Winner of the 2015 Max Weber Award from the Organizations, Occupations, and Work Section of the American Sociological Association

Winner of the 2015 William T. Goode Distinguished Book Award from the Family Section of the American Sociological Association

Winner of the 2015 Distinguished Scholarly Book Award from the Labor and Labor Movements Section of the American Sociological Association

“How long is the workday, and how thick the paycheck? To these questions, scholars have offered answers. But the key questions, Dan Clawson and Naomi Gerstel propose in this fascinating book, are: how shielded are we from unpredictable demands? And how do we control the unpredictability we’re made to face? Comparing doctors, nurses, EMTs and nursing assistants, men and women, the authors explore the lives of the ‘haves’ and ‘have-nots’ of such control, as well as the friends, co-workers and family on whom they call to create orderly lives in an increasingly disorderly world. A thought-provoking and very important read.”

—Arlie Hochschild, professor emerita, University of California, Berkeley

“Unequal Time is a meticulously and creatively researched study of how time at home and work is understood and managed. Time is not only an individual possession, but is relational. ‘Normal unpredictability’ rules. Dan Clawson and Naomi Gerstel explore the gaps between the rhetoric and realities of workplace flexibility. They find that flexibility is not just a matter of choice, but power.”

—Robert Aronowitz, M.D., professor and chair, History and Sociology of Science,
University of Pennsylvania

“Dan Clawson and Naomi Gerstel provide a powerful account of how inequalities are at the core of many of the vexing problems of work and family. Based on in-depth multi-method research in the health care industry, and this compelling book will change the way you think about work time issues. Essential reading for scholars and practitioners alike.”

—Juliet Schor, professor of sociology, Boston College

“This book's careful research design pays enormous dividends: comparing four critical occupations in the health care sector, Dan Clawson and Naomi Gerstel generate important new insights into the ways class and gender inequalities interact to shape struggles for control over working time. Unequal Time demonstrates that gender and class advantage and disadvantage are deeply implicated in the dynamics of ‘work-family balance’ and ‘flexibility,’ complicating the conventional wisdom in a provocative and fruitful way. This book is indispensable for scholars, policymakers, and anyone who cares about working families.”

 —Ruth Milkman, professor of sociology, The Graduate Center, CUNY

Life is routinely unpredictable. Control over one's time is a critical resource for managing that unpredictability, keeping a job, and raising a family. But the ability to control one's time, much like one's income, is determined to a significant degree by both gender and class. In Unequal Time, sociologists Dan Clawson and Naomi Gerstel explore the ways in which social inequalities permeate the workplace, reverberating through a web of time in which the schedules of one person shape the schedules of others in ways that exemplify and often exacerbate differences between men and women, the privileged and disadvantaged.

Unequal Time investigates the connected schedules of four health sector occupations: professional doctors and nurses, and working-class EMTs and nursing assistants. While the work-family literature mostly examines the hours people work, Clawson and Gerstel delve into the process through which schedules are set, negotiated, and contested. They show how workers in all four occupations experience the effects of schedule uncertainty but do so in distinct ways, largely shaped by the intersection of gender and class. Doctors, who are largely male and professional, have significant control over their schedules, though they often claim otherwise, and tend to work long hours because they earn respect from their peers for doing so. By contrast, nursing assistants, primarily female and working-class, work demanding hours because they face penalties for taking time off, no matter how valid the reasons. Without institutional support, they often turn to co-workers to help create more orderly lives.

Unequal Time shows that the degree of control that workers hold over their schedules can either reinforce or challenge conventional gender roles. When male doctors work overtime, they often rely on their wives and domestic workers to care for their families. Female nurses are more likely to handle the bulk of their family responsibilities, and use the control they have over their work schedules to dedicate more time to home life. Surprisingly, the authors find that in the working class occupations, workers frequently undermine traditional gender roles. Male EMTs often take significant time off for child care, and female nursing assistants sometimes choose to work more hours to provide extra financial support for their families. Employers often underscore these disparities by allowing their upper-tier workers the flexibility that enables their gender roles at home, while low-wage workers are pressured to put their jobs before any unpredictable events they might face outside of work.

