pharmacists; pharmacy technicians; phlebotomists; physician assistants; physicians and surgeons; police officers; registered nurses; respiratory therapists; and surgical technologists.
Our selected occupations are by no means exhaustive. Other types of workers can be considered "essential," and definitions of essential or emergency workers vary by state. For example, Vermont and Minnesota additionally classify workers in grocery stores as "emergency workers" to preserve food supply chains. Other estimates could include occupations such as childcare providers, educators, truckers, and those employed in occupations in agriculture and food production.
2 As of this writing, Iowa, Maine, and Nebraska have not mandated statewide school closures, though local governments within these states have moved to close educational institutions.
3 These and other estimates are based on the analysis of Steven Ruggles, Sarah Flood, Ronald Goeken, Josiah Grover, Erin Meyer, Jose Pacas, and Matthew Sobek. IPUMS USA Version: 10.0 2014–18 American Community Survey five-year estimates. Minneapolis, MN: IPUMS, 2020. https://doi.org/10.18128/D010.V10.0. For more information, see the methodology section.
4 Bayham and Fenichel (2020) conducted a similar analysis and used 2018–20 Current Population Survey data to find that "29 percent of healthcare worker households have an obligation to care for a child between 3 and 12 years of age."
5 See methodology at the end of this article.
6 The CDC has issued guidance on childcare provision and K–12 schools.
7 One caveat is that the ACS microdata do not provide information on households that have a need for childcare, but address it by using more informal sources, such as friends or family members, as opposed to formally licensed childcare centers or in-home providers. In a 2009 paper, Lempel, Epstein, and Hammond use the 2004 Survey of Income and Program Participation to estimate that 57 percent of households with children under the age of 15, and where every adult is working, arrange some form of informal childcare, including a babysitter, another adult, a family daycare provider, or the child takes care of him- or herself. The authors did not provide information on how this share varies by geography and occupation. However, the availability of such informal childcare arrangements might currently be more limited due to state or local shelter-in-place orders or adherence to social distancing. This is particularly the case when grandparents can no longer take care of grandchildren due to the risk of exposure.