Last month, the Biden administration revealed the details of the $2 trillion American Jobs Plan.
The plan recognizes that investing in the care economy, as with investments in traditional infrastructure, can lift incomes, unleash productivity, and pave the path towards a more equitable economic recovery and growth.
Addressing the care crisis
Built into the plan is a pledge to “solidify the infrastructure of our care economy by creating jobs and raising wages and benefits for essential home care workers.” The plan calls for Congress to invest $400 billion towards expanding access to quality, affordable home- or community-based care for aging relatives and people with disabilities. These investments will help Americans to obtain the long-term services and support they need, while creating new jobs and offering care workers a long-overdue raise, stronger benefits, and an opportunity to organize or join a union and collectively bargain. Research has shown that increasing the pay of care workers leads to better quality care overall. Through creating well-paying care jobs with benefits and o collectively bargaining rights, as well as building state infrastructure, the plan aims to improve both the quality of job for care workers and the quality of service for care recipients.
Lack of access to childcare makes it harder for parents, especially mothers, to fully participate in the workforce, hurting families and hindering U.S. growth and competitiveness. In areas with the greatest shortage of child care slots, women’s labor force participation is about three percentage points less than in areas with a high capacity of child care slots. The pandemic has severely exacerbated this problem with more than 1 in 4 facilities still remaining closed as of December 2020. President Biden is calling on Congress to provide $25 billion to help upgrade child care facilities and increase the supply of child care in areas that need it most. These funds are to be provided through a Child Care Growth and Innovation Fund for states to build a supply of infant and toddler care in high-need areas. Also included in this $25 billion is a call for expanded tax credits to incentivize businesses to provide care facilities at their establishments. This will grant accessible, high quality care and learning environments for children of employees. This particular part of the plan is structured so that employers will receive 50 percent of the first $1 million of construction costs per facility.
Investment in care is investment in infrastructure
As Cecelia Rouse, Chair of the Economic Advisors for the Biden administration, recently indicated during a recent press conference, we need to “upgrade our definition of infrastructure” to include the care economy. Rouse defended the Biden administration’s plan to spend $400 billion of the infrastructure plan’s budget on the care economy, defining it as a legitimate infrastructure investment and a key component to addressing economic inequities in the U.S. The care economy is critical to U.S. economic activity, and its absence would greatly hinder economic productivity. The inclusion of care work and the care economy in the American Jobs Plan is a critical first step in mending a critically broken care infrastructure in the U.S.
Still, it is only the first step. The U.S. is the only industrialized nation that fails to provide national paid family leave and medical leave programs, and where hundreds of thousand sit on waiting lists for desperately needed home care. LeadingAge, which represents service providers in the sector, estimates that half of all Americans will need long-term services and support after turning 65, and that by 2040, a quarter of the U.S. population will be 65 or older. In addition to the President’s proposal for the care economy, we also need investments to finally put America on a path to universal childcare and early learning, national paid family and medical leave and paid sick days for all workers. The COVID-19 pandemic has exposed both the importance of care work and the vulnerabilities of our care infrastructure. At the same time, it has also created an opportunity for us to rethink the value of care and care work, opening ways for us to rebuild a more resilient care infrastructure and a more inclusive economy.
Institute for Women’s Policy Research released a report in February 2021”IWPR Women’s Priorities and Economic Impact Survey” outlining a recent poll of 1452 women in the U.S. The findings are backdropped by the experience of women throughout the pandemic and resulting economic turndown, in which 2.35 million women have left the workforce since February 2020.
Some of the key findings from this survey are:
- 1 in 4 women report that they are worse off financially than one year ago
- Nearly half of all women are worried about the financial situation of their families
- 1 in 4 women report having needed to take time work off but did not do so
- 40% of women reported care demands stopped them from working or forced them to reduce hours
- 69% of women support paid sick time to have a child, recover from a serious health condition, or care for a family member
- 20% of women with children want the Biden administration to address childcare and education in the first 100 days
In terms of women experiencing reduced paid work as a result care demands, this has also been pointed to within recent working papers put out by the
The impact of care demands on women’s paid work is explored in a number of Care Work and the Economy Working Paper Series. For instance in two recent papers, “Gender Wage Equality and Investments in Care: Modeling Equity and Production” and “Parental Caregiving and Household Dynamics”.
