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Care Work Is Climate Work

Overhauling the economy to cool the planet will require huge investments in care work. Biden’s infrastructure plan is just the start.

A nurse examines a woman's leg.

“What is infrastructure?” Somehow, this is the question under debate right now, thanks to America’s antiquated political system, which has made it virtually impossible to pass anything that isn’t a giant omnibus bill by the slimmest of margins. That could well make the recently proposed “infrastructure bill” President Biden’s last, best chance to jam something through the budget reconciliation process. Republicans are now arguing that any proposal that isn’t only about roads and bridges isn’t really “infrastructure,” and are trying to portray the package as a kind of Green New Deal lite.

It’s true that the American Jobs Plan Biden presented last week—due to be one half of the White House’s infrastructure proposal—has some focus on curbing greenhouse gas emissions through upgrades to the electric grid, research funding, and tax credits for electric vehicles, albeit at a drastically smaller scale than climate experts say is needed. What all counts as infrastructure is a tricky question in looking toward a climate-changed century, though. In the coming decades, everything from cars to kitchens will have to run on clean energy. That change will upend economies that have historically revolved around the extraction of coal, oil, and gas, and demand sweeping transformations of the built environment. And no matter how fast the world acts, rising temperatures promise to bring about more storms, droughts, and floods. Infrastructure of all sorts will need to be ready to deal with them.

Passed into law, parts of the White House’s plan really would help prepare for that. Among them would be the $400 billion worth of investments in the “care economy,” populated by nurses, domestic workers, and many others. Specifically, the goal is to “solidify the infrastructure of our care economy by creating jobs and raising wages and benefits for essential home care workers,” and expand “access to quality, affordable home- or community-based care for aging relatives and people with disabilities.” The forthcoming American Family Plan—part two of the administration’s infrastructure pitch—will likely expand this focus.

In analyses of the plan so far, the climate proposals and care proposals have generally been talked about as different buckets of funds doing different things and going to different groups of people; one common thread among advocates is that just about everything is too small. Yet as the Roosevelt Institute’s Climate Policy Director Rhiana Gunn-Wright told me, “Economic transformation is not possible without care infrastructure, at least if you want to do it equitably. If we’re going to reduce greenhouse gases, we’re going to have to change the way our economy is structured, not just the kind of energy we use.”

Without care infrastructure, women will have difficulty reentering the job market as the pandemic lets up, having been disproportionately left with the job of caring for children and elderly relatives. That poses a barrier not just to getting the economy back on track but to scaling up clean energy. Public, universal childcare, Gunn-Wright suggests, could offer a solution. There is not, after all, an endless reserve army of white, male workers standing by to build wind turbines and mount solar panels. Making sure that women and people of color can enter burgeoning green industries means spreading out work that for decades in the United States has been, as a matter of policy, considered a domestic responsibility. Care work is also rapidly growing and generally low-carbon, making it possibly a more prolific source of good, green jobs than the manufacturing revival the Biden administration is hoping to offer those transitioning out of fossil fuels. And more care workers—ideally, making a living wage in decarbonized hospitals and homes—will be needed to deal with the many patients that climate change will make sick, through increasing heat stress, the spread of insect-borne ailments like malaria that are creeping farther and farther north as temperatures rise, and potentially even future pandemics. “I don’t know how anyone could live through the pandemic and not see clearly that a care infrastructure is part of the backbone of an overall strong economy,” economist Lenore Palladino told me.

In Congress, Representative Jamaal Bowman has been leading the charge to think of care work as climate work. Bowman recently released a Care for All Agenda and $1.6 trillion plan to retrofit every K-12 school in the country. “Care is going to be even more essential as we cope with and solve the climate crisis. We cannot have a flourishing economy of any kind if our loved ones—children, older adults, people with disabilities, and all Americans—aren’t getting the care they need,” he told me over email. “Our country does not guarantee care as a human right. And care workers, who are disproportionately women of color and immigrants, are often extremely underpaid and exploited. These have to be high-paying, unionized jobs, and we need to create millions more of them—including with public jobs programs,” which so far have not been raised as an option in the American Jobs Plan.

Especially in the U.S., infrastructure tends to be treated by politicians more as a handmaiden to economic growth than as a way to build the foundation of a good society. This can lead to all sorts of imbalances. Economistic thinking, for instance, suggests that a low per-capita gross domestic product in poor neighborhoods makes them less worthy places for public investments like replacing lead pipes than a highway that—properly updated—can more ably deliver commuters to work and Amazon packages to homes within just a few hours of online checkout. This kind of cold, dollar-based cost-benefit analysis also explains why there is no shortage of public support behind infrastructure devoted to helping fossil fuels flow freely: from the roads and railways required to transport coal, to oil pipelines and ports for exporting fracked gas.

