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This article investigates the relationship between national-level institutions and care workers’ relative income position in 21 countries. Although it is well-known that care work, e.g. the work done by nurses or kindergarten teachers, tends to be associated with low pay and poor working conditions, it is still an open question whether this applies equally to different countries and different types of care work. We therefore explore variations across countries in care workers’ relative wages by analyzing data from the European Labor Force Survey (EU LFS) and the American Current Population Survey (CPS IPUMS), While we find that care workers tend to earn considerably less than equally qualified and experienced individuals in other professions, our analyses also show that national-level institutions are important predictors of the degree to which care workers experience a wage penalty. Care workers’ wage penalties tend to be smaller in those countries with higher participation of men in care-work employment, higher social spending, and a smaller informal economy. This study is the first to relate the income of professional care workers to country-level characteristics in a multilevel setting and thereby delivers important policy recommendations to improve wages and working conditions among the predominantly female and ever-growing workforce in the social services sector.