Education and childcare were listed among the top priorities for the Biden administration to address within the first 100 days among survey participants. This is largely because women’s ability to reenter the workforce largely depends upon safe reopening of schools and childcare facilities.
Latinas have been hit particularly hard according to this survey, reporting the highest levels of taking leave from jobs in order to provide care. However, across all ethnicities, 69 percent of women expressed strong support for paid sick leave and the ability to take time away from work to provide care or recover from illness.
The Unites States remains the only high-income country in in the world that fails to provide guaranteed paid sick or family leave for workers. The Family Medical Leave Act, which provides unpaid job protection, and only for about 56 percent of workers. The Families First Coronavirus Relief Act has provided access to paid leave as a result of the pandemic but falls short in the fact that more than 100 million workers are excluded from this because they are caregivers.
In order to address the many issues identified throughout this survey, there is strong need for targeted programs and policy solutions that will aid a gender equitable recovery. This recovery should not only address immediate short term needs but include long term strategies that will create more resilient systems that recognize the contributions of women to the workforce, society and family structure.
IWRP specific recommendations for the short term are:
- Continuing economic impact payments
- Expanding access to affordable healthcare
- Providing paid sick and medical leave
- Raising the federal minimum wage
- Building a new childcare infrastructure
Equitable economic recovery necessitates a national care system that meets the needs of all families, raises wages and provides quality childcare, treating it as a public good instead of a private obligation.
The need for an inclusive, gender-equitable recovery from the COVID-19 pandemic is slowly gaining recognition as it lays bare and exacerbates inequities in economic, social, health, and environmental policies and programs.
The Hawai’i State Commission on the Status of Women convened a working group to develop and share principles and practices for implementing a gender-responsive and feminist response to COVID-19, culminating in the publication of Building Bridges, Not Walking on Backs: A Feminist Economic Recovery Plan for COVID-19.
Similarly, the YWCA Canada and the Institute for Gender and the Economy (GATE) at the University of Toronto’s Rotman School of Management published a joint assessment, A Feminist Economic Recovery Plan for Canada: Making the Economy Work for Everyone. The plan highlights critical principles and provides actionable recommendations for the government to develop and implement post-pandemic recovery policies that are equitable and inclusive of all marginalized people.
Together, the Canadian and Hawaiian plans provide a roadmap to recovery through gender-transformative policy-making. Both are built on an intersectional analysis of the impact of the pandemic and call for an approach to economic recovery that examines and confronts the root causes of inequality, including but not limited to patriarchy, ableism, queerphobia, white supremacy, colonialism, classicism, and racism.
A recent brief by Alexandra Solomon, Kate Hawkins, Rosemary Morgan of the Gender and COVID-19 Working Group describes the intersecting, complementary, and mutually reinforcing elements of the two frameworks and echoes the call for feminist economic recovery. It provides a collection of best practices for the core tenets of post-pandemic policy-making which should be echoed and adapted by policy-makers from other settings.
Key Recommendations to Policymakers:
- Pandemic responses should be underpinned by data that is disaggregated by sex and other markets of inequity at the national and subnational level. This data should be made public and used in decision making.
- Women-led organizations, feminist academics and women’s experiences and ideas should be at the center of recovery efforts in government bodies, official consultations and online spaces.
- The provision of universally accessible, free childcare and long-term eldercare should be central to economic recovery plans and attempts to ‘open up’ the economy. Precariously employed immigrant care workers should be provided with an expedited path to permanent resident status.
- Austerity-induced budget cuts should be avoided as they impact most greatly on the poor, women and other marginalized groups. Instead policy-makers should strengthen public welfare assistance (such as unemployment benefit) and labor rights (such as paid sick leave, family leave and a guaranteed living wage).
