The Care Work and the Economy project’s 2018 fieldwork in South Korea helped us learn a great deal about how childcare and eldercare is provisioned, both in the paid and unpaid care sectors, in Korea.
The fieldwork consisted of both quantitative and qualitative surveys, including two sets of questionnaires for paid care workers and unpaid care providers. The qualitative component consists of two sets of in-depth interview questionnaires for care providers and recipients.
What We Learned about Family Caregiving in Korea
Although many families use at least one external care service to assist with childcare, 22% of respondents reported that their childcare was done only by family members (Kang et al.). Mothers spent six to seven hours more than fathers taking care of children on average.
(Kang et al.)
In contrast, 67% of respondents reported that their eldercare was done by family members; the rest reported using external care – usually the national LTC program. The primary caregivers were daughters-in-law (37% of the time), daughters (35%), spouses (15.6%), and sons (11%) (Kang et al.). Figure 12 shows how rather than the elder’s biological children, daughters-in-law provided the most care in terms of time, excepting the elder’s spouse.
(Kang et al.)
The cost of eldercare is shouldered solely by the primary caregiver in many cases (Kang et al., 2021)
Only 20% of family eldercare providers reported receiving regular financial support from other family members, less than 30% reported receiving help on an irregular basis, and only 8% of those over 65 years old were currently receiving LTC insurance program benefits.
Unpaid care provisioning impacts women’s employment.
The surveys showed that “families in which mothers were the sole caregiver for the child had the highest proportion of unemployed mothers, whereas families that received help with childcare from grandparents or paid care service had the highest proportion of employed mothers. With respect to both types of care arrangements, it was mostly daughters and daughters-in-law serving as primary caregiver, almost 70% of whom were unemployed.” (Kang et al.).
When asked about their preferred hours spent caring, eldercare workers reported a considerably lower number of hours on average than the actual hours they spent caring (see Table 2).
(Cha and Moon,2020)
Studies in the CWE-GAM Project stress concerns about the “quality of the caregiver’s life and the care they provide as well as the quality of life of the care recipient. Especially given that women are typically taking on the role of caregiver, this issue cannot be detached from concerns regarding women’s labor, women’s quality of life, and gender equality in Korea.”
Current Situation in Korea – Government Implications:
Korea currently “ranks amongst the top 10 OECD countries in terms of public investment in childcare and education” and implemented a mandatory universal LTCI program in 2008 (Peng et al 2021). Figure 2 and 3 show the evolution of child care and care work over time.
(Peng et al. 2021)
Studies report that despite the social care expansion, “childcare and long-term care sectors are heavily dominated by women, and these care workers are largely poorly paid, over-worked, and precariously employed. Care work is also accorded low social and occupational status, and many care workers experience significant social and emotional stress” (Peng et al. 2021; Suh 2020).
Suh (2020) finds that “public investment in quality care services tends to improve the working conditions of care workers (thereby benefiting care recipients), and unregulated private provision tends to worsen them.”
This suggests that “the government and public sector should drive the effort to meet the multi-faceted challenges posed by the growing demand for care work” (Suh 2020).
“The Korean government […] continues to see care work as an extension of women’s unpaid care work and social care expenditure as something that need to be tightly controlled. A better understanding on the part of policymakers about the importance of care and the role of care work and the care economy in generating employment and positive economic growth and supporting a healthy productive economy is therefore necessary.” (Peng et al.)
This blog was contributed by Aina Krupinski Puig, Research Assistant for the Care Work and the Economy project.
Cha, Seung-Eun, and Hyuna Moon. (2020). “A Glimpse of the Context of Family
Caregivers: Actual Time vs. Preferred Time for Elderly Care.” Care Work and the Economy (CWE-GAM), Program on Gender Analysis in Economics (PGAE), American University. https://doi.org/10.17606/dyfz-jp32.
Kang, Eunhye, Ki-Soo Eun, Jiweon Jun, Seung-Eun Cha, and Hyuna Moon. (2021). “Care
Arrangement and Activities in South Korea: An Analysis of the 2018 Care Work Family Survey on Childcare and Eldercare.” Care Work and the Economy (CWE-GAM), Program on Gender Analysis in Economics (PGAE), American University. https://doi.org/10.17606/8ZYD-AA52.
Peng, Ito, Seung-Eun Cha, and Hyuna Moon. (2021). “An Overview of Care Policies and the
Status of Care Workers in South Korea.” Care Work and the Economy (CWE-GAM), Program on Gender Analysis in Economics (PGAE), American University. https://doi.org/10.17606/EHN0-R646.
Suh, Joo Yeoun. (2020). “Estimating the Paid Care Sector in South Korea.” Care Work and the
Economy (CWE-GAM), Program on Gender Analysis in Economics (PGAE), American University. https://doi.org/10.17606/bpdf-v686.
In our project, we aim to promote and advocate for gender and socioeconomic equalities. We do this by working to reduce gender gaps in economic outcomes and by showing and properly valuing social and economic contributions of caregivers; and integrating care into macroeconomic policy making toolkits.
