by Alexandra Benis Molloy
"Family" is a word of inherent ambiguity. put simply, it can mean a lot of different things to a lot of different people. Take Luis Marquez, a low-income single father from the Dominican Republic raising two small children on an inadequate hourly wage that forces him to work overtime and nights. Or there's Karin and Carl Arnette, who hold a total of three jobs in order to meet the needs of three young children, one of whom has asthma and another a learning disability. Or Patricia Connell, an attorney and an only child, solely responsible for the care of her mother dying of cancer.* The very diversity of these real family situations shows just how far we are from the stylized archetypes perpetuated by the popular media, where issues of money and childcare, time constraints and illness, remain, for the most part, in the background. "There's no typical working family in the United States today," says S. Jody Heymann, associate professor of health and social behavior at the Harvard School of Public Health and an expert on work/family issues and policies. "They all have considerably different experiences. A two-parent family is going to be different than a one-parent family. Your family life is going to be quite different if you have a close support system or a job with flexibility than if you don't. We've interviewed thousands of families, and each one has been unique. But there are underlying commonalties too: namely the struggle to meet the health, educational, and developmental needs of children and other family members."
Aptly illustrated by our typical families above, this universal struggle in family care is defined today by work-a concept that can be equally as nebulous as family but one which weaves a common thread through virtually all manifestations of family life. According to the Families and Work Institute, 85 percent of this country's almost 142 million wage and salaried workers live with family members and have immediate day-to-day family responsibilities off the job. Work is the foundation upon which real-life households are built. It is the economic font from which we nourish, clothe, and house our family members. It is the architect of our daily schedules. And much like families themselves, it can be a source of unequivocal satisfaction and a source of unremitting stress.
While work/family issues have existed as long as work
and family themselves, better understanding the complex interplay between these
two life factors has become of utmost importance; in the last century, this
country has experienced rapid changes in labor and family demographics, employment
conditions, and care responsibilities of the family unit. "But we as a
nation have failed to respond," notes Heymann, "which has left a widening
gap between working families' needs and the combination of high workplace demands,
outdated social institutions, and inadequate public policies." The potential
adverse consequences for the health and well-being of our children, our families,
and ourselves is enormous, even in recent times of relative fiscal stability
and reduced unemployment. "In times of economic stress, when jobs are harder
to find, the challenges faced by working adults trying to meet both family needs
and work demands are highlighted," says Alison Earle, a research specialist
at the School's Department of Health and Social Behavior and a colleague of
Heymann. "But even in times of economic prosperity, these issues are always
in play. When many more people are working, it's a good time to explore work/family
issues, and when the economy is thriving and there are potentially the resources
to address problems, it's an opportune time to look for solutions."
OUR FAMILY HISTORY
But to get an accurate picture of our country's current situation, one must go back to the time when these unprecedented changes in work/family dynamics began to take place. According to Heymann, the story of work/family issues in the United States begins, somewhat surprisingly, not with women's entry into the workplace, but with men's back at the start of the Industrial Revolution in the mid-1800s. Until that time, most children had been raised in an agricultural setting, where both parents worked at home; but by the 1880s, for the first time in U.S. history, it was already more common to grow up in a household with a father earning an outside salary and a mother staying at home than in a household with two parents working on the farm. By 1930, only 30 percent of children lived in farm families. And, although women were working as early as 1800, the majority were unmarried; two-thirds of women stopped working once they were wed, primarily due to rampant biases against employing married women at the time. It would not be until World War II, when the need to fill men's jobs outweighed the inclination to discriminate, that married women would start to flood the labor market. By 1990, more than 70 percent of children lived in households where both parents worked outside of the home.
"If you compare my generation to my parents' generation," says Jodi Grant, a Washington, D.C., lawyer–advocate, who recently became director of work and family programs for the National Partnership for Women and Families (NPWF, formerly the Women's Legal Defense Fund), "all of my mother's friends-and this was a luxury I had growing up in middle-class America-they all stayed home. Whether they would have chosen to do it differently is not the issue; economically it was feasible. Today, you have a lot of families where it's not even a choice whether you want to work or stay at home; either you need that second salary or as a single parent you're relying on that first and only salary. Even though the economy might be better, there's a lot more economic pressure on American families."
But whether for reasons of finance, fulfillment, or a
combination of the two, the progression of both men and women into the workforce
has irrevocably transformed the family unit. In her recently published book,
The Widening Gap: Why America's Families Are in Jeopardy and What Can Be Done
About It, Heymann likens the movement to a "revolution" in labor,
at the conclusion of which most families had become reliant on outside wages
and salaries for basic essentials and no longer had an adult at home full-time.
