Close up of woman using a walker

Attitudes towards family care are changing. Only 27% of Koreans surveyed in 2018 agreed that the family is responsible for elderly family member care. As for population aging, the middle age group of Korean society is becoming a true “Sandwiched Generation” (supporting both unmarried children and elderly parents) due to the longevity increase among elderly parents and postponement of marriage among the young generation. In addition, caring for grandchildren by the young elderly group is becoming more prevalent as the number of employed married women has increased in recent decades. To respond to this family burden, Long Term Care Insurance for the Elderly (LTCI) has been expanded since 2008. Statistics of the LTCI program show a stiff increase in care provision for supporting the daily lives of elderly who suffer from physical and mental ailments.

Cha & Moon (2019) investigate the nature of family care in the context of expanding public care provision. Using the 2018 Family Survey for Child and Elder Care, the authors assess the role of family care and how family members take part in the changing elderly care process. Family caregivers spend, on average, about 8 hours a day providing care to elderly family members on caring days, or about 50 hours a week. However, the average preferred number of hours for care is 24 hours per week, almost half of the actual care hours. Those who are classified as mildly or severely over-caring tend to live with their elderly family member, partly because the elder family member has a severe limitation in their Activities of Daily Living (ADL) and is unlikely to spend more than 3 hours per day alone.

On the other hand, care givers whose hours matched their desired hours are relatively young and the employment rate is higher than among other types. Compared to this matched case, over-caring is more common when attentiveness is required, when the caregiver perceives the necessity to take on greater responsibility for the elderly care recipient, and when time consuming care tasks are needed to care for the elderly family member. The authors speculate that the different types of care arrangements—under-caring, matched, and over-caring—appear to represent the sequential process of elderly care, from making regular care-visits to constantly ‘being there’ next to the recipient.

This paper will be available December 2019.

Nurse holding an elderly patient's hand

In response to the imminent aging problem in South Korea, the National Long-Term Care Insurance (NLTCI) system was introduced in 2008. The goal of the NLTCI was to give support to the families who are taking care of their elderly. The burden of family care can be grouped into four broad categories – unpaid and at home, paid and at home, paid and in facility, and unpaid visit of the family when care recipient is in facilities. Moon et al (2019) focus on the challenges faced by providers of unpaid care within families – unpaid care by family members is the most prevalent form of elderly care in Korean society.

Korean’s attitudes or thoughts on the family care responsibility of their old parents have changed surprisingly as time passed. In 1998, 89.9% of Koreans agreed with the idea that the care responsibility of their old parents belongs to the family. In 2014, the figure dropped to about a third of the population – only 34.1% of surveyed adults agreed to share the responsibility. The authors take this trend and generational gap as the departure point for their qualitative analysis of the difficulties faced by caregivers, with a view that there might be a clash or inconsistency in the care behaviors of the family members or in their ways of thinking on elderly care.

Using a combination of oral history and in-depth interviews, Moon et al (2019) shed light on the increasing burden of labor force participation and aging parents and in-laws on Korean women. Many elderly persons need attention and care continuously for 24 hours – in this regard the public care service providers provide limited relief as they work for only three hours at a time. In addition to the public-private and paid-unpaid differences in the burden of care, the authors draw attention to the difficulty of deciding who in the family takes up the responsibility. In many cases, the traditional caretaker roles fulfilled by the daughters-in-law have shifted to the daughters of the elderly. Social norms also contributed to the disproportionate caretaking burden borne by women.

The rise of the care crisis in South Korea has evolved with Korea’s demographic shifts, increasing female work force participation, and changes in the norms and values of family and care over previous decades. Childcare and eldercare, once regarded as women’s typical role within family, are now gaining more social recognition in the public realm. Kang and Eun (2019) examine the nature of, and demand for, caregiving in various areas of the South Korean economy, including family care, care services, childcare and eldercare. The study is based on the nationally representative Care Work Family Surveys on Childcare and Eldercare.