In this era of demographic shifts, economic change and chronic underinvestment in care provisioning, innovative policy solutions are desperately needed, now more than ever. Sustainable and inclusive development requires gender-sensitive policy tools that integrate new understandings of care work and its connections with labor market supply and economic and welfare outcomes.
The Care Work and the Economy Project, currently based at the Economics Department of American University and co-led by Maria S. Floro and Elizabeth King, includes more than 30 scholars around the globe, working closely together to provide policy makers, scholars, researchers and advocacy groups with gender-aware data, empirical evidence and analytical tools needed to promote creative macroeconomic and social policy solutions. In the next phase of the project, Care Economies in Context, we will be scaling up our project to include 8 different countries, in 4 global regions. I will be leading this next phase of the project, which will be based at the University of Toronto.
I define Care work is defined broadly as work and relationships that are necessary for the health, welfare, maintenance and protection of all people – young and old, able bodied, disabled, and frail. This definition may seem broad – but care– at its core is a very basic human need and a necessity. Whether we know it or now, we all participate in providing care work – paid or unpaid, and in receiving care every day.
By care economy, I am referring to the sector of economy that is responsible for the provision of care and services that contribute to the nurturing and reproduction of current and future populations. More specifically, it involves child care, elder care, education, healthcare, and personal social and domestic services that are provided in both paid and unpaid forms and within formal and informal sectors.
Care work is important because it is important work that sustains life. It is also important now in particular because it is one of the fastest expanding economic sectors and a major driver of employment growth and economic development around the world. For example, across the OCED, the service sector economy now accounts for over 70 percent of total employment and GDP. In lower- and middle-income countries, it is estimated to comprise nearly 60 percent of GDP. Within the service sector economy, care services is one of the fastest growing subsectors.
The International Labour Organization (ILO) estimates that the global employment in care jobs is expected to grow from 206 million to 358 million by 2030 simply based on sociodemographic changes. The figure will be even more dramatic to 475 million if governments invest resources to meet the UN sustainable development goal targets on education, health, long-term care and gender equality.
In Canada, the service sector already makes up for 75 percent of employment and 78 percent of GDP. Within this sector, healthcare, social assistance and education services are key drivers of economic and employment growth. In the U.S., healthcare is already the largest employer, larger than steel and auto industries put together. In short, our current and future economy is and will be increasing dominated by care services and care work.
However, at the same time, much of the care work continues to be performed for no pay, by families and friends, at home and in communities. This unpaid care work is not including in in our national GDP because GDP only takes into account work that is done for pay in the formal market. Therefore, if we only look at the GDP as a measure of the economy and economy growth, we miss a huge segment of the economy and economic activities. As the pandemic has shown, without both paid or unpaid care work, our economy will not be able to function effectively, nor would it be able to sustain itself.
What we are trying to do in our project is to make the care economy clearer and more visible by measuring and mapping out the size and shape of the economy, and to develop macroeconomic models that would help policymakers and civil society actors to develop better policies and better strategies to ensure more sustainable and equality inducing economic growth.
Listen to the full talk “The Care Work and the Economy Project” to learn about what the care economy is and why we should know more about it, particularly now.
Faculti, an organization that presents digital media from leading experts and academics outlining their work, recently released a digital presentation by the Care Work and the Economy Principal Investigator Dr. Maria S. Floro entitled “Macroeconomic Policies, Care and Gender in the Post-COVID Era.” The discussion describes the interconnections between the crisis of care, the deepening ecological crisis and growth and accumulation processes.
There are many common threads with the climate and ecological crisis and the care crisis. Significantly, the idea that economic growth is overall beneficial. The type of economic growth generally pursued worldwide has not only increased stresses put upon the earth’s resource base but also on care labor capacity, which is similarly but wrongly perceived to be of infinite supply. Moreover, arguments that equate economic growth with overall improvement fail to recognize the distributional element of rising income inequality, which is far more nuanced. In fact, among countries that are higher income, gains from economic growth within those nations do not trickle down to everyone. When looking at care, the widening income equality gaps has shifted distribution of care givers across social classes and national boundaries. As a result, the quality and adequacy of care within a single nation can be very different, which exacerbates differences in social reproduction.
At the same time, income inequality has created a solution for the care needs of those that have the means to hire care for children and elderly, because care workers in those sectors are often paid low wages. But for the working poor, hiring care work help is inaccessible due to financial constraints, therefore they rely on their kinship networks to help provide this care. Furthermore, much of the care work burden still falls on women even as they enter to labor force. Economics and social policy in many parts of the world continue to neglect the heavy work burden put upon women and the necessity to balance household care activities and market work. What can also be observed is a global care supply chain, with the migration of women and girls to urban areas to provide care for wealthier families. Care itself is becoming one of the drivers of income inequality.
