“The thing I hate about the job is the wear and tear on your body,” caregiver Allena Pass says. “It breaks you down: the aches and pains and soreness. The frustration you have when you have people in the home that can’t help and won’t help. When you have people in the home that are never satisfied no matter what you do or how you do it. I know what I’m doing, and I know I’m doing right.”

“I want the public to appreciate me and treat me with respect because I treat my job with respect,” Pass says. She’s one of the many caregivers profiled in a new reportPay, Professionalism, and Respect: Black Domestic Workers Continue the Call for Standards in the Care Industry, a collaboration between the Institute for Policy Studies and We Dream in Black, a project of the National Domestic Workers Alliance.

The report authors spoke with black domestic workers across Durham and Atlanta, conducting citywide surveys to examine the challenges and desires of caregivers across the industry. Georgia and North Carolina were singled out as they have some of the highest number of domestic workers in the United States, as well as some of the lowest levels of pay in the industry.

Common threads run through many of the workers’ stories, including wage theft and inadequate compensation, job precarity, and lack of workplace protections. The caregivers share story after story of injuries on the job, and many of them describe working through the pain. A majority of workers in the survey — 57 percent in Durham and 55 percent in Atlanta —  said they’d worked while sick, and workers in both cities cited injuries and health issues as a concern.

“I have torn ligaments, plus I have nerve pain from lifting and pulling,” said Durham healthcare worker Lurika Wynn. “Sometimes, I will go to these clients’ homes or even the facility in pain, but I’ve got to try to help [clients get] up. Yes, I have injuries to my back from this job. I’m never going to [get workers’ comp] for it. When this back is done, I’m out.”

The lack of workplace protections compounds the issue. “Despite the similarities to other professions that provide care and service, domestic workers are not afforded the pay, protections, or respect that they deserve for the critical services they provide and the skill with which they perform their duties,” write study authors Kimberly Freeman Brown and Marc Bayard.

Along with agricultural workers, domestic workers were excluded from the labor protections of the 1930s. The right to unionize was never extended to domestic workers. They weren’t given social security benefits until 1950, and had to organize to even receive a minimum wage and overtime pay 1974. Even still, live-in workers were exempt from receiving overtime pay, and home health care aides weren’t afforded minimum wage rights until 2015.

To this day, domestic workers aren’t covered by OSHA or civil rights employment laws, which only extend to businesses with more than 15 employees. They’re also denied the right to collectively bargain. The report draws a connection between the lack of workplace connections and the intertwined histories of domestic work and slavery.

“Domestic service, in many ways, became emblematic of racial inequality,” historian Pramila Nadasen wrote in the report. “African American domestic workers continue to encounter inequality in the labor market and experience systematic underpayment and racial and gender harassment. Like earlier generations, they also organize and fight back, refusing to submit to any situation they deem unjust.”

Black women in the field elevate their industry, the report says, both by setting standards for care that go far beyond what they’re paid to provide and by organizing for better working conditions. Two-thirds of domestic workers surveyed in both Atlanta and Durham said they didn’t have any work contracts, and about a third of respondents in both cities said they were asked to do work outside the scope of their job. In the face of these informal working arrangements, the report documents the professionalism the caregivers demonstrate every day on the job.

“Sometimes you don’t get things done at home. Sometimes your bills don’t get paid because you had to work,” Joan Samuel Lewis, a certified nursing assistant, said. “You go in when it’s dark and you come out when it’s dark. That’s for years. There’s no holiday; there’s no Christmas. You have to give up all of who you are and your life to fit your clients’ needs.”

“I don’t think the public sees us as people. That is what I want to change. You have to be someone that cares in order to do that kind of work—because I don’t think people see it as even a worthy profession,“ Lewis says. “People’s perceptions make me feel bad enough for me to change it. That’s one of my goals: to change it.”

Negin Owliaei is a researcher at the Institute for Policy Studies.

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