The authors find a significant gap between the number of hours spent on childcare by mothers and fathers. A majority of respondents (women) used at least one external care service. Among caregiving activities, housework such as preparing meals, cleaning, and laundry were reported as the most difficult as well as the most frequently performed activities. Relational and physical activities such as helping to dress, wash, or play with children were reported as less difficult. Caregiving for the elderly can be more complex compared to care arrangements for children, because the range of participants in the family varies. Among all respondents, daughters-in-law were the primary caregiver in the greatest number of cases, followed by daughters, spouses, and sons. Spouses spent the highest number of hours on caregiving, followed by daughter in laws. External care services were not as common for elderly care. Home visit care and home bathing services from the National Long-Term Care program were the most commonly utilized services, although the 3-hour limit per visit amounts to a low amount of total caregiving time. Assisting with bathing and using the restroom was considered especially difficult for the elderly. Housework was performed with the same intensity and frequency in both childcare and eldercare, highlighting the important role it plays in both.

This paper will be available December 2019

Providing care for others, especially for the frail elderly and young children, is one of the most important forms of human work that sustains our existence. However, caregiving is also often challenging and strenuous. Many informal caregivers are known to suffer negative physical, emotional, and social outcomes, and are at risk of losing their own health and well-being. Fengler and Goodrich, for example, refer to the wives of frail elderly men as ‘the hidden patient,’ warning the negative consequences of caregiving on informal caregivers. Since the 1980s, several instruments have been developed to measure the strain of caregiving among informal caregivers. Some measurements such as the Zarit Burden Interview and the Caregiver Strain Index have been applied more widely, while other measurements have been used for more specific groups of caregivers (e.g., who takes care of the elderly with cancer). Although these measures provide valuable information on various dimensions of caregiver strain, they are not sufficient to assess the overall level of strain experienced by caregivers. In most cases, these measurements consist of a list of questions or statements about the caregiver’s burden; the sum of the answers is then used to indicate the level of burden/strain experienced by the caregiver. Although useful, a simple non-weighted sum of answers may not be an accurate representation of the overall strain. For instance, two groups of caregivers may have the same average total strain score, but one group may consist of all caregivers who suffer strain in some statements, while the other group may have half of the care givers who suffer strain in all statements and the other half who do not suffer strain at all. While the marginal distribution may be the same, the joint distribution may not, and this has an important policy implication.

Adapting the Alkire-Foster method developed to measure multidimensional poverty, Jun et al (2019) propose a threshold-based approach to measuring overall caregiving strain that accounts for the multidimensionality of the caregiving experience. The approach is based on the premise that as in the case of poverty, the negative consequences of multiple strains attached to caregiving would be greater than the sum of their individual effects. The authors first identify the dimensions and indicators that are known to be important consequences of caregiving, such as physical, psychological, financial and relational strains, and daily life constraints. They then count the overlapping strains a care giver experiences under different indicators of caregiver strain. Next, they identify caregivers who are experiencing strains above a specific cut-off point as multi-dimensionally strained. This measure is tested using the data from the newly collected Survey of Eldercare and Childcare in Korea 2018, exploring whether receiving support, help and appreciation may be associated with reduced chance of being multi-dimensionally strained. By providing an overall measurement that identifies caregivers with multiple strains, the authors examine 1) which group of caregivers are more likely to be at risk; 2) which dimensions do most caregivers suffer strain; and 3) what may be potential buffers for caregiving strain.

This paper will be available December 2019

Care work, whether unpaid or paid, lies at the heart of humanitarian concern and expression, and our societies and economies are dependent on it to survive and thrive. Across the world, women account for more than three-quarters of the total amount of unpaid care time while two-thirds of paid care workers are women (Folbre et al. 2012; ILO 2018; Yoon et al. 2011).The outsized role that women play in providing care is readily observed in South Korea, with its strong patriarchal and familistic orientation that assigns primary responsibility for the care of children and elderly to women in the household, reinforcing the economic significance of gender. While unpaid care work by family members, especially women, makes up a large part of the care provided within Korean society, the rapid aging of the population and the fact that more than 50% of the female population aged 16 and older participated in the labor force in 2016-18 underscore the importance of paid care workers in meeting care needs(ILO 2018).They tend to the most basic necessities and help sustain the well-being of those in dependent positions, such as children, frail elderly, or people with illness and/or disabilities. Broadly, there is a spectrum of paid workers providing care, ranging from informal workers such as domestic service workers, nannies, and home care aides in private homes to formal workers in child care centers, nurseries and early childhood learning centers, elder care centers, nursing homes, and assisted living facilities, to nurses and teachers.