America's social and political response to the first wave of male workers at
the start of the Industrial Revolution was a testament to the resourcefulness
our nation; state and federal governments, recognizing the dire consequences
of families losing their sole wage earners, instituted unprecedented programs:
workmen's compensation, unemployment insurance, and Social Security. But despite
the profound implications for the adequate care of children and other dependents,
the women's wave has elicited only a meager response in comparison. Why? With
the complex mix of factors working at the heart of these issues, timing could
play a role--and could give us a reason to be hopeful. "It took us more
than 50 years to make the adjustment to having men in the workplace," reflects
Heymann. "It's now been just about that long with women in the labor force.
Maybe we're getting close to that point where things have to change."
ALL IN A DAY'S WORK
And change they must, if the research results of Heymann, Earle, and other colleagues at the Harvard School of Public Health are any indication. Since 1992, Heymann has led a research unit based at the School called the Project on Global Working Families (PGWF), which she established to better understand the multifarious challenges families everywhere face in meeting both their caretaking and employment responsibilities. It is the first project to systematically document the experiences of working families domestically and internationally, across social class, in both industrialized and developing economies. The domestic segment of this immense undertaking has centered around four major studies--the Urban Working Families Study, the Daily Diaries Study, the Department of Labor's National Longitudinal Survey of Youth, and the Survey of Midlife in the United States--which, in total, encompass thousands of in-depth personal interviews, daily diaries, child evaluations, and multi-year follow-ups. By examining how Americans of all ages and from all walks of life are balancing work with the health, educational, and routine and urgent care needs of their children, elderly parents, and other dependents, these studies paint a vivid portrait of the work/family experience in this country, from issues people have in common to those that diverge along lines of class and gender. They also offer a first glimpse of how our current situation impacts the health and development of our nation's children--a picture that is not always pretty.
For anyone who has been reprimanded for leaving work early to care for a sick family member or has endured a sleepless night wondering who's going to care for a child come morning, the project's findings thus far, chronicled in depth in Heymann's new book, may not be all that unexpected-but the pervasiveness and profundity of their impact was heretofore unexplored and undocumented. The majority of working Americans face long job hours, inflexible employment schedules, and inadequate preschool and out-of-school childcare. Conflicts between work and care responsibilities are ubiquitous and frequent, and workdays are often disrupted by commonplace events-both predictable and unpredictable-such as a family member falling ill, snow or teacher days, or even routine medical care. In a study of a representative sample of 870 adults interviewed every day over an average work week, 30 percent of the respondents had to cut back at least one day to meet their families' needs, and 12 percent needed to cut back on two or more days.
That these conflicts between work and family exist confirms
just how incongruous our schedules can be, particularly when it comes to kids.
School days are normally two-thirds shorter than typical workdays, and the school
year has 30 percent fewer days than most work years. Many familial obligations,
like doctor and dentist visits and teacher conferences, can only take place
between the hours of 9 and 5 on weekdays. "The reason we need to document
these experiences, whether or not they're surprising," declares Heymann,
"is that they're totally opposite to how we're formulating public policy
and instituting social change"-suggesting, she says, that there is a small
yet politically powerful subset of the population which, isolated by wealth
or social status, is still failing to see the reality of the majority's work/family
situation. Indeed, working parents have few options open to them. Only a fraction
of today's employees are covered by the Family Medical Leave Act (FMLA), considered
by many in the field to be the one tiny bright spot in the dark domain that
is work/family legislation. Passed by Congress in 1993, FMLA is the only federal
policy that addresses the need for adults to take time off from work to care
for family members, compelling employers to provide up to 12 weeks of unpaid
leave to tend to a child, parent, or spouse. But only half of the nation's workers
fulfill the requirements for FMLA, and the key word here is "unpaid,"
an option which few of the other half can afford. Paid leave and after-school
programs are the luxuries of a privileged minority, and affordable quality care
for preschool children, which can cost more than tuition at a state university,
is unavailable to even fewer families than paid leave.
