2

Daring to Lead

The first session of the workshop focused on the practical applications of power theory as used by leaders of movements for the rights of the domestic workforce and voter engagement. Participants discussed the effects of power on domestic workers and disenfranchised voters, as well as efforts to shift the power structure toward power sharing in a way that is centered on the values of respect and dignity for all human life. The session was moderated by Tony Iton, senior vice president of programs and partnerships at The California Endowment.

Iton noted that his organization is currently completing a 10-year Building Healthy Communities initiative, a “place-conscious” program that incorporates many of the factors discussed in this workshop such as changing the narrative and transforming communities most devastated by health inequities into places where all people have the opportunity to thrive. Although a technocratic approach to health is dominant in the system that trains most people who work in the field of health and health care, he suggested that health is better described as a democratic enterprise. “In a democratic enterprise what matters is power and a sense of belonging and ultimately for folks to come together to work on root cause conditions,” Iton stated, offering the shorthand of ABC to represent this dynamic: A is for agency, B is for belonging, and C is for changing conditions. These factors are at play in the community-led initiatives featured in this workshop.

NATIONAL DOMESTIC WORKERS ALLIANCE

Ai-jen Poo, co-founder and executive director at the National Domestic Workers Alliance (NDWA), described the conditions faced by domestic workers in the United States and efforts underway to build power within this workforce. NDWA advocates for quality work, dignity, and fairness for the growing number of workers who clean homes and care for individuals, the majority of whom are immigrants and women of color.¹ Founded in 2007, NDWA has partnered with more than 60 local affiliates and more than 200,000 members to pass domestic worker bills of rights in nine states and to bring minimum wage protections to over 2 million home care workers.

Scope of Issues Facing Domestic Workers

Poo provided an overview of the domestic worker population in the United States. Noting that domestic workers have been on the “front lines of every dimension of the COVID-19 [coronovirus disease 2019] crisis,” she said there are currently approximately 2.5 million individuals working for more than 5 million employers in more than 5 million workplaces nationwide. These occupations include nannies who provide childcare, house cleaners who maintain order and sanitation in homes, and home care workers who care for the aging and support people with disabilities to live independently in their homes and remain connected in their communities. She described domestic labor as “the work that makes all other

___________________

¹ More information about the National Domestic Workers Alliance is available at https://www.domesticworkers.org (accessed February 8, 2021).

work possible,” noting that this labor has always been essential. Yet, she added, it is some of the most uncertain and undervalued work in the American economy today, as reflected in the rights and benefits lacking in most domestic jobs, such as contracts, retirement benefits, health care, consistent hours, the right to unionize, a minimum wage, overtime pay, and weekends off.

Providing a historical context, Poo outlined factors contributing to the lack of security in domestic work. Traditionally performed by women, an underlying assumption that women will continue to provide these services—regardless of pay—has long influenced domestic working conditions. Furthermore, professional domestic work has historically been associated with women of color, as enslaved Black women served as some of the first domestic workers in the United States. Since then, Black, Indigenous, immigrant, Brown, and Asian Pacific Islander women have composed the majority of the domestic labor workforce. Since the 1930s, the historical ways in which race and gender have shaped both this nation and this workforce have been codified into laws that systematically excluded domestic workers from basic labor rights.² The result is an entrenched view that domestic labor is not real work, as demonstrated by the application of the term help to this field, she contended. Additionally, the nature of domestic work presents unique structural challenges to improving conditions and raising standards for this workforce. For instance, no registry exists to track the locations in which domestic workers are employed. Driving through any neighborhood, it is impossible to identify which houses are workplaces. The hidden and isolated nature of domestic labor poses barriers to identifying and connecting workers in the millions of residential workplaces across the United States.

