{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:45:44Z","timestamp":1791834344908,"version":"4.3.4"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Care Res Rev"],"abstract":"<jats:p>While the aging population increasingly relies on direct care workers\u2014personal care aides, home health aides, and nursing assistants\u2014insufficient income drives many of these workers to acquire second jobs. Using the Survey of Income and Program Participation (SIPP), we evaluate the earnings gap between direct care workers who do and do not hold second jobs and how it varies depending on the type of second job. On average, direct care workers with secondary employment work more hours and earn higher total income than those who hold just one job. However, after adjusting for total hours worked, multiple jobholding direct care workers earn 16% less than their single-jobholder counterparts. This earnings gap is larger among those who work two direct care positions than workers who combine a direct care job with an outside occupation.<\/jats:p>","DOI":"10.1177\/10775587261486596","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T10:17:57Z","timestamp":1791627477000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple Jobholding and Earnings Differences Among Direct Care Workers"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0816-3959","authenticated-orcid":false,"given":"Jiyeon","family":"Kim","sequence":"first","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6404-5222","authenticated-orcid":false,"given":"Lina","family":"Stepick","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,10]]},"reference":[{"issue":"1","key":"e_1_3_4_2_1","first-page":"101","article-title":"A study of impact of moonlighting practices on job satisfaction of the university teachers","volume":"38","author":"Ara K.","year":"2016","unstructured":"Ara K., Akbar A. (2016). A study of impact of moonlighting practices on job satisfaction of the university teachers. Bulletin of Education and Research, 38(1), 101\u2013116.","journal-title":"Bulletin of Education and Research"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3695394"},{"key":"e_1_3_4_4_1","author":"Bates T.","year":"2022","unstructured":"Bates T., Spetz J., Wagner L. (2022). Characteristics of multiple job holders in long-term care.","journal-title":"Characteristics of multiple job holders in long-term care"},{"key":"e_1_3_4_5_1","doi-asserted-by":"crossref","unstructured":"Baughman R. A. Stanley B. Smith K. E. (2022). Second job holding among direct care workers and nurses: Implications for COVID-19 transmission in long-term care. Medical Care Research and Review 79(1) 151\u2013160. https:\/\/doi.org\/10.1177\/1077558720974129","DOI":"10.1177\/1077558720974129"},{"key":"e_1_3_4_6_1","doi-asserted-by":"crossref","unstructured":"Bowblis J. R. (2011). Staffing ratios and quality: An analysis of minimum direct care staffing requirements for nursing homes: Staffing ratios and quality. Health Services Research 46(5) 1495\u20131516. https:\/\/doi.org\/10.1111\/j.1475-6773.2011.01274.x","DOI":"10.1111\/j.1475-6773.2011.01274.x"},{"key":"e_1_3_4_7_1","unstructured":"Brown S. Sullivan S. L. Maninger B. (2019). Moonlighting and morale: The impact on educators who moonlight and how classroom teaching suffers. Journal of Multidisciplinary Graduate Research 1(1) 1\u201317. https:\/\/jmgr-ojs-shsu.tdl.org\/jmgr\/article\/view\/20"},{"key":"e_1_3_4_8_1","doi-asserted-by":"crossref","unstructured":"Butler S. S. Brennan-Ing M. Wardamasky S. Ashley A. (2014). Determinants of longer job tenure among home care aides: What makes some stay on the job while others leave? 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Medical Care Research and Review 79(6) 844\u2013850. https:\/\/doi.org\/10.1177\/10775587221089414","DOI":"10.1177\/10775587221089414"},{"key":"e_1_3_4_12_1","volume-title":"Competitive disadvantage: Direct care wages lag behind\u20142024 update","author":"Kim J.","year":"2024","unstructured":"Kim J. (2024). Competitive disadvantage: Direct care wages lag behind\u20142024 update. PHI."},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2026.106149"},{"key":"e_1_3_4_14_1","doi-asserted-by":"crossref","unstructured":"Kreider A. R. Werner R. M. (2023). The home care workforce has not kept pace with growth in home and community-based services. Health Affairs 42(5) 650\u2013657. https:\/\/doi.org\/10.1377\/hlthaff.2022.01351","DOI":"10.1377\/hlthaff.2022.01351"},{"key":"e_1_3_4_15_1","doi-asserted-by":"crossref","unstructured":"Lal\u00e9 E. (2015). Multiple jobholding over the past two decades. 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