Unionization and employment in the public sector are linked to significantly lower turnover among direct care workers, according to a UCLA-led study announced Wednesday.
Researchers said they analyzed data from more than 18,000 direct care workers between 2009 and 2024, including home care aides and nursing assistants, and found that unionized workers were less likely to leave the workforce than their non-union counterparts.
Overall, 37% of unionized workers exited the field, compared to 45% of non-union workers, according to the study published in JAMA Network Open, a peer-reviewed medical journal. The trend held across employer types, including both for-profit and non-profit organizations.
“Direct care workers provide essential daily care for millions of older adults and people with disabilities, but very high levels of worker turnover make it increasingly difficult for people to receive the consistent care they need,” study lead Dr. Geoffrey Gusoff, assistant professor of family medicine at the David Geffen School of Medicine at UCLA, said in a statement.
Researchers said the findings suggest unionization could help retain direct care workers, save the health care system about $1.5 billion annually in turnover costs and improve care quality by increasing job satisfaction and reducing stress.
Gusoff said future research will focus on identifying which aspects of unionized jobs — such as pay, benefits and worker input — are most responsible for reducing turnover.
He added that researchers also plan to examine how different ownership structures, including worker-owned cooperatives, private equity firms and public companies, influence retention among direct care workers.