The Business Women Are Quietly Building Around Care

In a converted storefront in a small city in Ohio, a woman named Renata Alvarez runs a company that provides support services to families managing dementia at home. Her company is called Home Anchor. It employs 47 people. It has been profitable every year since its second year of operation. It serves approximately 300 families across three counties. Alvarez started the company in 2018 after spending four years caring for her mother through Alzheimer's disease, during which time she encountered nearly every failure of the existing care infrastructure and decided that she could build something better. She raised no venture capital. She took out a small business loan, refined the model, and grew the business by reinvesting profits. Home Anchor is not the largest company in its category. It is one of hundreds of similar companies being built across the country right now, most of them by women, and most of them operating below the radar of the business press that has continued to focus its attention on venture-backed technology companies. 

The pattern I want to write about is happening across the care economy. Women are founding companies at rates that outpace men in nearly every sector related to caregiving, from postpartum support services to elder care coordination to grief counseling to community mental health platforms. These companies are, in the aggregate, one of the more significant business stories of the current decade, and they have received a fraction of the coverage that has gone to companies in more traditional venture categories. The undercoverage is a story in itself, and it is worth examining alongside the actual businesses being built. 

What the Data Shows

The Bureau of Labor Statistics reported in 2024 that the personal care and social services sector employed approximately 4.9 million workers in the United States, with growth rates well above the overall economy. Women accounted for approximately 82 percent of employment in the sector and, according to Census Bureau data, approximately 71 percent of ownership. The care economy is not a small piece of the American economy. It is one of the fastest-growing sectors, and it is being built and run largely by women. 

The sector is also, according to research from the Aspen Institute, dramatically underserved by traditional business infrastructure. Care economy companies have received less than 4 percent of venture capital investment over the past decade, despite representing a substantially larger share of business formation. The mismatch reflects several factors, including the fact that venture capital has been optimized for a particular kind of scale and exit that does not align with the growth patterns of care businesses. It also reflects the persistent bias in venture funding toward male founders and toward industries dominated by male founders. 

What this has meant, practically, is that women founders in the care economy have been building companies with alternative financing models. Small business loans. Revenue-based financing. Bootstrapping. Community investment funds. The absence of venture backing has forced these companies to build sustainably from the start, and the sustainability has produced businesses that are, in many cases, more durable and more profitable than their venture-backed counterparts in other sectors. 

A 2024 study from the Kauffman Foundation examined 2,000 care economy companies founded between 2015 and 2022 and found that women-led care businesses had five-year survival rates of 68 percent, compared to 46 percent for the broader small business population. The care businesses also reported higher employee retention rates, higher customer retention rates, and more positive financial trajectories over the study period. The businesses were not the largest or the most valuable in the traditional venture sense. They were, by most measures of durability, more successful than their more famous counterparts. 

Who the Founders Are 

The women building these companies tend to share several characteristics. Most of them entered the sector after personal experience with the gap they eventually filled. Alvarez built Home Anchor after caring for her mother. A founder in Massachusetts I spoke with, who runs a postpartum support company, built it after her own postpartum experience convinced her that the existing infrastructure was failing new mothers. A founder in Georgia built a grief counseling platform after losing her husband and struggling to find culturally competent support for herself and her children. 

The personal origin is not incidental. It shapes what these companies build and how they build it. The founders know, from their own lives, what specifically was missing from the existing options. They know what women actually need in these situations, because they were the women in those situations recently enough that the memory is specific and detailed. They build companies that reflect that specificity, and the specificity is what distinguishes their offerings from the generic services their competitors provide. 

The founders also tend to be older than the founders receiving venture funding in other sectors. The average age of a founder in the Kauffman study was 43. In some subsectors, particularly elder care and grief support, the average founder age was in the mid-50s. These are not first-time entrepreneurs building companies as a first career. They are women with substantial life and professional experience who are directing that experience toward a specific problem they have decided is worth solving. The maturity shows up in the operating discipline of the companies they build. 

The founders are also disproportionately women of color. Black women, Latina women, and Asian women are overrepresented among founders in the care economy relative to their representation among founders in other sectors. This partly reflects the underlying demographics of the care sector, which has historically been staffed and led by women of color. It also reflects the ways in which women of color have often been excluded from other business categories and have built successful ventures in the categories that were more accessible to them. 

What Kind of Businesses They Build 

The businesses themselves vary widely. Home care companies coordinating in-home support for elderly clients. Postpartum doula collectives providing structured support during the first months of parenthood. Grief counseling platforms offering both group and individual services. Mental health clinics oriented toward specific communities. Elder care coordination services that help families navigate the complex logistics of aging parents. Support groups for family caregivers. Legal services focused on the specific needs of caregiving families. Educational programs for professionals entering the care sector. Technology platforms that connect families with vetted providers. 

What unites these businesses is not a shared product category. It is a shared orientation toward the customer. The founders in this sector describe their work in remarkably similar terms across categories. They are trying to build services that would have helped them, in the specific situations that led them to found the businesses. They are trying to close gaps they experienced directly. They are trying to make available to other women what they wish had been available to themselves. 

