For decades, these front-line caregivers labored in the shadows of a welfare state that shaped the conditions of the occupation. Disparate, often chaotic programs for home care, which allowed needy, elderly, and disabled people to avoid institutionalization, historically paid poverty wages to the African American and immigrant women who constituted the majority of the labor force. Yet policymakers and welfare administrators linked discourses of dependence and independence-claiming that such jobs would end clients' and workers' "dependence" on the state and provide a ticket to economic independence. The history of home care illuminates the fractured evolution of the modern American welfare state since the New Deal and its race, gender, and class fissures. It reveals why there is no adequate long-term care in America.
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