The economy is not all about material production; it is really about human vision and social provisions. However, an illusion has been created that unpaid care work is a natural resource that serves as an input for market production to promote GDP growth. However, this idea does not take into account that the wellbeing of people, especially the elderly, the sick and children should be an end in and of itself, to achieve sustainable growth. There is much work to be done to address these issues. To begin, economists must envision long term horizons that look forward to future generations while also taking into account the interdependence of life and moral responsibility. They must also integrate care and environmental consequences into our economic policy tools. Overall a new economic paradigm that includes green ecology and feminist economic concerns is needed.
Link to Part 1 of this blog here.
Faculti, an organization that presents digital media from leading experts and academics outlining their work, recently released a digital presentation by the Care Work and the Economy Principal Investigator Dr. Maria S. Floro entitled “Macroeconomic Policies, Care and Gender in the Post-COVID Era.” This discussion delves into the foundation of project itself, its context, the analytical tools utilized in the research, as well as the external factors that have served as the catalyst for the work being done.
The Care Work and the Economy Project was developed after a group of feminist economists observed that in the effort to reduce gender gaps in economic outcomes, as laid out within the United Nations Sustainable Development Goals, there were aspects of care work that needed to be addressed. The project includes 35 scholars from all around the world that are working to develop innovative analytical tools. The research has been applying and testing these tools in South Korea, a country that quickly industrialized in the 70s and 80s and therefore witnessed a very rapid demographic change in fertility and life expectancy.
The care economy, which is inclusive of caring for those that cannot care for themselves, underpins the production of all economies within society. This begins with the fact that if people stopped having children, which require care, then the economy would come to a halt due to lack of labor force. Generally, care work has a tendency to be undermined through a lack of gender awareness in macroeconomic modeling, which does not address care needs in any adequate manner. This aspect is also neglected within the policy making discourse, with the current economic paradigm failing to take into account the necessity for care work to achieve economic growth.
Economic models that display growth also fail to take into consideration social elements, making the assumptions that, for example, children will be cared for despite the lack of social investment into care. However, with care work there comes social, political and economic significance. The Care Work and the Economy project is working to demonstrate what a care focused macroeconomic model can reveal through the implementation of the analytic tools being developed and implemented through the research.
The absence of the care economy within macroeconomic models is in large part due to it being “invisible” since the work often unpaid. This has led to the neglect of care needs despite unpaid care work providing indispensable services in terms of economic activity and growth. The result is an emerging care crisis that has manifested itself in terms of uncared for elderly, sick and children. Furthermore, the crisis has provoked a form of silent protest against long unpaid work hours performed by women, leading to a decline in marriage and fertility rates. This in turn has resulted in a reproduction crisis.
The Care Work and the Economy project researchers are developing and using innovative analytical tools to bring care to the forefront, along with a deeper understanding of the nature of care work, while illustrating the intersectionality between care provisioning, economic growth and distribution. Although these analytical modeling tools are currently being applied in South Korea, the project believes they can be adopted and implemented into other countries as long as the provision of care is taken into context of those countries. The project research shows that governments have an important role and duty to invest in care provisions as well as comprehensive national care plans. One of the key findings is that it is important to take into account demographic change and climate change along with economic and structural changes taking place in policy making. This is a tall order but necessary to sustain economies and provide a future for next generation.
Link to Part 2 of this blog here.
This blog was authored by Jenn Brown, CWE-GAM Communications Assistant
In 2018, the Care Work and the Economy (CWE-GAM) Project’s Understanding and Measuring Care (UMC) Working Group set out to gain a deeper understanding of the nature of care work and the well-being of caregivers in the context of South Korea. The group used a unique qualitative method combining in-depth interview and oral historical approach to investigate care as a continuously recurring activity throughout one’s life course and a necessary part of human existence. As part of the project’s qualitative field work and with the help of Gallup Korea, the UMC Working Group conducted 96 interviews between May – December 2018, bringing together 96 comprehensive narratives of care work in the South Korea context.
The CWE-GAM Project’s qualitative field work in South Korea conducted 96 in-depth interviews of paid and unpaid caregivers to provide useful care narratives based on the Korean context to inform macro-modelling. The qualitative research team interviewed 25 family caregivers of the elderly, 20 family caregivers of children, 20 paid care workers for elderly, and 31 paid care workers for children. The interviews of family caregivers focused on the decision-making process and evaluation of care arrangements for the elderly and children. In-depth interviews were combined with an oral historical approach to gain a deeper understanding of care work, emphasizing active listening to gain a more holistic understanding of the narrator’s life story on care. Interviewees were also asked about their experiences with caregiving. The interviews of paid caregivers focused on dual care burdens in terms of paid care work in addition to unpaid care work in the home. To learn more about the CWE-GAM Project’s qualitative field work in South Korea, read the Qualitative Methodology Report by the Care Work and the Economy UMC Working Group.
The following is one of the 96 stories. The respondent, Sung, lives with and cares for her mother, who was diagnosed with dementia about ten years ago.