So far, the Biden administration has presented a different theory of growth and who benefits from it than its past few predecessors—one that in fact reflects recent shifts within the economics profession, which is beginning to focus more widely on concerns like climate change and racial and gender equity that have for decades been voiced from the field’s fringes. With that comes a different definition of infrastructure, including not just roads, bridges, ports, airports, and mass transit, but also broadband, clean water, and a clean electrical grid, as well as child and eldercare. Infrastructure, Biden said in a speech earlier this week, “depends on investing in ‘Made in America’ goods from every American community, including those that have historically been left out—Black, Latino, Asian American, Native Americans, rural communities.” In Building Back Better, he hopes to “scale to win the industries of the future,” including the critical minerals and battery technology essential to a clean energy economy and to giving the U.S. a leg up over China. “America is no longer the leader of the world because we’re not investing,” he added.

That plan’s focus on climate, accordingly, is framed as supporting American companies to be competitive in a global economy whose leaders are already treating the climate crisis as a matter of state-led industrial policy. That means not just investing in manufacturing and research and development but also tax incentives for renewable energy, electric vehicles, and the charging stations needed to power them.

But the Biden administration’s guiding philosophy of preparing American companies for competitiveness also means that the infrastructure plan doesn’t articulate care work as the core component of climate adaptation and fossil fuel transition that it truly is. Pittsburgh, where Biden announced the plan, is in fact a classic real-life example of where care workers have already acted as the shock absorbers of deindustrialization. Historian Gabriel Winant’s recent book The Next Shift chronicles the city’s transition from industrial heartland to a service economy—a process he called “the economy turning inside out.”

In 1950s and 1960s Pittsburgh, he explained over the phone, “if you wanted to have some economic security you either had to be a steelworker or you had to marry one.” The United Steelworkers fought for high wages and eventually won the right to negotiate for pensions and health care benefits in collective bargaining agreements. Industrial unionism built the model for today’s employer-provided health care system and created networks of hospitals built to serve the cities’ massive blue-collar workforce. The passage of Medicare and Medicaid—essentially, government-provided insurance coverage—swelled health care systems even more, which proved a boon when industrial decline turned the population “sicker, older, and poorer,” Winant said, as young people left to find work elsewhere and workers retired after decades of back-breaking work.

Care work performed mostly by women—in hospitals, but also by nursing home employees, teachers, home health aides, and family members—softened the blow of deindustrialization, providing not just income streams but treatment. Much of that work is not paid at all, or grossly underpaid in workplaces that blur the lines between public and private: Medicaid will pay for indefinite home care, but home health aides enjoy few on-the-job protections and often make low wages.

A similar situation now faces areas whose economies have historically revolved around fossil fuels. It’s not just bodies that have taken a beating but land, too. Coal mining in Appalachia has left behind both black lung and poisoned waterways, all to be serviced by tax bases facing massive shortfalls as resource revenues decline. West Virginia has the highest percentage of residents collecting Social Security disability insurance benefits in the country, 9 percent. Ted Boettner, senior researcher at the Ohio River Valley Institute, sees cleaning up abandoned mine lands and orphan wells as critical, along with Medicare for All, a federal job guarantee, and labor-intensive energy efficiency work, to repairing the damage caused by the fossil fuel economy and charting an economic future for the region that doesn’t depend on it.

The entire global economy is bound up in fossil fuels. Changing that means looking at which types of work have helped navigate transitions before, and reevaluating the priorities that have informed past rounds of infrastructure investment. “There’s a catalog of specific ideas for rebuilding America’s social infrastructure, and it looks like the Biden administration didn’t even open it,” sociologist Eric Klinenberg told me, noting that he is also optimistic plans could improve. He describes social infrastructure as “the physical places that shape our interactions,” from childcare centers to playgrounds. The preeminent form of social infrastructure, as he wrote in his 2018 book, Palaces for the People, is a public library, which “represents everything you would want in a generous open society: it’s accessible and welcoming to everyone, which in and of itself is radical. It does not charge. It doesn’t turn users into consumers,” offering internet access, entertainment, and English as a Second Language classes, among other amenities.

Libraries aren’t due to receive any funding in the American Jobs Plan, but like other forms of social infrastructure are an essential component of how the country responds to disasters. When temperatures spike, libraries can double as cooling centers. In hurricanes, libraries are places where communities can seek out resources and information. When a brutal heat wave hit Chicago in 1998, Klinenberg argued in a prior book, it wasn’t the poorest places that were worst off but those with the thinnest social ties. Social infrastructure—including care infrastructure—helps to build them. “Hard infrastructure—seawalls, energy grids, communication systems—tends to break down when it’s stressed in heatwaves or hurricanes or floods. And in moments like that, it’s social infrastructure that makes the difference between life and death,” he said. It also just makes life more enjoyable.

The New Deal, Klinenberg noted, invested heartily in public leisure amenities like trails and parks, but also in theater and the arts through the Works Progress Administration. “My concern is that I don’t want us to build a joyless infrastructure that’s not also about improving the quality of people’s lives,” he told me. “For me, this moment is not just an opportunity to build cleaner energy systems. It’s also about an opportunity to build a better social environment that’s more just, affordable, accessible, and democratic.”