From the mid-1960s to the mid-1980s, there was a very rapid expansion in all kinds of service-sector work. Healthcare was the leader within that. The people being drawn into this new labor market were overwhelmingly women, and the jobs in which they wound up were stratified by race. Early in this process, African-American women began to transition into healthcare work, from many sources, but especially from domestic work, which was shrinking as a category of employment by the 1960s. African-American women had always worked outside the home at higher rates than white women did, because African-American men always had less access to stable industrial employment of the Sadlowski type.

As economic dislocation and deindustrialization advanced, more and more white women joined African-American women in these new workplaces—hospitals, nursing homes, and so on. I found a document from a home health agency in the early 1980s in which a manager said that it’s great to have a workforce that’s been pre-trained by being mothers to meet rising demand. As white women entered this rapidly expanding workforce, they were often routed into occupational positions above African-American women.

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