Unionization, Ownership Status, and Direct Care Worker Turnover

How is workforce turnover among direct care workers (DCWs) associated with unionization and the ownership status of their employers?In this cross-sectional study of 18 175 DCWs from the 2009-2024 Current Population Survey, unionization and public ownership were associated with significantly lower rates of DCW turnover, with similar unionization-associated turnover differences at nonprofit and for-profit care organizations.This study suggests that structural interventions such as DCW unionization and public ownership may help retain DCWs in the workforce to meet growing demand.

Corresponding Author: Geoffrey M. Gusoff, MD, MBA, MS, Department of Family Medicine, UCLA David Geffen School of Medicine, 10833 Le Conte Ave, 50-080 CHS, Los Angeles, CA 90095 (ggusoff@mednet.ucla.edu).

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