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When it comes to both child care and home care for older adults, we find a serious disconnect between reality and public perception. Most people fundamentally don’t understand how people find and manage care, what care for children and adults costs, what goes on inside care settings, or what proposals like “universal child care” actually mean. Half of Americans think the United States spends as much or more on child care as other wealthy democracies, when in reality, the United States spends among the least. A majority expressed little confidence in their estimates of the cost of care, suggesting a significant knowledge gap.

That gap not only can lead to false or misinformed views about care, but has also shaped policy and public investment decisions that have profoundly impacted the lives of people and families with care responsibilities.

A majority of U.S. children ages 0 to 5 live in families where all available parents work, meaning require some kind of child care. At the same time, the United States is becoming older than it has ever been, with of those over 65 projected to need some caregiving help, and most would prefer to have that help in their own homes rather than have to move to a nursing home or assisted living facility. Because the United States invests so little in care from the moment of birth through to the end of life, and that support is targeted primarily to those living on low wages, most American families are left to shoulder the bulk of the cost of care alone. And those costs are quickly rising: Both and have outpaced inflation in recent years.

The lack of understanding about care in the United States uncovered in this survey contributes to both strain on families and a lack of action to alleviate it. Families are stretched to the breaking point paying for care. Child care costs are second only to housing in most family budgets, and home care costs can impoverish families. Millions of people for those over age 65 covers the cost of long-term care. It doesn’t. Only Medicaid does for those on low-incomes. Many middle-income families pay for expensive private care until their money runs out, “spending down” all their assets until they’re poor enough to qualify for Medicaid to get the help they need.

And because families can’t pay more than they already do for care, most care providers can’t—or in the case of many private home care companies, don’t—pay care workers living wages, leading to high turnover rates, which impact stability and the ability to deliver consistent quality care.

Beyond finances, the survey reveals that many Americans have little understanding of care or quality care. For instance, few people think child care programs are high quality. Thirty-eight percent think children regularly watch screens, though in reality, screen watching is relatively rare. When asked what has shaped their views, a 60–percent majority say they have no direct knowledge of child care or child care quality. In open-ended questions, many explained their views were uninformed: “No idea” or “Just a guess. No information,” were common responses. “Shooting in the dark,” wrote one. “Just what I hear,” wrote another. Says a third: “Vibes.”

This lack of understanding leads to low political action around care as a policy issue. It is hard to expect people to make demands to improve and better support the way people find and manage care when there’s so little understanding of the current complex and disjointed way people are forced to cobble together expensive care for their families, how much it costs, who bears the burden of the cost, and what child care should look like. Although polls show that voters are keenly concerned about , that has yet to coalesce into shaping voter behavior or expectations of candidate policy platforms around care.

For both child care and home care for older adults, more than 8 in 10 respondents say a candidate’s position never influenced their vote, and fewer than 1 in 10 have contacted an elected official about the issue. This does not mean the topics are not important—among parents of young children and those caring regularly for an elder, the salience is significantly higher. Twenty-one percent of parents with children under age five say a candidate’s position on child care influenced their vote, compared to an overall average of 15 percent. And 20 percent of those who regularly care for older adults say a candidate’s position on home care influenced their vote, compared to the overall average of 12 percent. 

Indeed, survey responses seem to indicate a general realization that families can’t bear the burden of care on their own. A slight majority of 52 percent believes that everyone has an interest in strong child care systems, and for home care systems that rises to 56 percent, including respondents who aren’t directly involved in caregiving. There is uncertainty, however, about whether care should be considered a right.

Perhaps most importantly, an overwhelming majority think that the government should have some role in paying for care: 81 percent for child care and for home care, 86 percent. This includes a majority of conservative respondents—76 percent for child care, 82 percent for home care—and at least half of very conservative respondents, 50 percent for child care and 64 percent for home care. Similarly, a majority of all respondents believe that businesses should play some role in care, at least part of which should include paying taxes into systems that benefit everyone, 78 percent for child care and 59 percent for home care. 

These beliefs point to the potential for greater political engagement with care issues across groups, particularly as the reality of care challenges comes into sharper focus. For instance, compared to those with no care responsibilities or experience, respondents who cared for children or older loved ones were more likely to say that a candidate’s position on care influenced their vote. Active caregivers were also more likely to report contacting an elected official about care.

Robust majorities believe that care work is both skilled (81 percent for child care and 85 percent for home care workers) and underpaid work (63 percent for child care and 58 percent for home care workers), with the recognition that most care workers don’t earn enough to support themselves or their families. Still, about one in five respondents say they are unsure whether care wages are sufficient, suggesting that the true cost of care work is still invisible to much of the general public.

These survey findings reveal shifting public opinion on care, as the COVID-19 pandemic and the country’s aging demographics have brought the challenges for families around finding and affording high quality care into sharper relief. For most of U.S. history, the view has persisted that care is a private duty that families, primarily women, are expected to carry alone. Even as mothers entered the workforce en masse in the 1970s—as both the women’s movement opened up more opportunity and stagnating wages drove more mothers into the workforce to keep their families financially afloat—the view that caregiving should be a private “labor of love” performed by women was intentionally reinforced by a coalition of and religious conservatives who viewed . That outdated narrative of care as a private family matter has fostered a broken system where many families are strapped, trapped, and feeling isolated and alone. 

A fuller understanding of the modern reality for families navigating work and care, and more robust support for care as a public good benefitting everyone that should be backed by taxpayer dollars—like public schools, libraries, and parks—could spark ideas and action for solutions that would lead to thriving children and families, communities, businesses, and state and national economies.