On television and in real life, home health aides are an underpaid, overworked, and invisible workforce. Like Elisa (Salma Hayek) on season three of 30 Rock, they feed, bathe, cook, and clean for the nation's elderly folks and people with disabilities in their homes. Yet these workers struggle to make ends meet; on average, they make less than $10 an hour. They receive no overtime pay, and their work can often be physically demanding. Moreover, home health aides work in private residences where their labor receives little oversight and where they lack a support network to help them advocate for better compensation. And these injustices to home health aides matter now more than ever because—guess what?—with a growing elderly population, it's the fastest growing occupation in the U.S. So while Elisa's plight is played for laughs against Jack's one-percenter lifestyle, the sitcom offers a surprisingly frank glimpse of an undervalued workforce, one that's comprised overwhelmingly of women and women of color—and one that hides in plain sight in homes all across America.
On 30 Rock, Jack (Alec Baldwin) falls for his mother's nurse and home health aide Elisa. The problem is, she's a working class Puerto Rican gal with two jobs, and he's a privileged, white male executive who expects his girlfriend to be at his beck and call. Elisa does demanding work taking care of the ailing (and tart-tongued) Colleen Donaghy (Elaine Stritch). So how can Elisa possibly say yes to dinner at Jack's place when his home is one of her workplaces? Fair enough, Jack thinks. How about dinner and a show? "Are you kidding me? I'd love to go out, get all dressed up, tip maître d's and be all like, 'Thank you, Roger. This table was super duper!'" she says. But in order to make enough money to get by, she's stuck taking care of her other client as well, the dementia-addled Mr. Templeton. "Why can't I have fun like an upper middle class person?" she wonders aloud. So Jack decides to treat both Elisa and her senile patient Mr. Templeton to a great night, including a Broadway show and a fancy restaurant.
Broadly speaking, 30 Rock kind of nails it. Of the two million home health workers in the U.S., 95 percent are female and only about half are white, reports the CDC. Marisa Penaloza of NPR says that the high demand for labor attracts immigrants to the job, and about one in four home health aides are foreign born. Moreover, Elisa's struggle to pay the bills is not uncommon; Jennifer Ludden of NPR says, "About half of home care workers are in households so poor they themselves rely on public benefits, like food stamps and Medicaid." And it's not surprising that Hayek's character feels so frustrated by work that she starts to push Jack away. Milly Silva, the Executive Vice President of the New Jersey division of 1199/SEIU United Healthcare Workers East said the following in a New York Times roundtable last week:
I think that [home health aides'] day to day work experience can in some ways be an isolating one. If you are a home care worker and you are going to someone's home to provide care for someone who's in need, you really are there one on one with that person. So who are the people who can listen [to you]? Who's your sounding board? Who can you vent to in terms of what you're experiencing on a day to day basis, both in terms of your job and also just being able to get by day to day?
To be sure, not all personal care aides are necessarily disenfranchised. Workers with additional qualifications may potentially earn more than the average hourly wages. And women who seek part-time work might be drawn to home health care; depending on your clients and whether you work independently or through an agency, the hours can be flexible. But for workers who have have been scraping by on poverty wages, this struggle is an urgent one.
So how has this sector gone underpaid and overworked for so long? Shockingly, it's because the Fair Labor Standards Act, which guarantees workers a minimum wage and overtime pay, excludes caregivers including personal care aides and babysitters. That is, the women who comprise this workforce have been ignored for decades. Their physical and emotional labor provides vital support for patients in need across the nation—but our institutionally sexist and racist job market favors cognitive labor, the kind of work to which privileged, white men like Jack have had outsize access.
But the disenfranchisement of home health aides may soon change. Bryce Covert says in The American Prospect, "As of 2011, the National Employment Law Project found that 15 states gave these occupations minimum wage and overtime protection, and seven more guaranteed only minimum wages." Moreover, "The White House appears to be close to announcing a rule change to the Federal Labor Standards Act, finally including home health aides." If and when that happens, this previously invisible workforce can then be eligible for the increased minimum wage that Obama announced in last week's State of the Union address.
So for Elisa and the two million or so underpaid and overworked home health workers like her, change is in the air. And if and when it happens, it won't be a (satirical) Cinderella story like on 30 Rock. It will be a hard–won success in a fraught labor rights battle that has to do with gender, race, and class—a battle that's not often shown on TV but rages on in real life.