Abstract
Eileen Boris and Jennifer Klein provide an ambitious exploration of social policy and the history of unionization of personal attendants, in-home support workers, homemaker-housekeepers, and home health aides. The various terms denote the complexity of what is called “home care.” Throughout the book Boris and Klein argue that it has been this liminal status of home care between private and public, employment and family care, which has been instrumental in the marginalization of this type of work from the 1930s to the present. As well, the authors assert that while racialized and gendered meanings of home care were crucial to the stigmatization of the occupation, they argue that the dynamic among institutions, experts, and state authorities also played a central role in devaluing home care.
Caring for America charts the beginning of this process with the onset of the Great Depression and the New Deal’s Visiting Housekeeper Program, which largely recruited poor women of color, especially African-American women, in the process of creating this new occupation. Such New Deal programs are shown as pivotal to the struggles of home care workers for decades to come, not only because of how they “reflected and reproduced the dominant racial and gender order” (p. 23) but in how they created a legacy of exclusion for this form of work, most notably in home care’s omission from wage and hour law.
Boris and Klein are at their most adept in detailing how the intricate dynamics among federal, state, local, and private institutions worked together to form “the political economy of care” (p. 11). They do so by shifting their focus away from a singular examination of federal policy to its implementation at the state level. They scrutinize the distinctive policies in states like California and New York, providing the reader a more nuanced understanding of how social policy shaped health care support, especially the privatization of services.
The authors deftly address the challenge of home care unionization in the second half of the book. They detail unions’ need to employ a combination of political, social movement, and service sector unionism, or “care worker unionism,” which developed as a “solidaristic attempt to move the labor of care away from its marginalized status to recognize its centrality to the contemporary political economy” (p. 17). Not only do they chart the different strategies employed by the unions like United Labor Unions and Service Employees International Union to organize home care workers, but they also integrate how political pressure at the state level and advocacy on the part of recipients complicated home workers’ struggles for union recognition.
Overall, the authors provide an outstanding grasp of the multifarious set of forces that resulted in the stigmatization of home care. Their account of California’s Disabled and Blind Action Committee’s successful advocacy of consumer-directed care, which complicated attendants’ efforts for recognition and improved work conditions, provides an engaging portrait of the complexity of these struggles. Their analysis of the racialized and gendered nature of home care work is especially relevant and timely for union activists because “women’s labors’ have now become the strategic sites for worker struggle and the direction and character of the labor movement” (p. 7).
Caring for America, with its illuminating and deeply analytical historical account of the changing terrain of social welfare policy and labor activism, would be an extremely useful text for labor educators or anybody interested in post-war American social policy, women’s history, labor history, and labor studies.