Who Really Cares?

The Widening Gapby By S. Jody Heymann, M.D.Basic Books. 254p. $28.

This is a crucially important book. I wanted, almost immediately, to send a copy to my congresswoman and to my nieces, who, like so many American women aged 35 to 42, are caught in the double-bind of caregiving for young children and aging parents. Heymann’s careful data would confirm what they already recognize intuitively: our nation’s failure to address working families’ needs and a growing national caregiving crisis.

S. Jody Heymann, M.D., Director of Policy at the Harvard University Center for Society, draws on ground-breaking research based on The Working Families Study and interviews with 7,500 care-givers. The majority (70 percent) of American children come from homes where both parents work full-time. For the working poor and lower-middle classes, the release of one parent for child care is no longer a viable economic option. These parents seek scarce child care, which is costly (the average cost for child care is the same as tuition for a state university) and often inadequate. There is almost no child care available during evening hours, when many parents, especially the working poor, must work. When their child is sick or needs medical attention, parents must take a leaveusually unpaidfrom work.


The one and only federal policy response to this growing pressure on parents to care for the health or special educational needs of children or the elderly is the Family Medical Leave Act. Half of working America is not covered by this legislation. Many of the working poor or marginally middle class simply can not afford to take unpaid leave to care for family emergencies. The legislation, moreover, envisions only major illnesses for children, a spouse and a parent. Grandparents, siblings or other close relatives are not covered. Nor are the ordinary, non-life-threatening, diseases that periodically disable children. Especially hard hit are parents of children who have special developmental problems or diseases such as diabetes or epilepsy. In Heymann’s surveys, a large percentage of respondents recount being penalized (by loss of pay, not getting promotions or even by being fired) for availing themselves of family medical leave. One in five elderly Americans over 65 (currently 13 percent of the population) has difficulty meeting basic care needs. Community resources are lacking or not adequate to cover elder care.

Nor are schools family-friendly. They schedule registration and teacher-parent consultations during school hours when parents work. Parents have to take off work because mandated immunizations for childhood diseases are not provided on school premises. The school day is less than two-thirds the length of a parent’s workday. The school year is 30 percent shorter than the ordinary work year. Only one in five schools offers systematic after-school programs. Few schools provide transportation for children who stay in school after the 3 p.m. leaving time. The United States lags behind 120 countries in granting paid maternity leaves. France, Belgium and Finland provide universal school or child care starting at age two.

As policy proposals, Heymann opts for a universal family leave insurance (similar to unemployment insurance), a lengthened school day and an extension of educational coverage downward to an earlier age (minimally at age three or four). Our nation seems currently unwilling to pay this price, but the price we will pay for neglecting our children will, in the long run, be costlier. The workplace is unable, unwilling or unlikely to address this problem seriously. Families find themselves in great stress because they lack resources. Civil society solutions are not forthcoming. The famed village needed to raise a child is at work or far away.

We will very soon learn who in our political system are truly in favor of family values in a working environment that is not in the least family-friendly. Why did we hear nothing about this pressing national crisis during the vacuous presidential election debates? Sixty-nine percent of Americans say they would vote for a politician who worked for a lengthened school day. The much sought-after soccer mom is most likely not at the soccer game, but at work!

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