Date: May 29, 2018
Interviewer: Hyuna Moon
Interviewee: Sung (pseudonym)
Sung, born in 1968, is 50 years old. She has a son and a daughter. They are both over 19 years old. One is attending college, and the other is studying for the college entrance exam. She is currently living with her children and her mother. As for siblings, she has one younger brother who is married. About ten years ago, Sung’s mother was diagnosed with dementia. Sung’s dad cared for her mom in the beginning, but her dad was also later diagnosed with Parkinson’s disease. Sung thus decided to move into her parents’ house to live together. It was by the time her first child entered middle school and her second child reached the upper grades in primary school. Her dad died four years ago, and she now looks after her mother. Her mother became a grade 3 beneficiary of the Long-Term Care Insurance (LTC) in her initial stage.
When Sung found out that her parents were ill, she didn’t think about passing the care duty to her brother. The siblings first considered making living arrangements so that each of them would live with one of their parents, for instance, Sung living with their dad and her brother living their mom, but their parents did not want this; they wanted to live together, not separately. Sung also felt that she ought to take care of her mother because of her ten years of experience living abroad, away from her parents. Sung has never thought that taking care of her frail parents is a son’s or a daughter-in-law’s duty. She didn’t think it was her brother’s duty to live with their parents and provide support. Nonetheless, her brother has taken up the role of financially supporting their parents. According to Sung, this was not negotiated but naturally happened. Sung and her brother also tried having their parents stay at her brother’s house during weekends, but it was always troublesome because he was not familiar with the situation, thus constantly calling up Sung for help. This weekday/weekend division of care duty did not work for them. Sung’s mother started going to the elderly daycare center from 2015 after her husband died. Her mother moved to a different center once because the center was located too far away from Sung’s place. Sung’s mother attended the first center for two years. When the center stopped running its shuttle bus to Sung’s house, Sung had to drive her mother to and from the center for a year. During that time, she had to hire a private caregiver who was responsible for driving Sung’s mother home in the evenings.
The hired caregiver also prepared meals and did some simple house chores for Sung. Sung paid her 1,000,000 KRW ($850 USD) every month, in addition to the monthly senior center fee of 300,000~400,000 KRW ( $250 – $335 USD). Other care-related expenses include Sung’s mother’s caregiver’s wage and other care services such as home-visit bathing service on weekends, food, medical bills and daily necessities such as diapers and etc., totaling about 2,000,000 KRW ($1,700 USD) per month. Sung’s brother helped to cover their mother’s care-related expenses, as Sung’s own income also had to cover her children’s education and living costs.
Description of Care Arrangement
Sung’s mother goes to the senior daycare center on weekdays and receives a home-visit bathing service every Saturday morning. The current elderly care center runs a shuttle that arrives at Sung’s house at 8:20 am to pick up her mother and to ride her back home at 9 pm. Sung’s mother is using the center service fully, spending the whole day at the center. Sung takes care of her mother after 9 pm until she goes to bed. When her mother comes back home, Sung helps her take medicine and changes her clothes and diapers. Her mother sleeps before 10 pm. Sung said her mother usually gets home tired after engaging in a variety of programs and activities offered all day long at the center.
Sung thinks her mother’s enrollment at the day care center is better than her staying at home and being bored. Sung said the most difficult part in caring for her mother happens at night, when her mother wakes up due to defecation. In such instances, Sung has to respond quickly to avoid what would otherwise become an even longer night, with her having to clean up the remains that will be all over the place. It got worse since last year and called for the most attention when caring for her mother. Nevertheless, Sung said her mother’s situation of dementia is not too bad, considering that some people with dementia can be very aggressive and easily agitated. Sung’s mother is relatively well-behaved, but she has this stubbornness which makes it difficult for Sung to help her get washed and change her underwear for she finds these to be a shame.
Sung said weekend care is tougher than weekday care because she needs to prepare food for every meal. The LTC-funded caregiver visits every Saturday to provide bath support, which is of great help, but Sung also needs to partake in the bathing assistance, requiring her presence.
The Cost of Caregiving
For Sung, it was an overload of work when she started supporting her parents by living together, while also having to care for her two adolescent children and working for her job at the same time. Sung said she had suffered from depression a few years ago due to the high stress of managing all her responsibilities. She had to seek psychiatric and medical treatments to overcome her depression.
Sung is considering sending her mother to the 24-hour nursing home as her health status is gradually deteriorating. She has applied for the institution for her mother’s stay, but she faces a long waiting list with more than 200 people. Sung said the reason for such a long waiting list is because this is a public nursing home, which is believed to provide better quality care and facilities.
Two years, she said, is what she thinks as the maximum number of years that she would be able to live with her mother if the current situation holds. But if it worsens, that is, if her mother’s dementia symptoms get worse, Sung will also consider sending her mother to some other facility with a shorter waiting list but also with lower quality of care.
She said that she would have to set a deadline to her caregiving for her own sake. She does not want to spend the rest of her 50s trapped with the care duty to her mother. Her children are now independent adults. Sung wants to start living her own life. She also feels she has done enough for her mother, her families and relatives all know it, and nobody will blame her for making this decision. Sung said because she is also a human, she needs to have her life and has the right to pursue it instead of sacrificing for her family.