The mission of NDWA is to support domestic workers and enable them to live and work with dignity. Poo noted this mission builds on the work of generations of Black women who organized to improve conditions and build power for this workforce. In spite of this history, challenges persist. Domestic labor is associated with poverty wages; coupled with the lack of access to health care or a safety net, these factors contribute to high levels of job insecurity. She highlighted the effect of the COVID-19 pandemic, which has been devastating for both the domestic workforce and for the people who depend on these workers. As baby boomers age and people live longer, the expanding aging population in the United States will increase the demand for home care workers. Whereas the growth of all U.S. jobs is expected to increase by 6.5 percent from 2014 to 2024, the growth in personal care aides and home health aides is anticipated to

___________________

² See, for example, the description of the Fair Labor Standards Act omission of domestic workers at https://www.dol.gov/agencies/whd/direct-care/faq (accessed June 2, 2021).

expand by 25.9 percent and 38.1 percent, respectively, during the same time period (Hogan and Roberts, 2015). Poo emphasized that these jobs, which cannot be outsourced or automated, will make up a large share of jobs in the future, yet the current average annual income for a home care worker is just $17,000 per year. These poverty wages signify “This workforce that we count on to care for us cannot take care of their own families,” Poo stated.

A THEORY OF POWER TO ACHIEVE CHANGE

The theory underpinning NDWA’s work is that centering the domestic worker community allows for power building along multiple dimensions, resulting in a transformation of the quality of domestic jobs and the future for this workforce, Poo explained. She then described the four dimensions of power: political, narrative, economic, and disruptive/modeling (see Figure 2-1).

Poo defined political power as both the ability to change policy and the ability to determine who makes policy. Narrative power is the capacity to explain and justify the legitimacy of power structures in place and maintain the status quo. Economic power is the ability to direct capital and shape markets. Disruptive and modeling power leverages the ability to build compelling models and disrupt the status quo to convey the urgency of needed change. Models for the future can demonstrate that alternatives to the status quo are both possible and scalable, she noted. The approaches used by NDWA to achieve needed changes involve

organizing people around civic engagement, innovation, policy, and culture. For example, this work can take the form of mobilizing voters and advocating for policy change. It also includes changing the media narrative and cultural norms around the domestic workforce and industry. Furthermore, building innovative products, especially in the technology space, can improve conditions for this workforce, Poo added.

Policy Change

Outlining a number of successes that NDWA has achieved, Poo described the organization’s foundational work that took place in New York City. In the late 1990s, organizers brought community members together in immigrant community centers and church basements. This work eventually led to the launch of a statewide campaign to establish the first Domestic Workers’ Bill of Rights in the United States.³ This campaign involved thousands of domestic workers in communities across New York State in a 7-year effort and resulted in the passage of the Bill of Rights in 2010. This achievement inspired domestic workers to organize at the community level across the country. In the 11 years since, domestic worker legislation has passed in nine states: California, Connecticut, Hawaii, Illinois, Massachusetts, Nevada, New Mexico, New York, and Oregon. Furthermore, legislation has passed in Philadelphia and Seattle that pushes the envelope further to bring more power and voice to the domestic workforce, Poo continued. Seattle created the first-ever Domestic Workers Standards Board,⁴ which brings all industry stakeholders together to define the norms and standards that shape the future of domestic work in that city. In Philadelphia, NDWA won the right to portable paid time off for domestic workers in the United States,⁵ the first time such a right has been established in this country. The city is currently in the midst of implementing this policy, she added.

Poo noted that these legislative achievements scale up to the national level. Built upon community-level work, a National Domestic Workers Bill of Rights was introduced into the Senate by Kamala Harris before she vacated her Senate seat to become the U.S. vice president.⁶ NDWA has launched a coalition effort of every constituency with a stake in creating

___________________

³ More information about New York State’s Domestic Workers’ Bill of Rights is available at https://labor.ny.gov/legal/domestic-workers-bill-of-rights.shtm (accessed March 3, 2021).

⁴ More information about Seattle’s Domestic Workers Standards Board is available at https://www.seattle.gov/domestic-workers-standards-board (accessed March 3, 2021).

⁵ Refers to benefits that follow workers between jobs.

⁶ More information about the National Domestic Workers Bill of Rights is available at https://www.nytimes.com/2019/07/14/opinion/harris-jayapal-domestic-workers.html (accessed February 9, 2021).

a strong care economy, including older adults, people with disabilities, and family caregivers (Poo, 2019). Additionally, NDWA is advocating for universal family care, a social insurance fund that would help people pay for childcare, paid leave, and long-term care (Poo and Veghte, 2019). Poo explained that this concept would enable people to access care for their families while they are working outside the home, while simultaneously investing enough money into the system to enable every job in the care economy to provide a living wage, benefits, and real economic security.

