Around the seminar rooms of London and Washington, there is much talk about the need for an industrial strategy to support sectors of the economy with the most potential for employment growth. Often, the focus of these discussions is infrastructure investment and green jobs. Below the surface, however, is a nagging concern on the part of policymakers about the sharp decline in the employment-to-population ratio of men in their prime working years. Although this development preceded the recent recession, it was greatly exacerbated by it.

In part, the decline can be explained by the dominance of women in the US industries exhibiting the strongest growth in payroll employment in the years prior to the downturn – education and health services. Even as the recession led to a collapse of employment in the rest of the economy, privately provided education and health services added 844,000 jobs. Between December 2007 and April 2011, employment in education and health services increased by 7% as the sector added more than 1.3 million jobs. Home health care jobs alone grew by 20%. Overall, paraprofessional jobs in health care are predicted to grow three times faster than all other occupations in the years to come.

These jobs are unattractive to men because of the very low wages paid – too low to support a family – but also because of cultural stereotypes. The marginalised status of occupations in paraprofessional health care in terms of wages, benefits and employment law protections is a legacy of the politics of race and gender in the US as it applied to work performed in what was viewed as the domestic sphere. In the late 19th and early 20th centuries, domestic work was viewed as women's work – good marital training for women – and outside the sphere of production. In the New Deal of the 1930s, the economic interests of the South shaped the legal framework surrounding domestic service. Unwilling to expand the political or economic power of African- Americans and seeking to maintain an inexpensive supply of labour, Southern politicians worked to exclude domestic service (and farm labour) from the New Deal labour reforms.