Accounting for the contribution of paid care workers is crucial to our understanding of the centrality of care in the development of human capabilities and economic progress; itis a crucial part of the effort to make women’s work and all forms of care work more visible. As the ILO (2018) points out, “care workers close the circle between unpaid care provision and paid work” (p.166). It is also critical to understand their work conditions since they represent one of 5the fastest growing segments of the labor force. For that reason, it is of particular concern that the paid care workforce experience slow wages and difficult working conditions across occupations and industries (ILO 2018). For instance, domestic workers are most vulnerable to exploitation and abuse among all workers in the labor market (UNDP 2015), a consequence of their frequent exclusion from laws and regulations affording labor protections. Understanding paid care work is therefore critical to shedding light on the implications of economic, cultural, and policy contexts that shape the larger labor market as well.

Suh (2019) provides a comprehensive picture of the paid care workforce in South Korea by measuring its size and extrapolating the median wage earnings and aggregate hours spent on care-giving by the workers using following data sources: the Local Area Labor Force Survey, Child Care Statistics, Social Services Voucher Statistics, and Long-term Care Insurance Statistical Yearbook for 2009 and 2014. The size of the paid care workforce in South Korea in this estimation focuses on the value of the labor provided by care workers that are directly and indirectly involved in elder care and childcare provision. The estimation will be used for making the paid care sector visible in the Korean Social Accounting Matrix (SAM), which serves as the base for developing the GAM Care Computable General Equilibrium (CGE) model for policy analysis.

This paper will be available December 2019

Mainstream economists continue to define economic growth in terms of conventional measures such as market employment and income per capita. Women’s taking on full-time employment outside the home, therefore, has stimulated Gross Domestic Product (GDP) growth, while the social cost of a shift from informal to the formal economy has been ignored. The importance of fully recognizing the economic contributions of all forms of work –paid and unpaid–as a precondition for achieving gender equality has been proposed by feminist researchers since 1980s (Waring 1988, Folbre 1991). They have emphasized the need for empirical analysis of time devoted to unpaid care work, especially direct care of children, adults in need of assistance because of illness or disability, and the frail elderly.

Unpaid care work, i.e. household production, is the most significant part of production which is excluded from the production boundary of the system of national accounts(SNA) and hence, from the most commonly used economic indicator, Gross Domestic Product (GDP). The failure to recognize the economic value of unpaid care work leads to the belief that people who, without compensation, devote time to caring for others are unproductive or inactive and their unpaid activities fall outside the business of economic life. To be sure, unpaid household services and care work are now recognized in the landmark resolution for defining and measuring work passed during the 19th International Conference of Labour Statisticians (ICLS) in 2013.  Nevertheless, the lack of recognition of unpaid care work in the national accounts hinders the promotion of gender equality at the macroeconomic level due to the importance of these accounts as instruments for policymaking.

Suh (2019) first explores the concept of unpaid care work and its two forms, direct or relational care activities and indirect care activities. It then examines the role of time use data in estimating the unpaid, direct or relational care labor time provided by household members and the various methods by which this form of unpaid care work can be measured and valued, highlighting methodological and measurement issues. The input-based approach is then applied to the estimation of the imputed value of unpaid care provided by women and men aged 18 years and older based on the national Korean time use survey data and the Korean Labor Force survey for 2009and 2014. A range of wage rates is used for the estimation and differences between women and men are highlighted. These estimates are then aggregated for the population of South Korea. Finally, the paper concludes with a brief commentary on the importance of measuring and valuing unpaid care work.

This paper will be available December 2019

 

The last couple of decades have seen a dramatic transformation of the care infrastructure in South Korea. This is evident from the introductions of successive government policies and programs to socialize care and to address the issue of work-family balance. These new policies and programs have resulted in a steady expansion of publicly funded and publicly or privately provided care services for children and the elderly, financial support for families with young children, and family support programs such as maternity and parental leaves and family care leaves. Although there has been a significant amount of research on child and elder care policies in Korea, not as much attention has been paid to the status of care workers. This is unfortunate particularly given that social care expansion in Korea has been one of the most important drivers of employment growth in the country for the last decade and a half.

