Care Has Always Been Infrastructure

Care Has Always Been Infrastructure

Illustration: Angelica Alzona/GMG

The emerging debate over whether care is infrastructure isn’t new or surprising. The question “what is infrastructure?” was triggered by President Biden’s announcement that the American Jobs Plan includes a $400 billion investment to expand Medicaid coverage of home and community-based services for people with disabilities and older adults, and to improve wages and working conditions for the nation’s direct care workforce. Politico went so far as to say that it’s “silly” to call care infrastructure, as “no previous politician who put forward a similar caregiving proposal has done so under the guise of infrastructure spending.”

That’s precisely the point and what makes the American Jobs Plan the new and bold plan we need.

Care has always been infrastructure; from child care to paid leave, to home and community-based services, care is a need shared by all at some point in our lives, and is fundamental to enabling economic activity.

But it has never before been seen or valued as such in our political discourse because women and women of color have shouldered the work of our care economy. Today, the work of care as a profession falls overwhelmingly on women: 91.5 percent of domestic workers—nannies, house cleaners and home care workers—are women, 86 percent of direct care workers are women, and 61 percent of family caregivers are women. The wages for care work mirror the devaluation of unpaid family care: the median hourly wage for a domestic worker is $12.01, and the median wage for home care workers—who make up the majority of domestic workers—is $11.89 for non-agency workers and $12.08 for agency-based workers.

The devaluing of the profession, and the persistent low wages, has deep roots in racism and the legacy of slavery. The centuries-long exploitation of Black women’s domestic labor, including enslaved African women, was cemented by the exclusion of domestic workers, including home care workers, from the foundational labor laws that Congress enacted as part of the New Deal in the 1930s. Today, just over half (52.4 percent) of the domestic workforce are Black, Latinx, or Asian American/Pacific Islander women, including 61.3 percent of agency-based home care workers. In particular, Black women make up a little over a tenth of all women workers in the U.S., yet they constitute almost one-third of women working in homecare.

And yet, the case for investing in care as infrastructure is far more than a case for equity. A report from just last month cited how investing $77.5 billion per year in care would support over two million new jobs at an average cost of $34,496 per supported job (this proposal would commit $50 billion per year to start). Care jobs generally are also job-enabling jobs, allowing mothers and family caregivers to return to the workforce and workers to stay in their jobs as their family’s needs change, rather than forcing them to choose one or the other.

The debate over whether care is infrastructure is sorely out of touch with the majority of Americans. In 2019 a survey showed 73 percent of Americans believed there are not enough caregiving professionals to take care of those in need (then or in the future)—and that was prior to the pandemic revealing the current and impending crisis. The survey also showed that 82% of Americans - across party lines - supported a federal program that everyone pays into and everyone could access for support including child care, paid family leave, long-term care for a disability, and care for a family member as they get older. Just this week a survey showed that support for the American Jobs Plan has bi-partisan support of likely voters, backed by a 52-percentage-point margin (73 percent support, 21 percent oppose), firmly placing the debate of care as infrastructure in the chattering class, not with voters.

Care can’t wait. For those already struggling to provide care or access it, the pandemic created a crisis within a crisis. It’s time we created bold solutions that will make a meaningful difference for Americans across the country, of all party affiliations, who need a strong care infrastructure. That’s why many of us joined Vice President Harris, Speaker Pelosi, Secretary Raimondo and others for the Care Can’t Wait Summit to share our care stories, and demonstrate the urgency for action.

Care has always been infrastructure, and we’re finally having a conversation about what is needed for that infrastructure to be strong enough to support the needs and potential of women, women of color, our families, and our workforce. If we’re serious about economic recovery, it would be “silly” not to prioritize care jobs and infrastructure.

Ai-Jen Poo is the executive director of National Domestic Workers Alliance and director of Caring Across Generations.


I don’t think there’s a reasonable argument to be made that “infrastructure,” in the context of the term “infrastructure week” and the infrastructure bills that Congress passes from time to time, refers to something other than things like bridges, roads, the power grid, buildings, dams, etc.—i.e., the building or maintenance of the literal physical instrumentalities that directly allow for the movement of people, goods, energy, and communication across/through the country, and upon which our supply chains and streams of commerce rely. I understand that most actual dictionary definitions of the word “infrastructure” can be ready very broadly, but generally speaking, what I wrote above is what has traditionally been referred to as “infrastructure” in the parlance of American politics.

With that in mind, it seems like the people arguing for this new, more expansive definition, are mostly making a moral argument. The argument is not that long-term care is like a dam, road, powerplant, fiber optic line, or program to renovate an Interstate highway (though I’m sure that specious argument can and will be made with all requisite mental gymnastics)—it’s that long-term is super duper important, it’s the right thing to do to fund it, that it would be indecent not to fund, etc. etc.

Okay, well, there are alot of things that I could make the same argument for—universal healthcare, gun control, a higher minimum wage, laws that protect voting rights, criminal justice reform, immigration reform, etc. We probably all agree that these are worthy moral causes (assuming of course that you buy into the de rigueur social politics espoused on Jez,) and I could argue that any one of those things are essential infrastructural improvements because people’s health, safety, and peace of mind are essential elements to their proper functioning in society—and society functioning properly is basically the point, no?

The problem here is that infrastructure is supposed to be dry, boring, and amoral. Unless you’re one of handful of neo-primitivist hyper-libertarians who won’t be happy with anything other than a world of every-person-for-themselves isolationist feudal fiefdoms, you probably like roads and power lines and power plants, and telecom (among other things.) I’m sure there has always been some degree of log rolling and coloring outside of the lines when it comes to these bills (that wheels need greasing is just a reality of our society, and has always been,) but putting potentially divisive shit into a bill that the country otherwise basically needs (and is long overdue for,) in order to continue function in the most basic and fundamental sense of the word ‘function’, is worrisome.