Repair work in raced welfare capitalism: community health workers in the United States

In modern capitalism, the costs of care and social reproduction are widely externalised to women in households, but also to (women in) community organisations. This article analyses the role of community medicine in the US, and in particular the labour and struggles of community health workers (CHWs). Highlighting the gendered and raced inequalities of US welfare capitalism, I explore how CHWs sustain individuals and communities through three main forms of repair work: Safety net plugging is the often-invisible work of addressing unmet community needs; bridging is the work of intermediating between (punitive) state authorities and oppressed communities; and transforming lived experience is the devalued personal work of turning discrimination into care. Drawing on qualitative fieldwork in the US with a focus on California, my findings stress the laboriousness of caring in a punitive welfare state, and the devaluation of doing so in a ‘meritocratic', credentials-centred social order. I argue that CHWs' repair work might be a cost effective ‘fix’ for the health system, but that their struggle for professional recognition also challenges ingrained, racialised concepts of merit and professionalism. Their struggles connect with broader debates about reparative justice, repair, and labour value in our current socio-ecological crises.