Culture Change and Innovation

To access the narrative dimension of power, NDWA partners with artists to tell the stories of the domestic workforce. An example is the film Roma (2018), in which the protagonist is a domestic worker, and around which NDWA built a campaign for culture change in partnership with the film’s producers.⁷ Poo said this type of storytelling can shape both popular narrative and culture, demonstrating that domestic workers are the “unsung heroes in our lives” and are the “protagonists not only in their own lives and in our homes, but in our future.”

The NDWA innovation lab has created a portable benefits platform called “Alia” that allows domestic workers to gain access to benefits, such as paid time off and various insurance products, for the first time.⁸ Poo explained that during the COVID-19 pandemic, NDWA has been able to leverage this platform to deliver emergency cash assistance to more than 50,000 domestic workers who were negatively affected by the pandemic but did not have access to any type of federal relief.

Civic Engagement

Poo asserted that all these efforts have shaped the public narrative, ultimately resulting in real-life improvements for domestic workers. For example, during his presidential campaign, Joe Biden announced a $775 billion plan to invest in the U.S. care economy to support working families and the caregiving workforce as part of his economic recovery strategy for responding to the COVID-19 pandemic (Miller et al., 2020). Needed change “begins and ends in community,” she emphasized. NDWA hosts meetings of democratically elected councils of workers from local communities around the country. These councils collaborate to define needed

___________________

⁷ NDWA developed a case study describing this work. See https://www.domesticworkers.org/wp-content/uploads/2021/05/Roma-Case-Study.pdf (accessed July 2, 2021).

⁸ More information about Alia is available at https://www.ndwalabs.org/alia (accessed February 15, 2021).

standards, determine what it means to have respect and recognition, and establish what it looks like to have health and safety in communities. Next, the councils work together to discern how to make this vision real. These efforts are fueled by a belief that community-driven solutions and community-rooted power building are the future, said Poo. The future of health, of care, and of American democracy all depend upon elevating the people who have been long failed by our systems to the forefront of this process. She explained that this is not only for their benefit, but for “the sake of a healthy, multiracial democracy that can sustain and support us across generations.” Poo concluded that if communities who have not had power within American democracy are given that power, it will benefit all people and lead to “the future we deserve.”

RADICAL REIMAGINING

LaTosha Brown, co-founder of the Black Voters Matter (BVM) Fund, a power-building, Southern-based, civic education organization, spoke about the need for a vision of an equitable world that is centered on human value. An organizer, philanthropic consultant, activist, and singer–songwriter, Brown is the principal owner of TruthSpeaks Consulting LLC, a philanthropy advisory consulting firm, the project director of Grantmakers for Southern Progress, and the co-founder of BVM Capacity Building Institute.

Envisioning a World Without Racism

Although models and strategies for organizing are needed, Brown’s remarks focused on “a greater conversation that is not happening.” She asked participants to close their eyes and consider the question: what would America look like without racism? Regardless of whether the setting is an Ivy League school, a corporate room, or a community center, people find this question difficult to answer because racism has become normalized and deeply integrated into how people interact with and perceive one another. While many people say they want to address and end racism, this cannot happen without first being able to envision it. Thus, in order to bring a nonracist, nonsexist nation into being, the first step is “radically reimagining” what the systems of a country that focuses on human value and that opposes the oppression of human life would look like. Brown remarked that while conversations about policy, programs, and approaches are common, innovation in how we see ourselves in human relationships is rarely discussed. Questioning how we see human value is often missing from discussions on change.

Erosion of Human Value

Brown remarked that a challenging component of racism is that people have accepted that there are some positive attributes to racism, particularly in the white community. She continued that while racism does provide some level of privilege to those in the “primary race that is lifted up in white supremacy,” an “erosion of human value across the board” is taking place. Racism erodes human value for all people, including those who are privileged by the system. Brown contended that the reason the United States does not have universal health care is not simply because millions of Americans profess not to want it. Rather, it is rooted in the efforts of the Freedmen’s Bureau to expand health care to newly released enslaved Africans during the period of Reconstruction. A cadre of white political actors opposed this move, establishing a value that persists to this day. Currently, it is not only Black people who do not have access to health care, but also white, Asian, and Indigenous people. Brown asserted that an erosion of thinking around human value, rooted in an institution of slavery that some thought would only affect Black people, is responsible for the millions of Americans of all races who do not have access to health care.

