Book Review: Coe, Cati. The New American Servitude: Political Belonging among African Immigrant Home Care Workers. New York: NYU Press. 2019. pp. 304. Price: $32 (Paperback)

Reviewed by

Lisa Krajecki, American University
B. A. Paxton, American University
Alana Lee Glaser, St. John’s University

Anthropologist Cati Coe’s ethnographic monograph The New American Servitude: Political Belonging among African Immigrant Home Care Workers, provides a powerful narrative of intimate labor and its attendant inequalities. The focus here is on home healthcare agencies and their employees’ relationships with elderly clients in the Washington, D.C. metro area and offers an account of how West African immigrant workers are funneled into home healthcare sectors in the United States. Coe argues that these job positions are an important site for African immigrants’ political belonging and identification. She successfully builds a political anthropological argument regarding the dehumanizing implications of these occupations, illustrating how these marginalized job positions exclude African immigrants from the broader circle of US political incorporation. This insight alone effectively updates existing scholarship on African immigrants in the United States and provocatively extends the author’s previous work on transnational family forms (Coe 2013). Coe’s ethnography also contributes to the well-established and rich literature on immigrant women of color employed in the caring economy in the United States and across the world. She includes a trenchant and accessible description of home healthcare and the policies that shape it across the United States and at the state level, explaining how this industry racializes the immigrant women drawn into it. For example Coe’s first chapter, aptly subtitled “The Racialization of the Care Workforce,” discusses how some jobs are seen as “immigrant jobs,” or jobs that do not receive respect and benefits exactly because immigrants are the main workers (43).

This book is a must-read for anyone interested in the plight of those working for home healthcare agencies.

Coe’s focus on the perspectives of care workers who care for upper-class elderly people in their homes allows her to explore the “practical kinship” (134) forged among care workers, patients, and their families while attending to the pervasive, harmful effects of elderly employers’ anti-black racism. Building on Pierre Bourdieu (1977), the author observes that care workers’ practical kinship with their elderly employers “rarely leads to political belonging, both officially and through social practice, because of its temporary and contingent quality” (134).

Coe draws on an impressive array of more than 100 interviews to understand how African immigrant care workers and their elderly clients interpret their intimate—if alienated—interactions. The introduction provides a succinct summary of the increasing demand for in care work in the United States, its legal protections and loopholes, as well as its prevalence as a job niche for African immigrants. Chapters one through three describe the racism that African immigrant home care workers experience and how these work positions complicate their political belonging. In chapters four through the conclusion, Coe describes home healthcare’s compensation structure and details the limits of labor protections for this sector. She then details home healthcare workers’ responses and interpretations of these subpar working conditions, racist treatment, and the resulting sense that as a community, African immigrants, thus remain outsiders in the United States. Throughout the text, Coe places interludes that illuminate some of the stories and culture of the care workers.

Through detailed descriptions of workers’ experiences, this book gives readers a sense of the daily indignities women (and some men) encounter while working in these roles, which Coe refers to as “dignity threats” (126). Her discussion of African immigrant workers’ perceptions of these threats in their workplaces alongside their strategies for recuperation of their dignity are among the most powerful and vivid sections in her book. Through portraits of individual workers that offset the chapters as stand-alone interludes, she provides a detailed, full account of the everyday lived experiences of women working in this sector. For example, in one such interlude, Coe tells the story of an interaction between herself and a care worker as an example of the powerful relief that care workers’ plans to build a house in Ghana provide, arguing that their “feelings of humiliation can be lessened through trying to attain the culturally designated goal of one’s own house in Ghana” (126). In other instances, caregivers brush off racist verbal abuse as a symptom of dementia, but the abuse is still painful, and sometimes violent (2019). Throughout the text, Coe’s voice is justifiably and compassionately concerned about the poor treatment of the people who take care of a vulnerable population—providing ample quotes and rich anecdotes that make for a rich and textured interpretation of her interlocutors perceptions.

The New American Servitude is an important and engaging contribution to our understanding of the relationship between eldercare labor and America’s widening racial, economic, and social inequalities. Despite the difficulty of care work positions, workers tend to see little payment for their efforts. The book contains descriptions of numerous instances when caregivers—who work to provide care to aging Americans—cannot afford care in the United States themselves (2019). Meanwhile patients (and their relatives) frequently express dissatisfaction, complaining about the cost of care (174). Home healthcare agencies profit significantly from the labor of care workers who have very few labor protections (2019). Coe concludes The New American Servitude by entertaining the possibility of care workers joining social movements and labor unions to improve their circumstances—a possibility that the exigencies of COVID-19 have hopefully hastened (2019).

The author deftly combines her impressive research with the stories of the care workers in a way that is accessible to researchers and the public in general. This book is a must-read for anyone interested in the plight of those working for home healthcare agencies. This work comes at a time when its themes—race, labor, immigration, and efforts to reform the asymmetries inherent in these systems—are at a crucial juncture in the United States. Researchers, activists, and allies will recognize the struggles that Coe delineates in her ethnography. For example, she describes several instances when her Ghanaian interlocutors, underemployed as home healthcare workers, are unable to materially benefit from the advanced degrees and academic credentials that they brought with them to the United States—a vexing and familiar issue facing immigrant workers across the country. Similarly, Coe’s accounts of workplace injuries, lapses in healthcare and unemployment coverage, and exploitative working conditions will resonate with scholars of labor as well as those who work in the myriad—and increasingly—precarious employment sectors.



Bourdieu, Pierre. 1977. Outline of a Theory of Practice. Cambridge: Cambridge University Press.

Cati Coe. 2013. The Scattered Family: Parenting, African Migrants, and Global Inequality. Chicago: University of Chicago Press.

This is an early view version. The final version is due to be published in Vol. 42, no.1 (2021) issue of Anthropology & Aging.

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