Monday, July 16 , 2018, 7:22 am | Partly Cloudy 65º

Your Health
A Noozhawk partnership with Cottage Health

UCSB Scholar Examines Social Policy and Home Health Care

In her book Caring for America, Eileen Boris examines how home care became attached to welfare

Why is it that, in the United States, middle-class individuals with the benefit of some financial resources often cannot get adequate long-term home care for themselves or their loved ones?

Eileen Boris
Eileen Boris

In her new book, Caring for America –– Home Health Workers in the Shadow of the Welfare State, Eileen Boris, Hull Professor and chair of feminist studies at UC Santa Barbara, takes on that question in a narrative history that covers the period from the Great Depression of the 1930s to present day.

“This book explains how public policies on the federal level, and as implemented by states and localities, created a system that relied on the underpaid labors of disproportionately black, Latina and immigrant women,” Boris said. “It examines how home care became attached to welfare, and, thus, became a question of how to get care work on the cheap.”

In Caring for America, Boris and co-author Jennifer Klein, a professor of history at Yale University, demonstrate the ways in which law and social policy made home care a low-waged job that was stigmatized as welfare and relegated to the bottom of the medical hierarchy. For decades, they contend, these front-line caregivers labored in the shadow of the welfare state that shaped the conditions of their occupation.

“It’s also a story of how what was private –– that is, in the home and within families as a form of intimate labor dealing with the activities of daily living, from brushing teeth, to bathing, to food preparation –– became public through various forms of social agencies and different forms of state funding, and, thus, subject to political struggle on the part of the people who need care, their families, health-care workers and employers,” Boris said.

The history of home care illuminates the fractured evolution of the modern American welfare state since the New Deal, and its race, gender and class fissures, the authors write. The history itself reveals why there is no adequate long-term care in America. That being said, they argue, a system such as home care is a product of political economy and policy-making and, therefore, can be changed.

Such changes may be in the offing, Boris notes, with President Barack Obama’s proposal last December that the “companionship exemption” be removed from the Fair Labor Standards Act. Without the exemption, employers would be required to pay home-care workers at or above minimum wage, and to pay overtime when they work more than 40 hours a week.

“They’re health workers, not companions,” Boris said. “They should be covered by labor law.”

Employers –– some of whom are agencies, while others are the individuals actually receiving care –– have argued that raising wages and requiring overtime pay would be detrimental to home-care workers because it would decrease the amount of work the employers could provide and, thus, the amount of money the workers could earn. Boris suggests, however, that their concern is unfounded.

“Very few workers actually spend enough time with any one employer to require overtime pay,” she said. “So it’s all ideological.”

The Obama administration is deliberating the new rules and is expected to make a decision sometime this summer.

The book highlights social movements of senior citizens for disability rights and independent living; the civil rights organizing of women on welfare and domestic workers; the battles of public sector unions; and the unionization of health and service workers. While re-examining the strategies of the U.S. labor movement in terms of a growing care work economy, the book rethinks the history of the American welfare state from the perspective of care work.

Support Noozhawk Today

You are an important ally in our mission to deliver clear, objective, high-quality professional news reporting for Santa Barbara, Goleta and the rest of Santa Barbara County. Join the Hawks Club today to help keep Noozhawk soaring.

We offer four membership levels: $5 a month, $10 a month, $25 a month or $1 a week. Payments can be made through Stripe below, or click here for information on recurring credit-card payments and a mailing address for checks.

Thank you for your vital support.

Become a Noozhawk Supporter

First name
Last name
Enter your email
Select your membership level

Payment Information

You are purchasing:

Payment Method

Pay by Credit Card:

Mastercard, Visa, American Express, Discover
One click only, please!

Pay with Apple Pay or Google Pay:

Noozhawk partners with Stripe to provide secure invoicing and payments processing.

  • Ask
  • Vote
  • Investigate
  • Answer

Noozhawk Asks: What’s Your Question?

Welcome to Noozhawk Asks, a new feature in which you ask the questions, you help decide what Noozhawk investigates, and you work with us to find the answers.

Here’s how it works: You share your questions with us in the nearby box. In some cases, we may work with you to find the answers. In others, we may ask you to vote on your top choices to help us narrow the scope. And we’ll be regularly asking you for your feedback on a specific issue or topic.

We also expect to work together with the reader who asked the winning questions to find the answer together. Noozhawk’s objective is to come at questions from a place of curiosity and openness, and we believe a transparent collaboration is the key to achieve it.

The results of our investigation will be published here in this Noozhawk Asks section. Once or twice a month, we plan to do a review of what was asked and answered.

Thanks for asking!

Click Here to Get Started >

Reader Comments

Noozhawk is no longer accepting reader comments on our articles. Click here for the announcement. Readers are instead invited to submit letters to the editor by emailing them to [email protected]. Please provide your full name and community, as well as contact information for verification purposes only.


Special Reports

Heroin Rising
<p>Lizette Correa shares a moment with her 9-month-old daughter, Layla, outside their Goleta home. Correa is about to graduate from Project Recovery, a program of the Santa Barbara Council on Alcoholism & Drug Abuse, and is determined to overcome her heroin addiction — for herself and for her daughter. “I look at her and I think ‘I need to be here for her and I need to show her an example, I don’t want her to see me and learn about drugs’,” she says.</p>

In Struggle to Get Clean, and Stay That Way, Young Mother Battles Heroin Addiction

Santa Barbara County sounds alarm as opiate drug use escalates, spreads into mainstream population
Safety Net Series
<p>Charles Condelos, a retired banker, regularly goes to the Santa Barbara Neighborhood Clinics for his primary care and to renew his prescription for back pain medication. He says Dr. Charles Fenzi, who was treating him that day at the Westside Clinic, and Dr. Susan Lawton are some of the best people he’s ever met.</p>

Safety Net: Patchwork of Clinics Struggles to Keep Santa Barbara County Healthy

Clinics that take all comers a lifeline for low-income patients, with new health-care law about to feed even more into overburdened system. First in a series
Prescription for Abuse
<p>American Medical Response emergency medical technicians arrive at Santa Barbara Cottage Hospital with little time to spare for victims of prescription drug overdoses.</p>

Quiet Epidemic of Prescription Drug Abuse Taking a Toll on Santa Barbara County

Evidence of addiction shows an alarming escalation, Noozhawk finds in Prescription for Abuse special report
Mental Health
<p>Rich Detty and his late wife knew something was wrong with their son, Cliff, but were repeatedly stymied in their attempts to get him help from the mental health system. Cliff Detty, 46, died in April while in restraints at Santa Barbara County’s Psychiatric Health Facility.</p>

While Son Struggled with Mental Illness, Father Fought His Own Battle

Cliff Detty's death reveals scope, limitations of seemingly impenetrable mental health system. First in a series