See the surveys utilized for conducting this research below:
The 2018 fieldwork for the CWE-GAM project aimed to understand and measure care work in the South Korean context in order to inform gender-aware care macroeconomic models. The fieldwork consisted of both quantitative and qualitative surveys. The quantitative surveys include two sets of questionnaires for paid care workers in eldercare and childcare (Paid Care Worker Survey) and two sets of questionnaires for the unpaid care providers in the households for eldercare and childcare (Care Work Family Survey). The qualitative component consists of two sets of in-depth interview questionnaires for care providers and care recipients.
PAID CARE WORK SURVEY
The Care Work and the Economy Paid Care Work Survey includes two sets of questionnaires for eldercare and childcare workers and a 24-hour time use diary. A purposive sampling method was used to sample 600 paid care workers, 300 eldercare workers and 300 childcare workers, because the exact size and distribution of paid care workers in Korea are unknown. Paid care workers are defined as those working in institutional settings, at the care recipients’ home, and informal workers working without formal contracts. The sample targeted those providing care of the elderly and children’s daily lives, excluding kindergarten teachers and health care workers at hospitals and medical eldercare facilities. The sample of paid care workers associated with institutions were allocated to reflect the national distributions of eldercare facilities and daycare centers, and the sample of informal care workers were equally allocated across regions.
The Paid Care Worker Survey collected detailed and comprehensive information on the care work provided by paid care workers. The stylized questions and time use diaries of paid care workers collect information on the type, intensity, duration, and evaluation of care work from the perspective of paid care providers. The survey aimed to investigate the characteristics and working conditions of paid care workers, including their background, condition of contract, working environment, task arrangement, and subjective evaluation of the working conditions, and their well-being. The 24-hour time use diaries were collected to provide insights on how the day of a care worker is constructed and how care work is associated with other domains of daily life and time use, which can be analyzed in tandem with the stylized questions on the well-being of care workers.
FAMILY CARE WORK SURVEY
The Care Work Family Survey also consists of two sets of questionnaires for main care providers in the household engaged in childcare and eldercare respectively. 1,000 cases of main care providers in the household were interviewed (500 cases for childcare, 500 cases for eldercare) using a stratified cluster sampling method. Because it is not possible to know the distribution of the population of people who provide unpaid care in a society, children aged below 10 and the elderly aged over 65 were treated as the target population from which to draw the sample. Based on the distribution of the 2018 National Resident Registration Data in Korea, we allocated the number of target households to each area, identified eligible households with elderly or children in need of care, and then selected eligible respondents within the selected households.
The Care Work Family Survey was developed to provide a detailed and comprehensive picture of the care arrangements in South Korea. The survey aimed to investigate how care provision is arranged for the children and the elderly and why it is arranged in such ways. Therefore, the survey collects information from the main care provider, not the care recipients themselves, as it is often the case that the main care provider is the one who knows most about the care arrangements.
After screening for eligibility, respondents were asked questions on their demographic characteristics and information on the respondent, care recipients and other household members. Respondents were asked about the specific activities involved with their care work including frequency, subjective intensity, preferences and willingness to engage in the activities. Information on care arrangements were collected as well including how the care work is shared within the household, whether there are any gaps of care provision, the history of caregivers, use of care services, and decision-making of using care services. Other information such as financial responsibility and burden, experience and evaluation of care work, dual care burdens and well-being of caregivers were collected.
The purpose of the in-depth interviews of paid and unpaid caregivers was to provide useful care narratives based on the Korean context to inform macro-modelling. The qualitative research team intervened 25 family caregivers of the elderly, 20 family caregivers of children, 20 paid care workers for elderly, and 31 paid care workers for children. The interviews of family caregivers focused on the decision-making process and evaluation of care arrangements for the elderly and children. Interviewees were also asked about their experiences with caregiving. The interviews of paid caregivers focused on dual care burdens in terms of paid care work in addition to unpaid care work in the home.
SIGNIFICANCE AND LIMITATIONS
The fieldwork for paid and unpaid care work in Korea was designed and conducted to investigate the nature and context of care work in Korea. The Paid Care Worker Survey and Care Work Family Survey have distinct characteristics that contribute to enhancing our understanding about the experience of caregiving in Korea. First, the set of questions that have been developed can be commonly applied to caregivers regardless of the type of care work or the subject of care to enable comparative analysis on the experience of caregiving. Second, not only the caregiving situation, but also the broader aspect of the caregiver’s life including the preferences and attitudes of the caregiver have been studied. Third, the surveys collect detailed information on how care is arranged. Lastly, a caregiver focused 24-hour time use diary has been developed to understand which activities could be considered as care.
This fieldwork only included certain types of caregivers due to the limited budget, time, and scope of the fieldwork. For instance, the sample did not include caregivers for the disabled, caregivers who work at hospital settings, and migrant care workers, despite their importance. Also, as the family survey for childcare limited the respondents to ‘mothers’, and consequently fathers and grandparents were excluded. We hope that the future rounds of surveys can be extended to have a larger sample size and to include a broader range of caregivers. Questions explored in this fieldwork provide important information about the experience of caregiving in Korea, and we hope the fieldwork in Korea can inform fieldwork in other countries.