Peng et al (2019) provide an overview of care policies in South Korea and their developments since 2000 and discuss the status of care workers in the context of the current care infrastructure. They focus on paid childcare and elderly care as much of the country’s current care policies are directed to these two sectors. A broad overview outlines the current care policies and systems, including some data on the number of people who are affected and serviced, and some of the immediate causes of the government’s policy focus on care and of social care expansions and reforms. Recent developments in Korea’s care policies illustrate a path of progressive and successful socialization of care that has yielded a significant employment generation, particularly for women. Despite the progress in social care, however, available data suggest that the working conditions and status of care workers in Korea are not very positive: women dominate care work in both child care and elder care, and care workers are largely poorly paid, over-worked, and their employment is precarious. Care work is also accorded with low social and occupational status, and many care workers experience significant social and emotional stress.

The authors conclude by discussing the implications of South Korea’s current care infrastructure for gender equality and the care economy. To better understand the nature of care work and the status and situations of care workers, and Korea’s care infrastructure, they call for more in-depth data collection on care workers as well as more comprehensive measures of care

This paper will be available December 2019

Cem Oyvat presenting paper at conference

According to the Global Gender Gap Index of the World Economic Forum (2018), South Korea is one of the lowest ranked countries in the world in terms of “Economic Participation and Opportunity” (124th out of 149 countries) as of 2018. The Global Gender Gap Index also shows that South Korea ranks 88th in terms of female labor force participation and 121st in terms of gender wage equality for similar work. The average wages of women in South Korea are on average 36.7% lower than average male wages (as of 2012, own calculations based on World Klems (2014) database). These statistics reflect that there is a significant economic gender gap in South Korea despite the fact that the country is now classified as a high-income economy. Moreover, the underdeveloped care infrastructure and reliance on unpaid care labor of women is posing serious demographic and social sustainability challenges in an aging society.

Existing research on the effects of public spending show a stronger positive effect of public spending in social care and education on female employment as well as total employment compared to public investment in physical infrastructure (Antonopoulos et al., 2010; Ilkkaracan, Kim and Kaya, 2015; Ilkkaracan and Kim, 2018; De Henau et al., 2016; Onaran, Oyvat and Fotopoulou, 2019a). These employment effects have further effects on the economy and the wellbeing of the society, as microeconomic studies across the board attest that a larger share of women’s income compared to that of men’s, is spent to satisfy the needs of the household (Blumberg, 1991; Antonopoulos et al, 2010; Pahl, 2000) and a possible increase in their income leads to increased spending on children’s education and wellbeing (Vogler and Pahl, 1994; Lundeberg et al. 1997; Cappellini, Marilli and Parsons, 2014). Onaran, Oyvat and Fotopoulou (2019a) confirm this finding at the macroeconomic level for the case of the UK. These consequently have further demand and supply side effects on output, productivity and employment (Onaran, Oyvat and Fotopoulou, 2019a; Seguino, 2017).

Oyvat & Onaran (2019) examines the short-run and medium-run impact of public spending in social infrastructure, defined as expenditure in education, childcare, health and social care on aggregate output and employment of men and women for the case of South Korea. They present a gendered Post-Kaleckian theoretical macroeconomic model. The authors estimate the macroeconomic effects of social expenditure using a vector autoregression (VAR) analysis for the period of 1970-2012. The results show that an increase in the public social infrastructure significantly increases the total non-agricultural output and employment in South Korea both the short and medium-run. Moreover, higher social infrastructure expenditure increases female employment more than male employment in the short-run and raises both male and female employment in the medium-run due to increasing aggregate output. Finally, estimates show that the South Korean economy is wage-led and gender equality-led in the short-run, hence overall equality-led, although the effects are economically small in comparison to the strong effects of increases social infrastructure spending, and become insignificant in the medium-run. The results indicate that sustainable equitable development and a substantial increase in employment requires a mix of both labor market and fiscal policies.