HEALTH, EDUCATION, AND WELFARE
What suffers most when parents are unable to take the time off to attend to their familial obligations is the health and education of the nation's most precious resource: its children. While the importance of parental involvement in children's recovery from both chronic and acute illness and success at school is well documented in the research literature, studies from the PGWF found that a sizeable percentage of parents lack the necessary leave to meet their children's health and educational needs-a situation that only gets worse, the poorer the family. In one five-year study of working mothers, the project found that more than half had less than one week of sick leave and nearly two-thirds lacked leave completely at some point over that time period; nearly 60 percent of poor working mothers had no sick leave at all during the entire five years. Another project study of low- and middle-income families found that 50 percent of parents with paid vacation or sick leave stayed at home with their sick children as compared to 13 percent without paid leave-a result that shows a direct correlation between workplace policies and children's health outcomes. Those parents who lacked leave often had to let their sick children stay at home alone, entrust them to the piecemeal care of others, or send them to school or daycare ill. This situation is only exacerbated by a changing health care system with its earlier hospital releases and more limited coverage, which places an even greater care burden on the family. Other PGWF research found comparable results with regard to the relationship between school performance and the availability of paid leave and job flexibility.
While children bear the brunt of these trends, it's not only kids who fall prey to the shortcomings of work/family policy. With a booming population of 34 million older Americans, as many as one in four working families are also struggling to meet the needs of their aging parents and relatives. And let's not forget the workers themselves; is it any wonder with all these balls in the air that their own health and quality of life begin to show signs of wear and tear? A Families and Work Institute survey found that employed married men and women have less time for themselves than their counterparts 20 years ago, leading to lower personal well-being and greater susceptibility to negative spillover from job to home. Harvard School of Public Health researchers (separately from PGWF) also found that employees in jobs that afford them the most control and make the fewest demands have the best health, while those with the least workplace control have the poorest health. "Often when proposals are made about providing leave or better flexibility, childless families balk at the expense, saying, 'We don't need any of that,'" comments Earle, who has worked with Heymann for more than eight years on PGWF's domestic segment. "And certainly the data that we've analyzed shows that yes, about half the time it is children who are being cared for when employees take time off. But employees are also taking time off to care for themselves, their parents, elderly family members, spouses, nieces, and nephews. It's not just a parents' issue; it's a family issue."
LAST AMONG EQUALS
"Adapting both social institutions and workplaces
so that working Americans can meet the health, educational, and basic living
needs of their families is critical to everyone in the country," agrees
Heymann, "because everyone at some time will be in need of care. It is
not only important to those who receive the care; it's also critical in the
effort to ensure equal opportunity in our country." As it stands now, things
are about unequal as they can get when it comes to our nation's workers; the
widening chasm in income differences in the United States over the past two
decades is mirrored by a deepening shortage of options available to meet the
growing needs of working families. To sum up a bad situation: the lower the
economic resources, the greater the risk for problems in health, schooling,
and behavior, and the less likely the presence of paid leave, job flexibility,
and other family support systems. "The social gradient we found was striking,"
says Earle. "These are the sort of graphs that you don't expect to find
when you are a researcher. Data are rarely perfect-things are complicated, things
are messy. But these results fell so smoothly in a line, showing that not only
were middle-income employees consistently worse off than those at the top of
the income spectrum in terms of both resources available and their caretaking
burden, but those at the bottom were consistently worse off than middle-class
workers." While middle-income families fare worse than those in the upper
economic strata, they appear to be able to safeguard themselves against some
of the more ruinous consequences of this inequitable situation, but the poverty
stricken are the most directly and adversely affected because they have the
most limited resources and face the most substantial problems from the onset.
"I think what the data clearly shows from our studies is that there are
individuals who, given the poor social conditions they face and how poor we've
allowed as a nation their social conditions to become, are being placed in this
20-foot deep pit and are being asked to jump six feet above the ground,"
notes Heymann. "Now, there are Olympic athletes who can do that but there
aren't many."
PUTTING A FACE TO THE NUMBERS
Getting people-particularly policymakers who are in a
position to institute change-to understand just how dire our work/family situation
is can be an Olympian task as well. "I think making the bridge between
research and policy is the hardest thing," notes Cara Bergstrom, a doctoral
student in sociology at the University of Michigan who has worked on PGWF both
domestically and internationally over the past three years, "and I think
it's something Jody does extremely well, better than any researcher I've ever
worked with. Academicians too often sit around and say, 'Why that's what we
ought to do,' and not act on it, and policymakers maybe don't take advantage
of what's going on in the research world. But Jody does a remarkable job of
making that connection." Heymann's effectiveness in this regard can be
attributed in part to her use of qualitative studies-those based on in-depth
personal interviews-in addition to purely quantitative research. "When
you spend time with people and hear their stories, you get a depth and a richness
that you don't get through the numbers," comments Earle. All the participating
researchers agree that the personal accounts can often be very poignant; one
read of Heymann's book, which relates numerous vignettes of normal people in
intractable work/family situations, pays testament to that fact. "But we
try to keep in mind," Earle adds, "whether it's a child left home
alone sick or a parent struggling with a boss giving them a hard time, that
it's critical to get these stories out. We hope there will be some impact, maybe
not directly or immediately to that particular person, but more generally for
all people who are going through the same thing. These compelling individual
stories complement and strengthen the results from our analyses of national
data."