Learn more about care arrangements and activities in South Korea based on our analysis on the 2018 Care Work and Family Survey here.
A growing concern in many countries is an aging population and an increase in the number of elderly in need of long-term care. However, the impact of elderly care on the well-being of care providers remains relatively understudied. One of the primary factors which complicate analysis is that a majority of elderly care is provided informally by family members, with adult children often comprising the largest share of care providers. The pervasiveness of unpaid care due to cultural or family ties has even limited the development of long-term care insurance in economically advanced regions like Europe. However, while children may provide an informal safety net, parental caregiving is a time-intensive task and must be met by adjustments in leisure or work hours on the part of the care provider. Hence, in order to understand the full macroeconomic implications of growing elderly care needs and the appropriate policy response, it is imperative to understand how households cope with these caregiving needs.
Economic models of elderly care have focused almost exclusively on inter-generational bargaining between parents and children or bargaining among siblings. However, little attention has been paid to the influence of care demands on the power dynamics between partners within a household (e.g. husband and wife). This is despite data showing that caregiving falls disproportionately on women and that some caregivers respond to increased parental care needs by reducing work hours, taking more flexible jobs, or by quitting paid work entirely. Moreover, caregiving may have spillover effects on the caregiver’s spouse or partner. For example, a spouse may work longer hours or reduce their spending to cope with fewer hours of paid work by the caregiver. So it is unclear to what extent partners reallocate their time and resources and share the burden of parental care needs when they arise.
In the study detailed in the CWE-GAM working series paper published May 2020, we develop a theoretical model to explore how unpaid parental caregiving can affect the allocation of time and resources across partners under different household power structures. As parental caregiving disproportionately falls on daughters, we consider a model in which a woman’s parent is in need of time-intensive care. The provision of care across partners is then a bargained outcome between the couple. We not only examine how power dynamics and work arrangements impact caregivers and their partners but also how these factors may influence unmet care needs and care recipients.
After developing our model, we use cross-country data from the Survey of Health, Age-ing, and Retirement in Europe (SHARE) to illustrate our theoretical concepts with some numerical exercises. Broadly our results indicate caregivers may face a “triple burden” of market work, domestic chores, and caregiving. For example, our model predicts that for a duel-earning couple in France, the total cost of unpaid parental caregiving to the male is only about 57% that of their female partner—a skewed but shared burden. The higher cost to the female stems from two sources; (1) relatively fewer hours of leisure due to her provision of unpaid care; (2) the additional mental or emotional cost of leaving her parent with some level of unmet care needs.
Overall, our theoretical and numerical results show that ignoring bargaining power differentials across partners can misrepresent the true cost of unpaid parental caregiving by not taking into account the uneven distributional consequences. Moreover, our cross-country findings suggest that lower female bargaining power results in a larger burden on female caregivers and additional unmet care needs for their parents. If bargaining power is determined by relative earnings, government policies subsidizing long-term care could decrease the well-being gap within a household by providing financial relief and improving the bargaining position of the caregiver. This could further result in reduced levels of unmet care needs and improved outcomes for elderly care recipients. We further show that inflexible work arrangements also exacerbate the total cost of unpaid caregiving to the household as well as the unequal distribution of the burden. This implies policies that promote flexibility, such as caregiver leave or part-time options, could provide substantial relief, particularly to high-intensity caregivers.
This blog was authored by Ray Miller and Neha Bairoliya, who are both expert researchers for the Care Work and the Economy Project within the Rethinking Macroeconomics working group. To learn more read the CWE-GAM working paper upon which this blog was based here.
About half of all the time devoted to work in the U.S. is devoted to unpaid work in the home. The Institute for New Economic Thinking has created an adorable animation of some comments I made in an interview with them on this topic a while back.
It’s quite a lot of fun, and basically accurate. Just don’t pay too much attention to the numbers they inserted into my discussion of two families, each with a market income of $50,000–the animation seems to imply that leisure should be assigned a monetary valuation–not something I advocate. Still, the main point comes through just fine: conventional measures provide a misleading picture of living standards.
The animation provides a great introduction to the topic for students, and you can find a more academic version of the basic argument in a short briefing paper I wrote for the Washington Center for Equitable Growth.
Original blog published on CARE TALK: FEMINIST AND POLITICAL ECONOMY on June 11, 2020. See here for the original posting.
Reposted with permission from Dr. Nancy Folbre from University of Massachusetts Amherst and an expert researcher for the Care Work and the Economy Project within the Rethinking Macroeconomics working group.
The Unpaid Care Work and the Labor Market. An analysis of time use data based on the latest World Compilation of Time-use Surveys
How much time do people spend on doing paid and unpaid care work? How do women and men spend their time differently on unpaid care work? Are there any differences in time use among the regions? How do socioeconomic factors influence people’s choices to do paid and unpaid care work?