We tend to consider personal and work scheduling an individual affair, but Clawson and Gerstel put forward the provocative hypothesis that time in the workplace is both collective and highly unequal. A valuable resource for workers' advocates and policymakers alike, Unequal Time illustrates how social inequalities in the workplace shape the lives of workers and their families.

DAN CLAWSON is professor of sociology at the University of Massachusetts, Amherst.

NAOMI GERSTEL is a distinguished university professor of sociology at the University of Massachusetts, Amherst.

Social scientists have repeatedly uncovered a disturbing feature of economic inequality: people with larger incomes and better education tend to lead longer, healthier lives. This pattern holds across all ages and for virtually all measures of health, apparently indicating a biological dimension of inequality. But scholars have only begun to understand the complex mechanisms that drive this disparity. How exactly do financial well-being and human physiology interact? The Biological Consequences of Socioeconomic Inequalities incorporates insights from the social and biological sciences to quantify the biology of disadvantage and to assess how poverty gets under the skin to impact health.

Drawing from unusually rich datasets of biomarkers, brain scans, and socioeconomic measures, Biological Consequences of Socioeconomic Inequalities illustrates exciting new paths to understanding social inequalities in health. Barbara Wolfe, William N. Evans and Nancy Adler begin the volume with a critical evaluation of the literature on income and health, providing a lucid review of the difficulties of establishing clear causal pathways between the two variables. In their chapter, Arun S. Karlamangla, Tara L. Gruenewald, and Teresa E. Seeman outline the potential of biomarkers—such as cholesterol, heart pressure, and C-reactive protein—to assess and indicate the factors underlying health. Edith Chen, Hannah M. C. Schreier, and Meanne Chan reveal the empirical power of biomarkers by examining asthma, a condition steeply correlated with socioeconomic status. Their analysis shows how stress at the individual, family, and neighborhood levels can increase the incidence of asthma. The volume then turns to cognitive neuroscience, using biomarkers in a new way to examine the impact of poverty on brain development. Jamie Hanson, Nicole Hair, Amitabh Chandra, Ed Moss, Jay Bhattacharya, Seth D. Pollack, and Barbara Wolfe use a longitudinal Magnetic Resonance Imaging (MRI) study of children between the ages of four and eighteen to study the link between poverty and limited cognition among children. Michelle C. Carlson, Christopher L. Seplaki, and Teresa E. Seeman also focus on brain development to examine the role of socioeconomic status in cognitive decline among older adults.

Featuring insights from the biological and social sciences, Biological Consequences of Socioeconomic Inequalities will be an essential resource for scholars interested in socioeconomic disparities and the biological imprint that material deprivation leaves on the human body.

BARBARA WOLFE is professor of public affairs, economics, and population health sciences at the University of Wisconsin-Madison.

WILLIAM N. EVANS is Keough-Hesburge Professor of Economics in the Department of Economics at the University of Notre Dame.

TERESA E. SEEMAN is professor of medicine and epidemiology in the school of public health at the University of California, Los Angeles.

CONTRIBUTORS: Nancy Adler, Jay Bhattacharya, Michelle C. Carlson, Meanne Chan, Amitabh Chandra, Edith Chen, William H. Dow, William Evans, Elliot Friedman, Tara L. Gruenewald, Daniel A. Hackman, Nicole Hair, Jamie Hanson, Arun S. Karlamangla, Catarine Kiefe, Ed Moss, Seth D. Pollak, David H. Rehkopf, Hannah M. C. Schreier, Teresa E. Seeman, Christopher L. Seplaki, Barbara Wolfe

As women moved into the formal labor force in large numbers over the last forty years, care work – traditionally provided primarily by women – has increasingly shifted from the family arena to the market. Child care, elder care, care for the disabled, and home care now account for a growing segment of low-wage work in the United States, and demand for such work will only increase as the baby boom generation ages. But the expanding market provision of care has created new economic anxieties and raised pointed questions: Why do women continue to do most care work, both paid and unpaid? Why does care work remain low paid when the quality of care is so highly valued? How effective and equitable are public policies toward dependents in the United States? In For Love and Money, an interdisciplinary team of experts explores the theoretical dilemmas of care provision and provides an unprecedented empirical overview of the looming problems for the care sector in the United States.