- Special stimulus funds should be designated for high risk groups, such as those who are not eligible under existing government schemes, are disproportionately experiencing financial hardship and poverty, and already face barriers to accessing their rights to health, safety, independence and education.
- Invest in universal, affordable, and sustainable access to water, sanitation, hygiene and housing, and prioritize closing the gender digital divide.
- Support women in female dominated economic sectors particularly hard hit by the pandemic as well as historically marginalized women workers, such as Indigenous women and sex workers.
- A feminist recovery is aligned with a ‘green’ recovery and the two should be considered in conjunction.
- Revisions of fiscal and monetary policies should be taken as opportunities to address inequality in wages, employment, and quality of life.
- Health systems should be restructured to focus on Universal Health Coverage and to address problems in service access and quality due to sexism, colonialism and white supremacy. Tackling the social determinants of health should be a priority.
- All hate, violence, and oppression against women, gender-diverse people, and Indigenous, Black, and racialized communities must be addressed in the COVID-19 recovery.
READ FULL BREIF:
Solomon, A., Hawkins, K., and Morgan, R. (2020). Hawaii and Canada: Providing lessons for feminist pandemic recovery plans to COVID-19.The Gender and COVID-19 Working Group.
The childcare system in the US was already in a critical state of inadequacy, and the COVID-19 pandemic has only made this worse. A recent report released by the U.S. Congress Joint Economic Committee (JEC) – “We Need to Save Child Care Before It’s Too late” – explores the U.S. childcare crisis in detail, outlining the shortages in child care and the consequent economics effects of those shortages.
According to the report, as of August 2020, roughly 214,000 U.S. childcare workers were out of a job and 4 out of 5 childcare providers expected to close permanently if no public assistance is provided. This is of course having a trickle-down effect on the working parents that rely on this childcare, and 13% of parents reported having to reduce their working hours.
This issue is further compounded in the many areas throughout the country considered to be “childcare deserts” where the supply of childcare falls well below the demand and for many families is not accessible due to cost constraints. Although there are assistance programs available for those in need, such as the Head Start program, many of those that qualify still do not receive assistance due to severe lack of funding. In over half of states, childcare and early childhood education exceeds the cost of college tuition, and bearing this burden is extremely difficult for lower income families.
Middle income families that do not qualify at all for government funded programs are under even more strain with the financial obligations of childcare. Infant care is in particular incredibly expensive, and a median income family home could spend anywhere from 23% to 77% of their income on the care of their infant, depending on the state. For single mothers in the median income range, this could be from 29% to 94%.
Childcare costs in the U.S. are exponentially higher than its OECD counterparts. The U.S. spends less that half the amount of its GDP on childcare in comparison to the average of other OECD nations. In fact, the U.S. spends 3 to 6 times less than France, New Zealand, and all the Nordic countries. Where in many OECD nations, childcare is free or very inexpensive, making it widely accessible, in the US, the accessibility and quality of childcare for working parents is contingents upon their economic status. A lack of accessible and affordable childcare leads to lost earnings for parents, an estimated $20 – $35 billion in total, according to the Economic Policy Institute. This in turn translates into a loss of roughly $4.2 billion dollars in federal and state tax revenue per year. The cost of childcare is skyrocketing past the rate of inflations as well, between the years 2000 and 2020, day care and preschool costs rose double that of inflation.
Extensive research has shown that accessible and affordable childcare has strong positive economic benefits and contributes to the well-being of children and parents. Without the benefit of accessible and affordable childcare, many parents, mostly women, experience reduced earnings for the duration of their careers. This also contributes tremendously to the gender wage gap. Furthermore, according to a 2015 Council of Economic Advisors report, every dollar spent on childcare and early education carries the potential to yield eight dollars in societal benefit.
