The Politics of Care: An Introduction

My grandfather died a month after the beginning of the Covid-19 pandemic in 2020. My grandmother had just undergone heart surgery and required a significant amount of help, both from grief and continuing medical issues and recovery. As most of our family was distant from  her, we sought care workers to fill in gaps in family aid, and through searching for and conversing with these care workers, I learned several valuable lessons. First, care work is prohibitively expensive, and much of it isn’t at all covered by health insurance (thank you American healthcare system). I also learned that care work, and those involved in it, are devastatingly undervalued, something I had known conceptually but not seen in person. The activist in me sought a comprehensive explanation of exactly how care work is exploited and what could possibly be done. In so doing I stumbled across a concept that was unfamiliar to me at the time, the “politics of care.”

The term “politics of care” has existed for decades in academia, historically with an explicit focus on healthcare and the impact public policy has on it. The advent of the Covid-19 pandemic, however, has encouraged wider adoption of the more liberatory conception of the term long pushed for by feminist and anti-racist advocates, such as Joan Tronto and Patricia Hill Collins. Its usage outside academia is still new and the term is nebulously understood, but the component parts are already widely agreed upon by socialists: queer liberation, disability advocacy, universalized healthcare, racial justice, community building, and the like. Understanding the intersectionality of these issues, alongside the classic trifecta of race, class, and gender, and how a more equitable system would beyond repressive capitalist approaches to care work, constitute what we mean by a new “politics of care.”

Care, to use a single, brief definition, is the labor through which society is maintained and thrives. Healthcare and disability assistance are, naturally, significant parts of care work, but so are child and family care, social reproduction, education, and domestic work. Much of care work is behind the scenes, unpaid, and socially enforced as well as deeply gendered and racialized in terms of who shoulders the burden. It is “women’s” work, expected of people who society categorizes as women or feminizes regardless of their own self-conception and of those otherwise or additionally marginalized. Internationally, one study found that women spend three times as much of their week dedicated to unpaid labor as men while another study highlights that queer and black people are much more likely to engage in unpaid care work than their counterparts. These disparities extend to paid care, where the same populations are disproportionately employed amidst poor wages, workplace discrimination, and record lows in mental wellness. Care work is shouldered disproportionately by the marginalized. This weakens their financial independence, forcing workers to seek other avenues of survival, which in turn affects the quality of care work and provides yet another justification for its devaluation, at least to the minds of conservative lawmakers. 

Real wages for care workers have declined in the twenty-first century. Nearly 40% of care workers are on public assistance, and the number of care workers is beginning to falter while the number of those reliant on care work increases. It’s not hard to understand why care work is so difficult. The labor of women and people of color has long been systematically devalued in the US, whose patchwork and capricious welfare system forces many families to take on additional care work themselves. Patriarchal and white supremacist denigration of feminized and racialized labor economically disadvantages care workers and reduces their wellbeing and overall health as well.

Traditional conceptions of care insist on maintaining a hierarchy between physicians, nurses, and the great number of care workers that subsist on minimal or nonexistent wages. Many different kinds of care workers are underpaid and overworked, but there are still significant inequalities among them. While 13% of healthcare workers are unionized overall, support staff are less likely to be unionized than nurses, and physicians are the only group whose real wages have grown in this century. The fabrication of care as a scarce resource to be rationed shifts the onus of patient health from the industry onto the needy themselves.

Nancy Fraser argues that concern for the well-being of care workers themselves happens only when their labor is considered valuable, as it temporarily was during the worst days of the pandemic. In the wake of Covid-19, it appeared care work might gain limited economic ground with welfare policies primarily directed at care workers, such as the dramatic expansion of federal child tax credits under the 2021 American Rescue Plan. This expansion, which cut child poverty by more than half in a very short time, was phased out by 2023. However, none of the expansions were ever sufficient to compensate for the financial devastation from the pandemic suffered by care workers. 

Much of the socialist understanding of care and care work rests on the conceptual foundation of the Marxist-Feminist advancement of “social reproduction.” However, a newer politics of care not only acknowledges the labor of family care performed primarily by women but also the intersections of identity often neglected by Marxist writers. Any discussion of the gendered nature of care work has to recognize that the lowest strata of the industry are filled disproportionately by women of color, especially immigrants. In Black Feminist Thought, Patricia Hill Collins refers to “controlling images” (e.g., “mammies,” Black matriarchy, and “welfare queens”) that justify systemic bigotry and silence accusations of discrimination. Indeed, 60% of Black care workers describe workplace discrimination, often from their own patients. These workers further express their fear of retribution for voicing their concerns.

While Collins’ largely focuses her ire on controlling images of Black women, she also articulates that this process is weaponized against other oppressed people. Just as diametrically opposed controlling images of subservience and wantonness are used to silence Black women, so are they used to silence others in feminized positions. From these, we have caricatures to bludgeon marginalized people and all working people who ask for more than they are given by our hostile system.

