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Emancipating Intimate Labor in the Care Economy

Protect Patients Not Profits

On December 15, 2011, the White House announced “administration action” to protect the nation’s 1.7 million home care workers. President Obama called for the establishment of minimum wage and overtime standards that all workers recognized in the Fair Labor Standards Act (FLSA) received. These new reforms would virtually eliminate the “elder companion exemption” in the FLSA that Congress established in 1974 which allowed home care employers to continue their exploitation of home care workers.

President Obama delivered this announcement four years after the Supreme Court decided unanimously that the case’s plaintiff Evelyn Coke, and other home care workers, were not entitled to minimum wage protections and overtime pay. Like most home care workers, Evelyn Coke worked long hours for little pay. Coke performed what scholars Jennifer Klein and Eileen Boris call “intimate labor”—she cooked, cleaned, and bathed her clients.[1]  Coke worked 24 hour shifts often and she worked decades without receiving benefits. When Coke decided to sue for back pay, the Supreme Court ruled against her, reinforcing the historical stigmatization of intimate labor. Two years later, the home care workers’ movement lost Evelyn Coke. Home care workers are still waiting for Obama’s “administration action” four years after the ruling.

Recent shifts in the political economy provoke us to rethink how we view home care work. While these two developments may be coincidental, the home health care industry grew during the 1970s as more women began entering the nation’s workforce. The decline of male-dominated industrial work, the corporate assault on labor rights, and economic crises spurred a collapse in the male breadwinner wage model.   The breakdown of this aspect of the post-World War II social contract and income stagnation forced households to rely more on multiple income earners. These developments triggered what sociologist Susan Thistle refers to as another encounter between home and the market in her book, From Marriage to Market:  The Transformation of Women’s Lives and Work.

Today, almost two million workers perform intimate labor. Most of these laborers are family members, women of color, immigrants, and the poor. The baby boom generation is also entering into its twilight years.  In 2000, 2.5 million Americans turned 65. This year, around 3.5 million will turn retirement age.  According to a recent Institute for Women’s Policy Research (IWPR) study, 40.4 million elderly lived in the United States and they estimated that number would grow to 50.5 million by 2020. This growth in elderly has caused the IWPR to wonder if the U.S. could be heading towards a “care crisis,” where the industry suffers from a labor shortage.[2]  It is safe to say that the home care industry will be one of the fastest growing sectors in the U.S. economy in the coming decades.

HomeCareRocks

The growth of the care economy makes it necessary to join home workers in rethinking how we view home care workers and intimate labor. Historically, home care and domestic workers suffered from a type of labor exploitation distinct from those who worked in the “public” market.  The act of performing intimate labor and bodily maintenance represented the commodity. Since intimate labor consists of household work, especially the care of aging and presumably “unproductive,” bodies, it is assumed that mothers and daughters performed this labor intrinsically out of love. This sexist understanding of the market and domestic work rendered this labor invisible.  Some families, of course, outsourced this work. Many usually hired women of color and immigrants to work for low wages. Gendered understandings of work—mothers and daughters worked in the home for free, husbands earned a breadwinner wage outside the home, poorer women, women of color and immigrants worked for cheap wages—feminized and racialized intimate labor, even to the point where, as Boris and Klein state, men who now work in this field usually earn less than other men, generally.[3]

In their book, Caring For America:  Home Health Workers in the Shadow of the Welfare State, Eileen Boris and Jennifer Klein illustrates how the state further stigmatized home care work in the twentieth century. The state saw caregiving as a “labor of love” performed by mothers and daughters although women of color, immigrants and the poor have mostly performed domestic work. State regulation encouraged a “taylorization” of household work in order to pay workers for more “efficient” labor. New Deal legislation excluded them from the federal wage and hour law in the FLSA. Their work remained excluded for more than seventy years after it was passed in 1938.

Boris and Klein demonstrate how the devaluation of home care work produced another form of labor organizing—care worker unionism. United Labor Unions, the Service Employees International Union (SEIU) and the American Federation of State, County, and Municipal Employees (AFSCME)  have worked the hardest to organize caregivers. Advocacy organizations such as PHI Policy Works have also emerged and feminists and feminist policy organizations like the IWPR have continued to advocate for home care workers’ rights.* Often, coalitions of consumers, workers, and voters advocated for higher wages and improvements in care.

Pay Workers a Living WageThe history of the stigmatization of home care labor and the Obama administration’s failure to invest more political capital in pushing for proposed wage protections underscores the imperative for detaching gender and racial stigmas from intimate work. Reforming the FLSA to expand protections to home care workers is one step towards hopefully a fundamental solution. This includes detaching gender from working bodies and emancipating intimate labor (and all forms of labor, for that matter). Short- and medium-term goals include the struggle for living wages, health care benefits, and a reduced working load. We should also subsidize family members who also perform intimate labor. The question arising from the issue of intimate labor is not just do we value two vulnerable segments of society—seniors and the workers that serve them—but what does the idea of care mean in a capitalist economy? Can care and profit coexist, especially when employers fight against wage protections?

These economic developments and the market’s invasion of domestic work have contributed to home care becoming a multi-billion dollar industry.  The growth in the sector puts a premium on labor organizing, especially if the IWPR’s worries about a labor shortage come true. One cannot assume that a labor shortage would produce leverage for home care and service worker unions, but we could experience more days “without care,” as Sarah Jaffe explored in her recent article on care worker organizing.

We Can't Wait Cover

The White House titled their press release, “We Can’t Wait…,” Unfortunately, the nearly two million home care workers are still waiting for their rights.

Evelyn Coke would still have to wait if she were here.


[1] Eileen Boris and Jennifer Klein, Caring for America:  Home Health Workers in the Shadow of the Welfare State (New York:  Oxford University Press, 2012), 8.

[2] Institute for Women’s Policy Research, “Women and the Care Crisis:  Valuing In-Home Care in Policy and Practice,” April 2013.

[3] Boris and Klein, 8.

*PHI Policy Works released a report this April, “We Can’t Wait!:  Americans Speak Out for Fair Pay for Home Care Workers,” illustrating the challenges workers face in providing care. PHI presents the work through the voices of workers, sympathetic employers, and the families who purchase home care services. For a .pdf copy report: http://phinational.org/sites/phinational.org/files/articles-commentaries/fair-pay-stories.pdf.

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2 Comments Post a comment
  1. Reblogged this on Caring Compassion's Blog.

    April 27, 2013
  2. Way cool! Some very valid points! I appreciate you penning this post and also the rest of the site is very good.|

    August 5, 2013

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