Care4America Corps introduced at #TEDxUNC


Alison Stuebe introduces Care4America at #TEDxUNC #WhatIfMCH on January 17, 2017

Last winter, there was an ice storm just before New Year’s. A mom who was just 23 weeks pregnant was in preterm labor at a small community hospital in rural North Carolina. A day passed before the storm cleared and the ambulance could safely transport her to UNC. I met her on Friday afternoon, as she was transferred from the stretcher to a labor bed. 20 minutes later, her baby was born, weighing less than a pound. That weekend, he was fighting to survive in the neonatal intensive care unit. On Monday, mom was 100 miles from her baby, back at work because she could not afford time off to be with her critically ill newborn.

She’s not alone: financial pressures drive one in five employed mothers to return to work by 10 days after giving birth. Think about that. Ten days after giving birth, one in five employed mothers is back at work.

America, in orange, is the only high income country in the world without paid maternal leave; most other countries, in green, have paid leave for mothers AND fathers. The yellow countries have paid leave for moms, but not for dads. The civilized world values parents and values caregiving. The US does not. Paid, job-protected family and medical leave would enable all workers to maintain their livelihood and meet the acute needs of their loved ones. Continue reading

The American workforce has been transformed

In the past half-century, America’s workforce has been transformed. Consider physicians. In the 1960s, when this photograph was taken, women made up 8% of medical school graduates. We’ve come a long way in 50 years: in 2016, we were 47 percent of medical school graduates.[i]

As women have entered the workforce, we’ve transformed the American family. Especially for middle class women, the feminist movement offered inspiration and empowerment to pursue professional passions and build careers. In four of ten households with children under 18, mothers are the sole or primary source of income[ii]. And at its best, this paid work offers women self-realization and a sense of purpose. In 2017, women can be physicists and fighter pilots.


And yet, It’s important to remember that some women don’t make a choice to enter the paid work force. Poverty and stagnant wage growth mean that, for many American women, like my patient who was back at work 4 days after giving birth, paid work is not about self-realization; it’s about survival.



We have a fundamental disconnect


Regardless of why more parents are working full time, we have a fundamental disconnect: we live in a world built for a breadwinner Dad backed up at home by a full-time mom.  It’s still assumed, for example, that all mothers are at home and available on short notice for school events, even in the middle of the day. That’s why my son’s Mother’s Day Tea was held at noon on a Thursday. Of note, the Dads and Donuts Father’s Day celebration was on a Friday at 7:30 am, because, you know, Dads have to get to work. They have important things to do.

As modern families, we inhabit this Leave-it-to-Beaver reality with a much ease as we can stream high definition video via a 14.4 modem. The Mother’s Day Tea incident was irritating, but the underlying mythology has significant consequences, starting with the lack of value we place on care work.

We have a Care Work Deficit

Slide14In the distant past, when one salary could support a family, we had a care work surplus; today,  we face a care work deficit. This care work deficit matters: It’s why American parents more unhappy, compared with non-parents, than adults in 22 European and English-speaking countries. What explains the gap? The research team found that[i] “The most important predictor happiness for parents was the presence of family policies making it less stressful and less costly combine childrearing with paid work.” If you are a parent and you are stressed out, you are suffering the consequences of our care work deficit.


We need to rebuild our care work infrastructure

To close that care work deficit, we must upgrade our economic infrastructure ensure that each of us can both to nurture our loved ones and deploy our unique strengths.


As Dr. Howard Thurman wrote, “Don’t ask what the world needs. Ask what makes you come alive and go do it, because what the world needs is people who have come alive.” We must remake our economic infrastructure so that we can each do what it is that makes us come alive, while at the same time ensuring the safety and wellbeing of our loved ones.

What is the Care4America Corps?

The Corps will bring together and local caregiving agencies, community colleges and universities to engage a diverse population of young men and women in the caring professions.

  • First, the Corps will support direct service through a cohort of on-the-ground care workers to close the Care Work deficit.
  • Second, the Corps will support career development for future care workers, serving as the first rung on the career ladder for jobs in heath care, child care, and social services.
  • Third, the Corps will elevate the value and importance of care work in our society by engaging young people in direct care work early in their careers.

The Care4America Corps will be the first rung on the career ladder for careers in the caring professions


During their two years of service, recruits will shadow social service and health professionals and receive mentoring for careers in caregiving. In partnership with community colleges, the corps will support coursework, certification and licensure as health educators and personal care workers. The Corps will also provide funding for further training, as well as career counseling and job placement.

What if …we counted caring work?

Over the past half-century, the proportion of mothers in the paid work force has increased dramatically, from 30% of married mothers with children in 1965 to 65% in 2015. Coupled with growing numbers of single-parent households, this move to paid employment has created a vast deficit in unpaid care work. This care work – for young children, for ailing relatives, for school PTAs – is essential to the health and well-being of our communities, but it is uncounted in our gross domestic product, and it is profoundly undervalued. At the same time, the caring professions are the fastest growing employment sector, comprising 8 of the 12 occupations expected to grow by more than 30% in the coming decade. To close the care deficit and prepare our future care work force, we need a Care4America corps. Corps members would enlist in a 2-year program to provide front-line care as community health workers, home health aides, and childcare workers. For some, the Corps would be the first step on a career ladder as a front-line care workers. For others, this 2-year experience would lay the groundwork for further training in caring professions. Currently, many aspiring medical students spend a year or two in a research lab; service with Care4America would instill future physicians with hands-on skills and respect for the value of care work. Lastly, the Care4America corps would expand the supply of care workers, enabling provision of vital care services for children of parents who participate in the paid work force.

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