There’s No Place like Home: Long-Term Care and the Growth of Low-Wage Labor in the U.S. Welfare State

Lecture Description

Home aides and attendants perform intimate tasks of daily life—such as, bathing, brushing teeth, dressing, cooking, and cleaning–that enable aged, disabled, or chronically ill people to live decent lives at home. These essential workers are America’s front-line caregivers, but they earn average hourly wages lower than that of all other jobs in health care and historically have labored without security of employment, social benefits, or even workers’ compensation. They labor in private spaces meeting individual and family needs. But how they do so is a story of political economy, one that reflects the major shifts in the welfare state and economy that define contemporary America. Home care aides make up a vast workforce of over 2 million workers—much larger than those of the iconic industries of auto and steel– that links our most challenging social issues: an aging society; the enormous medical sector and its ability to prolong life; the neo-liberal restructuring of public services; immigration; disability rights; the prospects of health care for all, and the potential (or precariousness) of a new American labor movement.
Home care is currently the fastest growing occupation in the nation, adding hundreds of thousands of positions at a steady clip. These low-waged workers stand at the center of a new care work economy, defined by a continuum of jobs.
Just about the only growth in the U.S. labor movement has been in health care, public employment, food service and hotels, education, and domestic labors. These workers transformed organizing strategy, union demands, and the very nature of collective bargaining. Home care became a pivotal sector in which unions experimented with new tactics. Since home care stood outside New Deal labor laws, unionization had to take shape apart from that frame work. They also had to take account of the complex interpersonal relations essential to carework. They had to enter into alliances with the receivers of care (who have labeled themselves “consumers”.) Even though they labored in private homes, had no standing as employees, they turned the public welfare state itself into a terrain of social struggle. By 2010, over 400,000 home care workers had joined unions, although over the last year their union and bargaining rights have been jeopardized by the conservative governors that took over state houses in 2010 Republican sweep.
This talk rethinks the history of the American welfare state from the perspective of care work. It also looks at how government created this as a particular low-wage job for poor women and women of color, from the New Deal to War on Poverty to “Welfare Reform” of the 1980s and 1990s. It also looks at the unique strategies these workers developed to organize: through welfare rights movement, domestic workers movements, and ultimately labor unionizing.


Labor and Working Class Social Welfare and Public Assistance

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