Childcare workers also struggle due to low wages, poor benefits, and precarious working conditions. In 2017, an average childcare employer kept 13 workers on payroll, each of whom earned just $20,886 on average in annual compensation. In 2019, the median hourly wage of U.S. childcare workers was $11.65, a near-poverty wage. Nonetheless, employee’s compensation is the highest cost for these establishments, as they must maintain a low ratio of children to caretaker, which varies from state to state. Cost of rent is another major expense for childcare providers, but reducing the size of the facility, and therefore the rent costs, is not a viable option as crowding and lack of outdoor space has been shown to increase the risk of infections and injury within the centers.
There is still a great amount of work to be done in the U.S. The CARES Act passed in March of 2020 provided $3.5 billion of funding to states in childcare subsidies for low income families. Additionally, the inclusion of the Paycheck Protection Program (PPP) provided $2.3 billion to childcare providers across the country, enabling 460,000 childcare workers to remain employed. Although these measures were helpful, much more assistance is still needed. For the most part, smaller childcare centers and home-based programs were not able to access these PPP funds at all, with only 29% of them receiving these funds. The vast majority of childcare operations across the board, many of which single-person operations, were also not able to access these PPP funds at all. The HEROES Act, passed in the House of Representatives in May, would provide another $7 billion in relief for childcare centers and $850 to fund child and family care for essential workers. However, this legislation has stalled in the Senate.
This pandemic has dealt a devastating blow to an already inadequate childcare system in the U.S. Without desperately needed assistance, the U.S. faces the potential of losing 80% of its childcare capacity. This will in turn deprive working parents of the critical services and infrastructure needed for the economy to recover. Read the complete report “We Need to Save Child Care Before It’s Too Late.”
OECD Health Policy Studies has released a 2020 report “Who Cares? Attracting and Retaining Care Workers for the Elderly.” This report addresses a number of important issues while acknowledging the tremendous impact that COVID 19 has had on elderly people and their caretakers. Across OECD countries, more than one out of every six individuals is above the age of 65, and of those roughly 60% live with multiple chronic conditions, making them even more susceptible to the potentially deadly impacts of the virus. Furthermore, many elderly individuals struggle with sufficient access to social support and lack the ability to properly deal with the mental strain of living in a world being affected by a global pandemic.
Beyond these strains, there is a crisis in workforce shortcomings of the Long Term Care (LTC) Sector, which becomes even more problematic in light of the fact that an estimated 50% of COVID 19 related deaths are occurring in LTC facilities. This OECD report begins by addressing many of these shortfalls within the LTC sector, and policies that have the potential to address them.
Within three-quarters of OECD countries, the aging population has outpaced the workforce within the sector since 2011. This is the case even in the countries that have a higher workforce supply than the OECD average such as Japan and the U.S. Within the sector, women make up 90% of the LTC workforce. Attracting a younger workforce has been particularly difficult, and on top of that maintaining workers over the age of 50 is also a challenge. This is even more concerning given that the median age of LTC workers is currently 45.
Many OECD nations have made moves toward relocating their elderly out of facilities and back into the community. This is provoked by the desire to match the preferences of their elderly populations with home-based care, in addition to containing LTC spending. However, a lack of home-based workers has made this challenging, and LTC institution-based workers remain representative of the sector’s workforce across the OECD. This is in large part due to the fact that these institutions cater to the most disabled, which requires a larger workforce. Furthermore, many community-based solutions are not yet equipped to take in these types of complex cases.
The aging of the postwar “baby boom” generation is a factor that will contribute to the increased need for LTC workforce. This also contributes to the predicted increase in labor shortages in the sector to meet the needs of this population going forward. Further, unpaid informal care workers, like that of family members that would care for this aging population, have seen an increase in their own professional workload burdens. When the workload of professional life and caretaking becomes too great, LTC facilities are a means in which to relieve some of that strain. Additionally, as birth rates decline, families become smaller and more women are pursuing professional endeavors, the availability of informal caregivers for the aging population decreases looking into the future. This contributes to another foreseen LTC workforce shortage in the future.
These shortages call for an increase in recruitment within the LTC sector. As the sector workforce ages, attracting younger workers has proven difficult as they, mostly women, are drawn to sectors that have a more appealing image such as a child or hospital care. Additionally, LTC jobs are still widely considered to be feminine positions, and the sentiment on this subject matter has been slow to change.