Thus far, we’ve only touched upon one of the major groups damaged most by the devaluation of care work: people with disabilities. These people are themselves more likely to be unpaid care workers and thus subject to the financial turmoil and stress that status needlessly brings. Unacceptable work conditions and wages drive away candidates for care work they rely on, leaving a deficit in disability services. Because uncontrolled insurance and healthcare costs drive up expenses, family and friends need to work to make ends meet and pay for care. As a result, people with disabilities are left without the care they need, and too often, cannot afford. 

Unfortunately, even many socialists fail to consider people with disabilities or neurodiversity. As James Graham points out in “Socialism Needs Disability Justice,” the reduction of people with disabilities to another group of workers to advocate for, while frequently true, disregards disabilities that preclude traditional and outmoded conceptions of productivity. Class reductionism will leave behind people with disabilities who cannot sell their labor if identity is unaccounted for, just as it would with gender and racial inequalities.

The problems of care work under capitalism are many but relatively clear: necessary, sustaining, potentially enriching work has been feminized and racialized, so it might be cast aside and profited from. Factoring in the crisis of care, the outlook can appear grim. While no one person may have all the answers, once again feminist and antiracist writers have blazed the trail. The solutions are as varied as the problems involved and can be split into two broad categories: cultural and structural, or as matters of social and economic capital, respectively.

The denigration of care work is, primarily, patriarchal in nature, and secondly, part of the mass devaluation of the working class endemic to all capitalist societies. Everyone, especially those who have traditionally been exonerated by masculinity of the responsibility, must be brought in to shoulder an equal amount of care work, paid or unpaid, without setting aside the marginalized peoples that have thus maintained society through this work. Disentangling care from structures of gender and race underlines its nature as a universal benefit, something from all of us to all of us. More broadly, the dissolution of gender norms and the concept of “men and women’s work,” alongside the concepts of man and woman themselves, are needed for real parity. The nuclear family, as a hallmark of conservative self-management and upholder of traditional values, must also be displaced from its status as the typical family model.

There is, of course, a significant intersection between a necessary cultural shift to solve gender discrimination and one to eliminate racial injustice, advance queer, feminist, and black liberation, and combat racial and class inequalities. However, just as identity reductionism can too often result in a celebration of milquetoast politicians from marginalized identities, the inverse abandons the social and psychological effects of discrimination and bias as something not worthy of consideration and thus leaves those lingering prejudices in place. As we work towards our economic and political ends as socialists, we can never forget to uphold and respect the voices and experiences of marginalized people and adopt a collective liberation against sexism, racism, queerphobia, and discrimination against disabled people. Class reductionism would lead to the fragmentation of our movement and the abandonment of the causes of marginalized people.

Targeting segments of our population as responsible for the care of all only harms the common welfare,burdens the targets with labor they cannot achieve alone, and individualizes the pursuit of care instead of acknowledging the interdependent nature of communal systems. Cultural shifts alone will do little to rectify the material injustices created by the capitalist devaluation of care. Many of the structural changes necessary to value and uphold care work are policies familiar to and advocated by socialists already. These, however, must be taken with due respect in regard to identity, not only on a class basis. Paid leave for parents, for example, is an important step, but compensating parents and family members for currently unpaid care and domestic work is the surest method to aid the material stability of families and ensure that care workers are able to do their work sustainably.

The unionization of care workers would, of course, be one of the most significant benefits to their situation. Recent years have seen, propelled by the increased visibility and recognition of care workers from both the pandemic and our unique labor conditions, noticeable ground gained in this area, such as the unionization of healthcare workers at the University of Rochester and the University of Michigan. New York City and Chicago have both played host to significant movements to unionize home care workers this year alone.

There is also, of course, universal health care. Libraries of socialist literature have already been written on the myriad of benefits universal health care would provide, particularly where patients’ wallets are concerned, but it bears mentioning in brief the impact such policy would have on individual care workers. In addition to the myriad benefits of such a program for all workers, even a decidedly capitalist think-tank such as the Economic Policy Institute agrees that universal healthcare would relieve pressure on care workers by removing health insurance and medical costs as driving forces in workers’ lives. 

State-based solutions are, however, slow in implementation and can only go so far under our current system. Mutual aid fills in these gaps and provides bottom-up methods of care. Given how thoroughly inefficient our care industry is, it should come as no surprise that care workers (especially non-health professionals), and those who rely on them benefit significantly from mutual aid networks, and there is room for much more than currently exists. Notably, mutual aid networks kept many people housed and fed while the state faltered in its response to the pandemic, and many continue to do so specifically for care workers due to the instability of their income.

We must move beyond the misconception that care is a finite resource. It is a common labor and a common benefit. We as socialists, those in DSA in particular, are well positioned to effect change on care work and its workers. We hold the power as a collective to better the world for care workers and the people that rely on them, by better distributing care, and improving its quality.

Image: Works Progress Administration (WPA) photograph (1939) depicting women participating in a program aimed at training Black women to become domestic workers in New Orleans.