“We’ve got to have an honest conversation of how racism destroys our belief around human value for all human life,” Brown emphasized. She said:

She continued by saying that too often conversation around policy is driven by outcomes while neglecting process. A narrow focus solely on a specific outcome can be detrimental, she noted, giving the example of a school that increased from poor to high performance within 2 years. Expecting to find that structural changes and a shift in expectations enabled this school to turn performance around so quickly, Brown instead

___________________

⁹ In referencing “children locked in cages,” Brown is referring to the federal family separation policy instituted in 2018 in which child immigrants entering the United States were separated from their parents and detained under the supervision of the U.S. Department of Health and Human Services.

discovered a policy had been enacted that enabled the school to remove low-performing students from the school entirely. This practice gave the appearance that the school’s performance had increased, but in actuality, they were strategically removing students to improve the overall average. Brown described this as an example of how data can be tailored to support any desired narrative. Thus, rather than merely being data driven, Brown maintained that a love for humanity should be at the core of all change efforts.

Vision and Agency in Political Power

Brown reflected on a world in which each and every sector was driven by the love of humanity: “How will we interact with each other? What would the field of science look like? What would the field of medicine look like? What would government and politics look like?” During the U.S. presidential election on November 3, 2020, and the two U.S. Senate runoff elections on January 5, 2021, the majority of votes in the state of Georgia were cast for Democratic candidates for the first time in 2 decades. In dissecting this political shift, many people look for specific actions that were taken. Brown said nothing new was added to the “get-out-the-vote” model that has been used in the past and across the country. Rather, the transformative element was that instead of centering a candidate or a political party, BVM and other voting advocates reminded people that they have agency, power, and the right to shape everything that governs them in their lives. Brown noted that when a program centers itself around human value, this creates a shift that leads to transformation.

Seldom in politics is the goal of human development the focus, Brown said. She remarked that her “goal has never been democracy … [for] as a nation, we have killed people under the name of democracy, we have made and extracted wealth from people in the name of democracy, as if democracy is actually greater than the people.” Rather, she suggested that democracy is a means to an end—not an end in itself—and it seems like the best way forward is working toward the goal of recentering the notion of love of humanity. Brown explained that she roots a love of humanity in her politics and in the model of organizations she creates, refusing to reduce people to data points or desired outcomes.

Brown concluded by encouraging the audience to radically reimagine what a nation without racism could look like and to use innovative thinking to shape the systems needed to realize this vision. Not only will this involve changing external systems, but it will also require reordering people around a central notion of human value.

DISCUSSION

Facilitating Power Building

Racism, sexism, and anti-immigrant sentiment shape both the perceptions of the constituents within a community and how policy makers view those constituents, Iton commented. Given that stigma, devaluation, and dehumanization may be internalized by the members of communities being organized, Iton asked how to approach working with people whose experience of oppression and its associated trauma may have limited the ways in which they view their own power. Poo suggested that this work should focus on creating the context for people to connect to their agency and power, saying:

Poo added that this created sense of community and connection extends beyond power to encompass a sense of self, of belonging, and of collective confidence. In turn, this shared power can be used to change the conditions of people’s lives.

Brown added that real change centers the notion of human value. The effects of programs and strategies will be limited to the culture within which they are operating. When a society organizes itself around the idea that some human life does not have value, the result will be homelessness, exploitation, lack of health care, hunger, and an environment destroyed by climate change. In a value system that has eroded, Brown asserted, “the only thing that really matters is success, winning, and money, and not human life.” She noted that all people, herself included, are subject to devaluing others. She reflected on an experience in which she recognized that oppression lives within herself (see Box 2-1).

Approaches to Shifting Narratives

Iton asked what strategies can be used to shift mindsets by amplifying and diffusing new narratives to the greater public. Furthermore, he asked how narratives have been employed to support civic engagement, culture change, innovation, and policy. Poo said the first step in challenging and replacing dominant narratives is to analyze them. For example, dominant narratives that devalue human life see some forms of work as “real work” and other forms as “less than.” Similarly, some people are

seen as more human than others. These dominant narratives about who works and who matters must be uncovered. In beginning to replace them, Poo recalled Brown’s exercise of envisioning what society would look like without those narratives. She asserted that all people should challenge themselves to envision what replacement narratives—that is, those that affirm everyone’s value, dignity, and wellness—might look like. Lastly, people should put those new narratives into the environment via day-to-day activities, the media, and popular culture, building momentum around the narratives that should shape the future rather than holding on to narratives that perpetuate the status quo.

