Gillian Laub for TIME Ai-jen Poo in Madison Square Park, in New York City

“She’s like a member of our family.” Behind the well-intentioned sentiment, so often said of nannies and caregivers, lurks a sad truth. To be “like a member” of the family is a far cry from being a family member.

(VIDEO: Ai-jen Poo Discusses the Domestic Worker)

This week, the National Domestic Workers Alliance, the University of Illinois at Chicago and the DataCenter are releasing the first ever national survey of domestic workers, Home Economics: The Invisible and Unregulated World of Domestic Work, which reveals how vulnerable these workers are to abuse. Take Anna’s story from the report:

“Having honed her child development skills as a teacher in the Philippines, Anna was hired as a live-in nanny for a family of four in Midtown Manhattan … At night, she sleeps between her charges on a small mattress placed on the floor between their beds. She has not been given a single day off in 15 months. Like many domestic workers, Anna’s pay is low … On average, then, she is paid just $1.27 per hour.”

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While not every domestic worker — nanny, housecleaner or caregiver for the elderly — faces conditions as bad as Anna’s, the survey found that 23% of all domestic workers and 67% of live-in workers are paid below the minimum wage. Without formal contracts, tasks expand and workdays lengthen, often without any additional pay. Employers lack guidelines or standards, and domestic workers are left to toil alone in private homes unseen by co-workers with whom they could compare.

Researchers interviewed 2,086 workers and a third reported that they worked five or more hours without breaks, and few workers report receiving overtime pay when they work more than 40 hours per week. Many workers are paid late, which, combined with their low wages, leads to financial hardship: 40% of workers reported having to pay rent or other essential bills late, while 20% of workers reported that there were times when they went without food because they could not afford it.

Then there are the physicals hazards of the work. Housecleaners must regularly work with toxic chemicals. Caregivers for the elderly often injure themselves when lifting the people in their care, while many nannies report contracting an illness from the children they look after. Meanwhile, only 4% of workers receive health insurance from their employers, and fewer than 9% work for employers who pay into Social Security.

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According to the Census Bureau, there were 726,437 people working such jobs in private households in 2010, up 10% from 2004, but the actual number is undoubtedly higher as the census estimate doesn’t include people hired through agencies and undercounts undocumented workers. As people live longer and the baby-boom generation reaches retirement age, the nation’s reliance on the domestic workforce will only grow. Yet despite the importance of these caregivers to society, they are excluded from the basic workplace rights that others in this country take for granted. This discrepancy dates back to the 1930s, when the National Labor Relations Act and Fair Labor Standards Act were first written. At the time, Southern members of Congress insisted on the exclusion of domestic workers and farm workers, who were predominantly African American, and many of those exclusions remain in place today.

We have an opportunity to reverse this history of discrimination, with policy changes — at the state and federal levels — that establish basic rights and standards and ensure that these workers can live with dignity and safety. Over the past decade, domestic workers in California and New York have organized to pass Domestic Workers Bills of Rights in their state legislatures. Workers in Massachusetts and Illinois are now developing their own bills of rights, but it’s time for more states to take up the task.

In a nation based on the values of liberty and justice for all, the people who are raising our children should not have trouble feeding or caring for their own children, and the people who provide care for our elders should receive support for their own retirement. We should honor, respect and value the precious labor that they provide: the labor of love that serves as the foundation of our economy.

MORE: Ai-jen Poo in the 2012 TIME 100