Jacques Charmes addresses these questions in recent ILO report by providing a comprehensive overview of the extent, characteristics and historical trends of unpaid care work. The report is based on the analysis of the most recent time-use surveys carried out at the national level across the world, revealing the differences in time spent on unpaid care work between women and men and among people with different socioeconomic characteristics, such as geographical location, age and income groups, education level, marital status and the presence and age of children in the household. An insightful discussion of the concepts and methodological approaches underlying the analysis of time-use data is also offered.
Chart 7 in the ILO Working Paper the Unpaid Care Work and the Labour Market. An analysis of time use data based on the latest World Compilation of Time-use Surveys illustrates the time spent by women and men in various categories of unpaid care work across Sub-Saharan African countries including Cameron, Ghana, Benin, Madagascar, South Africa, Tanzania, Mali, Mauritius, Ethiopia and Cabo Verde. As with the case around the world, women in Sub-Saharan African countries are providing significantly more unpaid care services in households and communities. Read the report to learn more about time-use analysis concepts and methodologies, gender variations in paid and unpaid work across the world and across various socio-economic levels:
This blog was authored by Shirin Arslan, Program Manager for the Care Work and the Economy Project
When crisis hits, longer-term thinking can easily, and understandably, be cast as a distraction or a luxury—even when it relates to tackling critical issues like gender inequality, climate change, or extreme poverty.
Speaking personally, I’ve felt a bit silly trying to push forward projects that focus on gender lens investing or women’s economic empowerment in the last few weeks, given that my colleagues’ and collaborators’ attention, and frankly much of my own, lies elsewhere, and with something that seems much more pressing.
But for those of us who are in the position of privilege to continue thinking long term, it’s our responsibility to do so. Working towards structural changes that will take longer to come to fruition, especially those that relate to reducing global inequality, is the only way to radically decrease the extent of harm caused by moments of crisis, especially for vulnerable populations.
Dismantling unequal power structures, and in turn ensuring that every individual—regardless of gender, age, income level, national origin, and so on—has a safety net protecting them from vulnerability to health scares, income loss, and threats of increased violence, will allow us to focus on crisis without fearing fallout across every dimension of life.
In times of pandemic, the economically vulnerable cannot afford to stay home. Women in quarantine are facing increased risks of intimate partner violence. Girls staying home from school in some parts of the world may not have the opportunity to return. And none of this would be the case if we more effectively tackled the forms of inequality that underlie these realities. Then a virus could be a virus — assuredly deadly and destructive from a health perspective – but without inciting increased abuse, poverty, and lost prospects.
My colleague David Evans, drawing upon work by Claire Wenham, Julia Smith, and Rosemary Morgan in The Lancet, recently highlighted a range of problems stemming from the COVID-19 pandemic that disproportionately impact women and girls. In hopes of continuing to move the conversation forward, I propose some solutions to those problems here, and welcome others to add to this initial list. To be clear, these actions should not distract from immediate measures to address the pandemic. But we also can’t afford to risk forgetting about them when the focus on COVID-19 has faded; otherwise history is doomed to repeat itself.
1. Promote a Gender-Equal Health Workforce
Because the health workforce is disproportionately women (67%), women are at a higher risk of exposure to the virus within medical facilities.
More doctors worldwide are still men. But the vast majority of the global health workforce consists of nurses, community health workers, and others who are less highly compensated. All health workforce jobs need to become increasingly well-compensated, high-quality jobs. Not only will this incentivize men to seek these positions, destigmatizing their current positioning as “feminine” and dismantling occupational sex segregation within the healthcare sector, but it will also ensure that those on the frontlines of protecting populations from pandemics don’t also have to fear economic fallout on a day-to-day basis.
The number of women doctors is rising. Research from other sectors tells us what works to combat occupational sex segregation, including men acting as mentors supporting women to “cross over” into higher-paying occupations. These efforts will have to be paired with those that increase the perceived (and actual) value of work in sectors, including nursing and other frontline health work, where women dominate. More research is needed on this front, both on what works to incentivize men to take up traditionally “feminine” roles and how to avoid unintended displacement of women from those occupations.
2. Protect (and Expand) Existing Health Resources
With all hands on deck to fight COVID-19, particular groups of women and girls face other health risks.
Health facilities should not have to choose between providing lifesaving care in the face of pandemics and continuing to provide support for those in need in other areas, including pregnant women, adolescent girls (who have the highest prevalence of HIV infection, and in need of life-saving medication to keep their immune systems strong), and all women and girls in need of contraceptive access.
Increased investments in health are needed to ensure critical day-to-day care is not compromised during times of crisis. Establishing a Global Health Security Challenge Fund would help ensure countries are prepared to balance day-to-day needs with additional burdens in the face of pandemic, and evidence-based prioritization strategies are needed for when resources cannot be expanded.
3. Reduce and Redistribute Unpaid Care Work Burdens
As schools close and people fall ill, women and girls will assume increased unpaid care work burdens.