Drawing on diverse disciplines and areas of expertise, For Love and Money develops an innovative framework to analyze existing care policies and suggest potential directions for care policy and future research. Contributors Paula England, Nancy Folbre, and Carrie Leana explore the range of motivations for caregiving, such as familial responsibility or limited job prospects, and why both love and money can be efficient motivators. They also examine why women tend to specialize in the provision of care, citing factors like job discrimination, social pressure, or the personal motivation to provide care reported by many women. Suzanne Bianchi, Nancy Folbre, and Douglas Wolf estimate how much unpaid care is being provided in the United States and show that low-income families rely more on unpaid family members for their child and for elder care than do affluent families. With low wages and little savings, these families often find it difficult to provide care and earn enough money to stay afloat. Candace Howes, Carrie Leana and Kristin Smith investigate the dynamics within the paid care sector and find problematic wages and working conditions, including high turnover, inadequate training and a “pay penalty” for workers who enter care jobs. These conditions have consequences: poor job quality in child care and adult care also leads to poor care quality. In their chapters, Janet Gornick, Candace Howes and Laura Braslow provide a systematic inventory of public policies that directly shape the provision of care for children or for adults who need personal assistance, such as family leave, child care tax credits and Medicaid-funded long-term care. They conclude that income and variations in states’ policies are the greatest factors determining how well, and for whom, the current system works. Despite the demand for care work, very little public policy attention has been devoted to it. Only three states, for example, have enacted paid family leave programs.

Paid or unpaid, care costs those who provide it. At the heart of For Love and Money is the understanding that the quality of care work in the United States matters not only for those who receive care but also for society at large, which benefits from the nurturance and maintenance of human capabilities. As care work gravitates from the family to the formal economy, this volume clarifies the pressing need for America to fundamentally rethink its care policies and increase public investment in this increasingly crucial sector.

NANCY FOLBRE is professor of economics at the University of Massachusetts, Amherst.

A Volume in the American Sociological Association’s Rose Series in Sociology

Winner of the 2012 Otis Dudley Duncan Award for Outstanding Scholarship in Social Demography

The Americans with Disabilities Act (ADA) and other national policies are designed to ensure the greatest possible inclusion of people with disabilities in all aspects of American life. But as a matter of national policy we still place the lion's share of responsibility for raising children with disabilities on their families. While this strategy largely works, sociologist Dennis Hogan maintains, the reality is that family financial security, the parents' relationship, and the needs of other children in the home all can be stretched to the limit. In Family Consequences of Children's Disabilities Hogan delves inside the experiences of these families and examines the financial and emotional costs of raising a child with a disability. The book examines the challenges families of children with disabilities encounter and how these challenges impact family life.

The first comprehensive account of the families of children with disabilities, Family Consequences of Children's Disabilities employs data culled from seven national surveys and interviews with twenty-four mothers of children with disabilities, asking them questions about their family life, social supports, and how other children in the home were faring. Not surprisingly, Hogan finds that couples who are together when their child is born have a higher likelihood of divorcing than other parents do. The potential for financial insecurity contributes to this anxiety, especially as many parents must strike a careful balance between employment and caregiving. Mothers are less likely to have paid employment, and the financial burden on single parents can be devastating. One-third of children with disabilities live in single-parent households, and nearly 30 percent of families raising a child with a disability live in poverty.

