Evelyn Nakano Glenn, Forced to Care: Coercion and Caregiving in America [book]
Forced to Care: Coercion and Caregiving in America
Evelyn Nakano Glenn
This book is about the ideological and material foundations of the care crisis. It is grounded in the premise that the often untenable strains to which family caregivers are subject and the parlous situation of paid caregivers are closely intertwined and need to be examined together. The main thesis of the book is that the social organization of care has been rooted in diverse forms of coercion that have induced women to assume responsibility for caring for family members and that have tracked poor, racial minority, and immigrant women into positions entailing caring for others. The forms of coercion have varied in degree, directness, and explicitness but nonetheless have served to constrain and direct women’s choices; the net consequence of restricted choice has been to keep caring labor “cheap,” that is, free (in the case of family care labor) or low waged (in the case of paid care labor).
I put the social organization of care at the center of a number of important ethical, political, and economic dilemmas in American society and argue that the social organization of care has become preeminently a public issue, one that is integral to questions of economic and social justice, gender inequality, race inequality, class inequality, and citizenship rights. Let us start with some working definitions.
Caring can be defined most simply as the relationships and activities involved in maintaining people on a daily basis and intergenerationally. Caring labor involves three types of intertwined activities. First, there is direct caring for the person, which includes physical care (e.g., feeding, bathing, grooming), emotional care (e.g., listening, talking, offering reassurance), and services to help people meet their physical and emotional needs (e.g., shopping for food, driving to appointments, going on outings). The second type of caring labor is that of maintaining the immediate physical surroundings/milieu in which people live (e.g., changing bed linen, washing clothing, and vacuuming floors). The third is the work of fostering people’s relationships and social connections, a form of caring labor that has been referred to as “kin work” or as “community mothering.”  An apt metaphor for this type of care labor is “weaving and reweaving the social fabric.” All three types of caring labor are included to varying degrees in the job definitions of such occupations as nurses’ aides, home care aides, and housekeepers or nannies. Each of these positions involves varying mixtures of the three elements of care, and, when done well, the work entails considerable (if unrecognized) physical, social, and emotional skills.
By “social organization of caring” I refer to the systematic ways in which care for those who need it is allocated and how the responsibility for caring labor is assigned. Caring can be organized in a myriad of ways-in or out of the household, as unpaid family labor or as paid labor in the market. For example, caring can be provided within the home by a family member, friend, or community volunteer without pay or by a servant or home care worker for pay. It can be done in more collective settings such as community day care centers by a combination of volunteers and paid staff or in an assisted-living facility or a nursing home by paid employees. Furthermore, the care may be arranged and overseen by the care receiver, the care receiver’s family, a non-profit entity, a government agency, or a profit-making company. Caregivers can be remunerated by care receivers or their relatives, by private insurance, or by government agencies. These arrangements are not mutually exclusive. All these forms exist simultaneously in contemporary societies.
However, the particular mixture and balance of paid and unpaid, commodified and non-commodified, and private and public forms have varied across time and place, reflecting a society’s economic structure, prevailing beliefs, political systems, and cultural practices. In the United States the social organization of care has been characterized by reliance on the private household, feminization and racialization of care, devaluation of care work and care workers, and abnegation of community and state responsibility for caring. The persistence of these characteristics, despite (or perhaps because of) the frequent lip service given to the spiritual and moral qualities of caregiving, is rooted in fundamental philosophical principles, social structures, and cultural practices that have survived (in somewhat altered forms) since the early republic. For this reason, an examination of historical continuity and change in these structures, beliefs, and practices is essential for understanding the material and ideological underpinnings of the contemporary social organization of care. Such an analysis is also crucial to identifying contradictions and fault lines that might be exploited to transform the way care is organized in our society.
The final concept is that of coercion, which I define as physical, economic, social, or moral pressure used to induce someone to do something. In the case of caring, two specific forms of coercion are particularly relevant. The first form is status obligation. As described by Alvin Gouldner, status obligations are duties assigned to all those in a given status, for example, wife, mother, daughter. Gouldner notes that status obligations “may require an almost unconditional compliance in the sense that they are incumbent on all those in a given status simply by virtue of its occupancy.”  A status obligation can be contrasted with the norm of reciprocity, in which an obligation is incurred as a debt for gifts and services that one has received. Status obligation can also be contrasted with contractual obligations that are incurred as a result of voluntarily entering into an agreement to provide services in exchange for pay or other considerations. Scholars since the time of the nineteenth-century anthropologist Henry Maine have argued that as Western societies modernized, they shifted from reliance on status relations to contractual relations. In this view, market relations have been more or less completely contractualized, but family and kin relations have remained “premodern” in that status obligations remain in force.  I will argue that status categories such as race and gender continue to shape both market and kin relations. Consequently, women are charged with a triple status duty to care, on the basis of (1) kinship (wife, daughter, mother), (2) gender (as women), and (3) sometimes race/class (as members of a subordinate group).
The second form of coercion is racialized gendered servitude, by which I mean a labor system in which one party has the power to command the services of another. In some instances, the power is de jure, in that one party is recognized by law as having a property right in the person and/or labor of the other. Slavery, indentured labor, and debt bondage are prominent examples of racialized gendered servitude that have at one time or another been legally recognized in the United States. In other instances the power is de facto, in that it grows out of marked inequality between parties, whether economic, physical, or social. Contemporary examples of inequalities that have fostered servitude include undocumented immigrant workers in sweatshops in U.S. territories, impoverished child servants in many parts of the world, and women trafficked into sex work or domestic services. I use the qualifier “racialized gendered” because the lines that distinguish those who command services from those who provide them are often those of race and gender (e.g., white/black, male/female), and ideologies that support the rights of those who command others are framed in terms of natural differences between races and genders.