Brown stated that “culture will eat strategy for breakfast.” No matter how excellent the plans, they must be aligned with the culture of the community to take hold. Culture should not be ignored within the health care space, Brown advised. Rather, culture can be used to communicate, to affirm, and to help people access power in their communities. For many people, the reason they like to travel is to see other communities operating in their authentic voice of culture, Brown explained. She described

how when she travels to Jamaica, she does not want to hear the Southern accent and eat the grits and bacon that she finds in her hometown of Atlanta. Rather, she wants to experience the local foods—like oxtails and fresh fish with the eyes still in them—and hear the local patois. When she travels to France, she is intrigued with the way people sway as they walk and sit outside at cafes. Being in another culture “almost forces us to recognize the value in someone else,” Brown stated, adding that “culture should not just be a commodity in the entertainment industry;” its socially affirming quality should be used as an organizing tool.

Often, the approach used to counter a narrative actually continues to center the narrative that those efforts are intending to shift, Brown contended. She suggested that instead, new narratives should focus on the people living in communities and be designed in a way that encourages people and awakens their sense of imagination. She noted that many people are predisposed to enjoy the powerful gift of imagination, as demonstrated by the popularity of Disney World and cartoons. Too often, hard science is exclusively relied upon while disregarding the importance of culture, Brown remarked, adding that culture “is a science that has been created and perfected over thousands of years by a particular people based on a particular environment, based on a particular similar experience.” The power of culture should not be overlooked, she concluded. Poo added that data, arguments, and research are overly relied upon when attempting to create change. However, the attitude that society can research its way toward equality ignores that people are complex and emotional beings. In trying to effect change, it is not only the factual, rational minds of humans that must be considered, but also their emotional landscape. Reaching people as humans on an emotional level is foundational to achieving the change that we want and need, said Poo.

Harnessing Opportunities for Disruption

Iton noted the considerable opposition community organizers face, citing the legislature and government apparatus in Georgia that appears to be involved in voter suppression and the series of institutions that have treated the domestic workforce as expendable, disposable, and largely irrelevant in the policy space. Given the influence of these institutions and institutional norms, Iton asked how disruptive power can be leveraged in health institutions and in the concept of how health is created.

Poo replied that the present moment is an optimal time to leverage power, given that the COVID-19 pandemic has wrought such significant disruptions to the ways people live, work, and care across the country, and these present an opportunity to set new norms, narratives, and behaviors. Furthermore, the pandemic has spotlighted essential workers. Whereas

before COVID-19 there was an epidemic of low-wage work—with millions of working Americans unable to afford rent, food, and necessities—the pandemic has revealed that not only is this work dignified, it is also essential to safety and survival. The disruptions caused by the pandemic have created an opportunity for a collective effort to impart real change and cement these new narratives into policy, behaviors, norms, and practices. Poo described the health sector as the “tip of the spear” for recovery from the pandemic, which can set the pace of change in the fight for racial and gender equity. “You do not have to figure out how to create [disruption]. The question is how to pull the thread toward equity and justice,” she said.

Brown emphasized that institutions are created by people: just as people can change, so too can institutions, and “when people change and their values change, the institutional values will change.” Outcomes have been prioritized over purpose, she asserted, resulting in an inappropriate focus on programs and processes over people themselves. Regarding the opportunity afforded by the COVID-19 pandemic, Brown recalled that her grandfather, who lived to the age of 104 years, used to say, “Until the pain of staying the same becomes greater than the pain to change, people will never change.” In that sense, she said, the discomfort we feel can be seen as a gift that helps to reorder our thinking around how to move forward. Science can be used for more than merely advancing health outcomes; it can be used to provide factual evidence that when people are treated better, all people benefit, she added.

The present moment is well situated for reflection around the institutional changes that are needed, Brown suggested. At times, people become attached to institutions that have outlived their need and no longer serve a function. In such cases, people may be more attached to the institution than the outcome. Brown said she looks forward to the day when the Black Lives Matter movement is no longer needed—but for that day to arrive, the work must be centered around a vision of equality.

This page intentionally left blank.