Under business-as-usual scenarios, women and girls do more than their fair share of unpaid care work, which limits their educational attainment, workforce participation and advancement, and leisure time. To lessen these burdens in times of crisis and more generally, we need increased investments in child and elder care, and in the poorest countries, gender-responsive energy, water, and sanitation infrastructure that would reduce the time women and girls must spend collecting water and fuel, as well as cooking and cleaning. We also need shifts in household norms that mean men assume more unpaid care responsibilities. Initiatives focused on promoting women’s economic empowerment, such as 2X Challenge and the Women’s Global Development and Prosperity (W-GDP) initiative, as well broader investments in gender equality and economic growth, must prioritize reducing and redistributing women and girls’ unpaid care work.
4. Address Gender-Based Violence
With quarantine measures imposed and stress heightened, women are at increased risk of violence committed by their partners and family members, and essential support services are absent.
Early reports suggest that gender-based violence rates are increasing in light of COVID-19 quarantining, consistent with evidence documenting increased violence in other crisis settings. Gender-based violence needs to be elevated as its own public health crisis, and resourced accordingly.
We’re far from meeting this objective, considering that all OECD donors combined allocated less than $200 million to addressing violence against women according to 2016-17 data, and over half of this financing came from just three countries (Australia, Canada, and Norway). Increased resources should target evidence-based approaches, such as Promundo’s MenCare program.
In pandemic contexts, preparations for social distancing should include considerations of how individuals will be able to access social services when faced with violence in their households. The World Bank has taken a step in the right direction in positioning interpersonal and gender-based violence as priorities to address in its new Fragility, Conflict, and Violence Strategy, though time will tell how the bank and other donor institutions finance this priority.
5. Guarantee Girls’ Education
With schools closing as part of social distancing measures, girls who already face pressure to drop out of school may not return.
Even absent crisis, tens of millions of girls globally face pressures to drop out of school to care for siblings and do other unpaid domestic work, contribute to supporting their households financially, and/or marry and have children when they are still children themselves. These pressures may be heightened due to interruptions in their education, as observed when Ebola hit West Africa. School closures, especially those impacting adolescent girls, should be weighed against longer-term risks related to girls’ school drop-out and limited school-to-work transition prospects as a result. Where possible, efforts should be made to incentivize parents to allow their children to return to school and to ensure consistent access to sexual and reproductive health services in the interim, as unintended pregnancy is cited as a reason for girls’ failure to return to school.
6. Promote Women’s Economic Opportunities
Across the globe, women are more likely to work jobs that are low-paid, informal, and lacking in benefits.
In large part due to the disproportionate unpaid care work women take on, they are less likely to be employed full-time, in the formal workforce, or in jobs that provide paid sick leave, unemployment insurance, and other protections.
We must continue to invest in evidence-based programs and policies that improve women’s economic opportunities and support organizations such as the Self-Employed Women’s Association and Women in Informal Employment: Globalizing and Organizing—organizations that are well-positioned to provide and advocate for dignified work.
Cash transfers should be considered as a means of ensuring a social safety net for those most in need. Critical to transfers’ success will be (1) ensuring that delivery mechanisms (through digital technology or otherwise) are properly designed and implemented and (2) that those in need, including low-income populations and workers vulnerable to economic backslides because of the virus, are prioritized.
7. Ensure Women’s Representation in Decision-Making and Critical Research
Women are not equally represented in decision-making roles responding to the COVID-19 pandemic.
The White House Coronavirus Task Force is over 90 percent men, and the team Prime Minister Johnson just assembled to lead the United Kingdom’s COVID-19 response is all men. As in the contexts of peace and security, international trade, and climate change, an exclusionary approach to decision-making will yield inferior decisions: those that don’t account for the needs and constraints of populations absent from the table.
Going forward, decision-making teams should be equally representative of men and women, and also prioritize other forms of inclusion, such as those based on race and ethnicity, as called for by Women in Global Health’s Operation 50/50 campaign.
Women must also be equally represented in clinical trials as biomedical treatments and other interventions are developed. As my colleague Carleigh Krubiner has noted speaking to the context of Ebola, women who are pregnant or breastfeeding are typically excluded from experimental studies, and in some high-fertility contexts, this means up to 80 percent of reproductive age women are virtually invisible in trial samples. Lack of representation means a lack of essential data on the types of prevention methods, treatments, and other interventions that work for women, risking higher fatality rates and other complications.
Times of crisis magnify the cracks in our systems and highlight disproportionate risks to the most vulnerable among us. COVID-19’s impacts, those already felt as well as those still anticipated, should serve as a wake-up call. They should spur action to address underlying inequalities, including those that disadvantage women and girls worldwide and make the consequences of a pandemic even worse than they would otherwise be. Increased prioritization of women and girls’ health, education, economic opportunity, safety, and decision-making power can help create a world where no one falls through the cracks. Decision-makers should realize this is inextricably linked to today’s pandemic response.
Original blog published on Center for Global Development website March 18, 2020, see here for the original post
Reposted with permission from Megan O’Donnell Assistant Director, Gender Program and Senior Policy Analyst at Center for Global Development