This orientation shows up in operational details. Care economy businesses are more likely than businesses in other sectors to invest heavily in staff training, employee retention, and quality assurance. They are more likely to build long-term customer relationships rather than optimizing for transaction volume. They are more likely to price for sustainability rather than for growth. They are less likely to make the aggressive marketing claims that dominate other sectors. The businesses look and feel different from other kinds of businesses, and the difference is not incidental to the theory of the company. It is central to what the founders are trying to build. 

Why They Have Been Overlooked 

The undercoverage of these companies in mainstream business press is worth examining. The publications that cover business have tended to focus on companies that fit a particular narrative structure. Fast growth. Big funding rounds. Charismatic founders in their twenties or thirties. Technology or consumer product categories. Businesses that produce dramatic outcomes visible in short timeframes. 

Care economy businesses do not fit this narrative. They grow steadily rather than explosively. They rarely raise significant capital, which means they do not generate the funding announcements that drive coverage. Their founders tend to be older and less interested in personal celebrity. They operate in service categories that do not lend themselves to the product-focused coverage that dominates business media. Their outcomes accrue slowly, in the form of retained employees, retained customers, and stable community relationships that are difficult to summarize in a business feature. 

The undercoverage has had real consequences. Founders in the sector often report difficulty finding role models, mentors, and peer networks because the coverage that would surface these connections has not been present. They report difficulty accessing capital because investors have not been exposed to the sector's economics through media coverage. They report difficulty being taken seriously in business communities because the businesses they run have not been described as the significant enterprises they are. 

The undercoverage also has downstream consequences for the workers in the sector. Care work has been chronically undervalued in American economic policy, in part because the businesses employing care workers have been culturally categorized as marginal or nonprofit rather than as substantial enterprises worth serious attention. The mischaracterization has kept wages low, kept working conditions poor, and kept the sector from attracting the investment that would improve both. 

The Business Case 

There is a straightforward business case for taking care economy companies more seriously, and it is worth naming plainly. The sector is growing. Demographic trends are pushing the growth. The American population is aging. Families are increasingly geographically dispersed. Traditional caregiving structures have eroded. All of these factors are producing sustained demand for the services these companies provide, and the demand is not going to decrease. 

The companies that have been built in the sector so far are producing the outcomes their customers want. The customer retention rates are high. The employee retention rates are higher than in most comparable sectors. The financial performance is solid. The companies are not losing money at scale while chasing growth. They are producing sustainable profits while providing services that their customers value. 

The founders building these companies represent one of the more talented cohorts of entrepreneurs currently operating in any sector. They are drawing on deep personal experience, substantial professional backgrounds, and clear-eyed understanding of the problems they are solving. They are building companies with operational discipline that would be considered exemplary in any category. The businesses they are building are, by most measures of durable enterprise, better run than many of the more heavily covered companies in other sectors. 

Investors who have started paying attention to the sector are reporting positive early returns. Revenue-based financing funds focused on care economy businesses have shown strong performance. Community development financial institutions that lend to the sector have shown low default rates and strong portfolio outcomes. The financial infrastructure that is beginning to develop around the sector is producing evidence that the businesses are more investable than the traditional venture model has recognized. 

What Comes Next 

The undercoverage of the care economy is likely to shift, driven by several factors. Demographic pressure will continue to grow the sector, and the businesses succeeding in the sector will continue to accumulate the kind of scale that eventually attracts attention. Alternative financing models will continue to develop, and the deployment of capital into the sector will produce funding announcements that generate coverage. Policy attention to care economy issues, including proposals for care infrastructure investment at the federal and state level, will continue to raise the profile of the businesses operating in the sector. 

The founders currently building companies in this space are, in effect, running a large-scale experiment about what kinds of businesses actually deserve investment and coverage in the current American economy. Their success is producing evidence that businesses oriented around durable value creation, sustainable growth, and meaningful customer service can be as economically significant as the businesses that have dominated the business press for the past two decades. The evidence will eventually shift the conversation. 

For women considering starting businesses in this space, the current moment offers particular opportunities. The sector is growing. The models are established enough to learn from but not yet saturated. The alternative financing infrastructure is more developed than it was a decade ago. The pool of experienced founders who can serve as mentors is larger and more accessible. The undercoverage that has held the sector back is likely to lift, which means founders entering now will benefit from the eventual attention that current founders have been building without. 

Renata Alvarez, who I met with in Ohio, told me that she did not start Home Anchor because she wanted to be an entrepreneur. She started it because she had encountered a specific problem in her own life, had seen how many other families were encountering the same problem, and had realized that she was probably better positioned than most to build the solution. Her story is the story of most of the founders I have interviewed for this piece. They did not begin with entrepreneurial ambition. They began with problems they knew intimately and solutions they could imagine. The businesses grew from there. 

This is a different origin story than the one that has dominated business media for a generation. It is worth taking seriously. The women building these companies are quietly reshaping one of the largest and fastest-growing sectors of the American economy, and their work deserves the attention it has not been receiving. The businesses are here. The founders are here. The customers are being served. The coverage will catch up, eventually. In the meantime, the work continues, in converted storefronts and small offices and community centers across the country, produced by women who saw what was missing and decided to build it themselves.