Health Care

Shining a Light on Invisible Labor

June 22, 2017  • Ai-jen Poo

Ai-jen Poo is executive director of the National Domestic Workers Alliance and the co-director of the Caring Across Generations campaign. She has been organizing immigrant women workers for over two decades, forging pathways to sustainable, quality jobs for the caregiving workforce and working to ensure access to affordable care for the nation’s aging populations. She will be speaking in the Caregiving track at Spotlight Health. 

What led you to this work and what makes it important?

Like most people, my own family has a caregiving story. When my grandfather became ill and needed more support, my family didn’t have a plan for his care, and he ended up spending his last days in an isolating nursing home. The thought of it still haunts me. But my grandmother, who is still living and thriving at the age of 92, is able to live at home and be active in her community, in large part because she has the support of a devoted home care worker. She makes it possible for my grandmother to live on her own terms.

Their vastly different experiences inform my work to elevate caregiving. I began organizing with domestic workers in New York City in the 1990s, and saw how critical their work was to the families who employed them, caring for the most precious elements of their lives — their children, loved ones with disabilities, parents and grandparents, or their homes. Care work makes all other work possible. Yet in far too many cases, these women were undervalued and vulnerable to abuse. It’s a workforce that works hard and struggles to make ends meet. Their economic insecurity is not only a profound moral dilemma, it makes it hard for the families they support to be secure. People like my grandmother, and someday my parents and myself — we will all need a strong care workforce to live well as we age.

You often refer to caregivers and domestic workers as invisible labor. What makes them invisible?

Like the air we breathe, caregiving work is invisible, yet it’s all around us and so essential to all of our lives. Rosalynn Carter has that famous saying: “There are only four kinds of people in the world: people who are caregivers, people who will be caregivers, people who need care and people who will need care.” But once you’ve become aware of just how fundamental it is, all of a sudden, you see it everywhere. Whether it’s professional caregivers or family caregivers, the work is happening all around.

And, for the most part, women still do the bulk of caring for children as well as our aging parents and grandparents. It’s always been taken for granted as “women’s work,” and continues to be devalued as a result. Often, even as a profession, care work isn’t thought of as real work at all. We think of it as a form of babysitting, or just “help” that happens in the privacy of our homes. Making it a visible part of our economy will require a shift in culture, one that’s long overdue.

Caregiving is difficult work that requires social, emotional and technical skills. It’s rewarding but not rewarded.

What do you wish people understood about caregivers?

Many people don’t know that there are tens of millions of caregivers in the United States — not just the professional care workforce, but the millions of women and men who have taken up the important work of caring for their family members — their parents, grandparents, spouses, or other relatives. For those of us who are not caregivers ourselves, we may not realize that our neighbor, our coworker, or our friend is spending hours of their time every week supporting a loved one. We all have caregivers in our lives — we just may not know it.

Caregiving is difficult work that requires social, emotional and technical skills. It’s rewarding but not rewarded. We should recognize caregivers for the incredible contributions they make to our society. They are the unsung heroes and heroines of our nation.

You estimated that by next year, the US will need almost 2 million more professional caregivers to accommodate the aging Baby Boomer generation. How should the country be preparing for the elder boom?

To start, we must understand that the investment we must make in the caring economy is just as necessary and fundamental to the economy as the digital and physical infrastructure we rely on every day, from the internet to our roads, bridges, and highways. We need an infrastructure-like investment in childcare and eldercare systems, one that turns care jobs into good jobs while helping families afford the care they need.

States have an important role to play in creating innovative solutions. That’s why at Caring Across Generations, we are working in states to create a new framework called Universal Family Care, a public benefit that would help working families afford care for everyone from newborn babies to aging grandparents while they work. These programs will help bring us into the 21st century as they begin to account for the struggles facing working adults in today’s economy.

How does your work intersect with immigration reform?

The future of caregiving in this country is so intimately intertwined with the future of immigrant women. It’s impossible to imagine how we will meet the need for elder care in America without a strong immigrant workforce. They must be a part of the solution. But our current immigration policies don’t acknowledge this reality. Already today, about two-thirds of all domestic workers are immigrants, and many of them are undocumented; their lack of status makes them particularly vulnerable to abuse. A report that NDWA released in 2012 found that 85 percent of undocumented workers who work in exploitative situations don’t speak up because they fear their immigration status will be used against them.

The future of caregiving in this country is intimately intertwined with the future of immigrant women.

So many of us rely on the work of immigrant women to care for our families, yet if they are undocumented, they live every day under a constant threat of deportation and of being separated from their own families. The fear has escalated along with the raids and deportations ordered by this new administration We can change all of this by supporting immigration policies that keep families together and include pathways to citizenship for immigrant women and families.

What do you consider the greatest success of the National Domestic Workers Alliance?

Since 2010, we have passed Domestic Worker Bills of Rights in seven states, creating important new rights and protections for domestic workers. I am incredibly proud of these victories, in large part because they were won by domestic workers who achieved these victories through organizing and asserting the dignity of their own work. We also worked with the Department of Labor to bring 2 million home care workers under minimum wage protections after more than 80 years of exclusion.

These campaigns have been rooted in the belief that care work is valuable and deserves recognition. I am proud that our work has contributed to a change in our culture and policy to uplift care work and the caregiving workforce for its true worth.

What can the average person do to promote the rights of caregivers and domestic workers?

Something I always tell people is this: everyone has a role to play in building the caring economy our country needs for the future. We all have a care story, whether it’s our own or that of someone we know. All of us can help make caregiving more visible by talking about it with our families, friends and neighbors. And together, we have the power to ensure our elected officials work to change our policy to better support our caregiving relationships.

What makes you optimistic about the future of caregiving in this country?

When I look back at our country’s history, we have achieve the impossible, over and over. Together, we pushed for the creation of the social safety net that has improved the lives of millions of older Americans, people with disabilities, and working people — Social Security, Medicare, Medicaid, and more recently, the Affordable Care Act.

By joining together in unions, workers built a movement to transform manufacturing jobs from sweatshop jobs into good jobs that provided economic security and stability for themselves, their families, and their communities. The civil rights movement equality and opportunity; it called for us to become a stronger democracy, without which we would not have ended Jim Crow and made strides toward ending racism.

Our task in the 21st century is to build on this history, and make care work for today’s working families. I take inspiration from the fact that we’ve done it before; I know we can do it again.

The views and opinions of the author are her own and do not necessarily reflect those of the Aspen Institute.

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