Because of the high levels of stress these families incur, support networks are crucial. Grandparents are often a source of support. Siblings can also assist with personal care and, consequently, tend to develop more helpful attitudes, be more inclusive of others, and be more tolerant. But these siblings are at risk for their own health problems: they are three times more likely to experience poor health than children in homes where there is no child with a disability. Yet this book also shows that raising a child with a disability includes unexpected rewards—the families tend to be closer, and they engage in more shared activities such as games, television, and meals.

Family Consequences of Children's Disabilities offers access to a world many never see or prefer to ignore. The book provides vital information on effective treatment, rehabilitation, and enablement to medical professionals, educators, social workers, and lawmakers. This compelling book demonstrates that every mirror has two faces: raising a child with a disability can be difficult, but it can also offer expanded understanding.

DENNIS HOGAN is Robert E. Turner Distinguished Professor of Population Studies at Brown University.

"Culture counts" has long been a rallying cry among health advocates and policymakers concerned with racial disparities in health care. A generation ago, the women’s health movement led to a host of changes that also benefited racial minorities, including more culturally aware medical staff, enhanced health education, and the mandated inclusion of women and minorities in federally funded research. Many health professionals would now agree that cultural competence is important in clinical settings, but in what ways? Shattering Culture provides an insightful view of medicine and psychiatry as they are practiced in today’s culturally diverse clinical settings. The book offers a compelling account of the many ways culture shapes how doctors conduct their practices and how patients feel about the care they receive.

Based on interviews with clinicians, health care staff, and patients, Shattering Culture shows the human face of health care in America. Building on over a decade of research led by Mary-Jo Good, the book delves into the cultural backgrounds of patients and their health care providers, as well as the institutional cultures of clinical settings, to illuminate how these many cultures interact and shape the quality of patient care. Sarah Willen explores the controversial practice of matching doctors and patients based on a shared race, ethnicity, or language and finds a spectrum of arguments challenging its usefulness, including patients who may fear being judged negatively by providers from the same culture. Seth Hannah introduces the concept of cultural environments of hyperdiversity describing complex cultural identities. Antonio Bullon and Mary-Jo Good demonstrate how regulations meant to standardize the caregiving process—such as the use of templates and check boxes instead of narrative notes—have steadily limited clinician flexibility, autonomy, and the time they can dedicate to caring for patients. Elizabeth Carpenter-Song looks at positive doctor-patient relationships in mental health care settings and finds that the most successful of these are based on mutual “recognition”—patients who can express their concerns and clinicians who validate them. In the book’s final essay, Hannah, Good, and Park show how navigating the maze of insurance regulations, financial arrangements, and paperwork compromises the effectiveness of mental health professionals seeking to provide quality care to minority and poor patients.

Rapidly increasing diversity on one hand and bureaucratic regulations on the other are two realities that have made providing culturally sensitive care even more challenging for doctors. Few opportunities exist to go inside the world of medical and mental health clinics and see how these realities are influencing patient care. Shattering Culture provides a rare look at the day-to-day experiences of psychiatrists and other clinicians and offers multiple perspectives on what culture means to doctors, staff, and patients and how it shapes the practice of medicine and psychiatry.

MARY-JO DELVECCHIO GOODis professor of social medicine at Harvard Medical School and teaches in the Department of Sociology at Harvard University, in addition to being a faculty affiliate of the Asia Center, the Center for Middle Eastern Studies, and the Weatherhead Center for International Affairs.

SARAH S. WILLEN is assistant professor of anthropology at the University of Connecticut.

SETH DONAL HANNAH is lecturer on sociology at Harvard University.

KEN VICKERY is director of external fellowships at the University of Illinois, Urbana-Champaign.

LAWRENCE TAESENG PARK assistant professor of psychiatry at Massachusetts General Hospital.

CONTRIBUTORS: Antonio Bullon, Joseph D. Calabrese,  Elizabeth Carpenter-Song,  Sadeq Rahimi, Lisa Stevenson, Marina Yaroshenko.