DOMESTIC POLICY AND GLOBAL POLARITY
But for all the compelling stories and powerful data, convincing politicians that the time is ripe for revised work/family legislation may still be an uphill battle-the rugged individualism and bootstrap mentality upon which this country was founded can sometimes get in the way. "There's an intrinsically American assumption that it should be entirely an individual responsibility with individual solutions," notes Heymann. Grant, the NPWF advocate, agrees: "Many opponents to work/family reform argue that the government should not be dictating what businesses should do; they believe if it's a good thing employers will do it on their own." While nothing can replace the individual commitment of parents and families, they are both quick to note that federal involvement in education and labor has created certain minimum baseline standards, which have only enhanced this nation's prominence in these areas.
The average working American already seems to be won over by the logic of such arguments. According to a 1998 nationwide survey of the National Partnership, one of the original proponents of FMLA's passage, the majority of Americans say that both employers and government should do more to help ease mounting pressures on working families; nine out of ten say that employers should do more while nearly three out of four say that government should do more. Remarkably, these views span all facets of society-Republicans and Democrats; working women and homemakers; baby boomers and seniors; whites, blacks, and Hispanics. "I think that the more men and women say that these benefits really matter to them," says Grant, "the more they will be provided with them."
One obvious place for improvement is FMLA. More than 35 million Americans have taken leave under FMLA since it was enacted eight years ago, with 84 percent of employers reporting that the benefits of providing leave outweigh the costs. "The truth is, it's working," says Grant. "So now the question is, if it's working, how do we make it work for more people?" Currently, millions of U.S. employees simply cannot afford to take the unpaid leave provided by FMLA, and many of the reasons workers need leave, such as caring for "minor" as opposed to "serious" illnesses or "indirect" versus "direct" relatives, are not covered at all. "As important a benefit as FMLA is," reflects Heymann, "it's like saying that providing one meal every other day for people who otherwise have no food is an adequate solution." Most Americans support expanding FMLA, with upwards of 75 percent of men and 82 percent of women favoring the use of unemployment or disability insurance to help provide at least some paid coverage and other leave benefits. And government is beginning to respond to their call at the level of much historic innovation-the state; a variety of family leave benefits bills have been introduced in 25 state legislatures in 2001 thus far.
Beyond FMLA, Heymann proposes a medley of solutions-some of which are breathtakingly simple-from more flexible work schedules like the 4 1/2–day workweek, to greater investment in preschool and early education, to expanding the school year and after-school programs, to improved public transportation. To those opponents who cry lack of money for such innovations, most researchers and advocates point out that the U.S. currently lags behind a vast array of countries with far fewer economic resources and less political stability in terms of paid maternity leave, paternity leave, pre-school care, and out-of-school education. It's a fact not lost on Heymann, who has expanded her research project on working families internationally to take a broader look at these issues and weigh both problems and solutions on a global scale. Studies are ongoing in Botswana, Mexico, and Vietnam, as well as the United States. And while the driving force behind these studies is the concern for the work/family issues of all populations, "If you care about the U.S.," notes Bergstrom, who is currently working on PGWF surveys in Mexico, "it only makes sense to look at it in the context of what's going on in the world. We've taken a hard look at where we stand in terms of family leave and found ourselves at the bottom of the pack. So now we have to ask ourselves, do we want to be there and are there things that we can do to catch up with the rest of the world?"
How poorly we stack up with our neighbors today could paint a grim picture for the health, education, and well-being of future generations in this country, but Heymann and her colleagues, who are already being approached by policymakers, advocates, employers, and unions about their research, are not without optimism. "I think sometimes the situations we place families in are bleak, but I don't think our situation is bleak in the sense that we are a country with vast amounts of resources," she asserts. "There's absolutely no reason we can't solve these problems-if there's a will to solve them. We're one of the first countries to have public education. It has revolutionized this country; it has dramatically increased, not only the human capital and human richness of the U.S. to have that investment in education, but also happened to increase the economic wealth and welfare of this country. We need a parallel investment in solutions for working families."
Harvard Public Health Review Winter 2002/text version
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