This paper will be available December 2019

Close up of Hyun Lim LeeHyun Lim Lee, kindergarten teacher and organizer for the Childcare Workers Chapter of the Korean Confederation of Trade Unions, stood in front of the room full of civil society organization representatives and Korean and international researchers.  She is passionate about her job as a kindergarten teacher and passionate about the need to improve working conditions for caregivers in South Korea. She told the group about the challenges she faces as a kindergarten teacher, explaining how the high child-to-caregiver ratio and long hours without breaks make it difficult to provide quality care.  She shared how low pay and poor benefits have made it challenging to attract and retain early education teachers in the country.  Lee is one of 35 participants who came together on February 25, 2019 in Seoul, South Korea to kick-off a new project led by Care Work and the Economy (CWE-GAM) and its partner Seoul National University (SNU). The event brought together organizations working to support the power of care workers in South Korea with researchers from academia and the government to discuss the issues and challenges in getting care on the policy agenda to promote informed policies that enhance the quality of life of both those providing and receiving care.

Society Cannot Exist Without Care. The Economy Cannot Exist Without Care.

As Ito Peng, Professor at the University of Toronto, stressed at the February 25 kick-off conference: “Society cannot exist without care. The economy cannot exist without care.”  Caring for children, the elderly, and other dependents is a vital form of work that sustains human existence, enhances individual and broader societal well-being, and promotes sustainable development. Despite producing tremendous benefits for individuals, families, and communities, care work is enormously undervalued.  Peng’s concluding remarks at the conference highlighted how “we often say care is invisible, but what care workers shared with us at today’s conference shows that care is actually very visible – care is being provided all the time – it is just something people refuse to see.” This leaves paid formal caregivers, like Hyun Lim Lee, feeling underfunded and overstretched. And informal family caregivers, who are mostly women in South Korea and around the world, are left struggling to balance their care responsibilities with working conditions and career paths that tend to ignore other, non-work obligations.

CWE-GAM, a network of over 35 researchers, is producing new data and empirical evidence and developing policy tools to advance our understanding of care work, care arrangements, and policy impacts on growth, distribution, and gender equality in South Korea.  The project has undertaken a national survey of paid care workers (600 respondents) that includes a 24-hour time use diary, a nationally representative household survey of families responsible for caring for children and/or elderly (1,000 respondents), and in-depth interviews with caregivers and care recipients (90 respondents).  The research will provide rich information on paid caregivers – illuminating their working conditions, well-being, and providing detail on the types of activities they undertake.  The research also will provide robust data on families in South Korea and how they arrange, provide, and share care responsibilities within the household.  A signature output of this work is the development of new macroeconomic tools to guide decisions on fiscal policies and public investments to reduce and redistribute unpaid care work. The project will use our new data in conjunction with existing data to develop a macroeconomic model of South Korea that incorporates care to allow for a more comprehensive understanding of how specific social and economic policies impact economic, welfare and distributional outcomes.

To ensure that this research is used to inform policy design, implementation, and evaluation, CWE-GAM’s new project will convene civil society organizations, researchers, and policymakers over the next year.  The first conference on February 25 developed a strong dialogue between care and women’s rights focused civil society organizations, the broader research community in South Korea, and researchers concerned with issues of care and women’s and care workers’ rights internationally.  Representatives from more than 12 civil society organizations and researchers from four distinct universities as well as institutions like IOM Migration Research and Training Centre, Korea Women’s Development Institute, Korea Institute of Child Care and Education, and Population Association of Korea spent the day together to articulate and better understand the challenges facing South Korea in providing quality care as well as the challenges care workers face, ranging from issues related to well-being in their jobs to job and income insecurity.

The meeting was an incredible first-step in a long-term commitment to bring together research, civil society, and policy communities to advance the policy discussion on care in South Korea.  Over the next year, the CWE-GAM team, led by SNU, will convene several small group workshops around the country and will host two more interactive conferences as well as a high-profile policy dialogue in Seoul in the Spring of 2020.  The aim of the engagement is to:

    1. Support the strategic use of our research and build the capacity of groups to use research more effectively;
    2. Provide insights into the production of our research outputs and research-based materials; and
    3. Share research findings, policy recommendations, and strengthen relationships among groups and between the civil society, research, and policy communities;

The project aims to build connections among and between these communities. The hope is that working collaboratively to ensure we are producing the data and research needed by those on the frontlines working to change policy and practice will lead to more informed policies that better address the needs to those providing and receiving care.