Foreign-born workers play a significant role in recruiting and retaining LTC workforce. They are highly over representative within LTC across the OECD when compared to other care sectors, and many of them are young, Often, they tend to come into the sector with high levels of skill sets, even overqualified. Micro-econometric analysis has shown that in the U.S. and the UK, these foreign-born workers have higher retention rates than others within the sector.
In terms of recruitment, drumming up interest in the available positions is also problematic. In some cases, many vacancies receive no applications at all. On top of this, recruiters often have a difficult time identifying qualified candidates out of those that do apply.
In order to address this, many countries have focused on four main policies:
– Target recruitment to the traditional pool
– Improve the Image of the sector
-Recruit outside the traditional pool
-Increase the recruitment of for foreign-born workers
Overall, better policies are needed in order to improve recruitment within the LTC sector, and thus far few OECD nations have implemented policies in order to do so. By addressing these issues addressed within the first section of this report, there is potential for effective improvement.
Joe Biden has officially accepted the Democratic Presidential nomination, and he and his team plan to make substantial investments in the infrastructure of care in the U.S. if he wins in the Presidential election. The potential of this plan to provide much-needed support for care workers, both paid and unpaid, is more important than ever amidst the pandemic.
Even prior to this pandemic, the U.S. has long suffered a caregiving crisis. Family caregiving needs often come with incredible financial, emotional, and professional burdens. Professional caregivers, disproportionately women of color, have long been underpaid and undervalued. The pandemic has exacerbated these issues, leaving parents struggling to find the care services needed while juggling careers. There are a number of measures that have been proposed by the Biden team to address the many issues currently plaguing the overall care system in the U.S. today.
Elderly individuals in nursing homes are feeling an increasing need to be cared for at home rather than in community living situations where they are more vulnerable to COVID-19 exposure. The Biden care plan addresses this by aiming to close the existing Medicaid gap to allow for home and community-based care services while creating a state innovation fund for cost-effective direct care services. This will provide more affordable and accessible care on that front. This step will also help to alleviate the extensive waitlists now existing for those under Medicaid to enter home and community care programs, providing these services for 800,000 individuals. If implemented properly, this initiative allows the opportunity to provide more functional care systems that grant greater independence to elderly individuals, while also freeing many unpaid care workers, such as family members, to pursue professional endeavors.
This plan also proposes increasing wages and benefits for caregivers and early childhood educators while providing opportunities for training, professional growth, and unions. This particular initiative takes into consideration the fact that early childhood development is incredibly important, and quality childcare is essential for children to grow into healthy, productive members of society. Universal preschool will also be provided via tax credits and sliding scale programs. Furthermore, included is an investment into safe and developmentally appropriate childcare facilities, including bonus pay for those providers that operate non-traditional hours, such as early mornings, late evening, and weekends. By increasing access to childcare centers with more flexible hours, the burden for many families will be lifted; currently, many parents that don’t work traditional Monday through Friday hours are left scrambling to find adequate care. These initiatives overall will have significant positive impacts on working parents, particularly women. Far too often, women find themselves sacrificing professional progression and development due to the constraint of inadequate or unaffordable childcare.
For those parents who grapple with the decision to further their education as a result of unaffordable and reliable care, investment in childcare centers at community colleges is also included in this plan.
Lastly, expanding the awareness of the Department of Defense fee assistance childcare programs so that all military spouses have the ability to pursue their professional development and education.
In order to pay for these initiatives, the Biden team has estimated a cost of $775 billion over the span of ten years, to be funded by rolling back certain tax breaks for those earning over $400,000 annually. A $5000 tax credit or Social Security credits for those providing unpaid care for members of their family is also proposed. Further, the plan seeks to offer low- and middle-class families up to $8000 in tax credits to assist in paying for childcare. For those that choose not to claim this credit, high-quality care is to be provided on a sliding scale, where it is estimated that families will not pay over $45 per week.
Although this plan is incredibly ambitious, and its implementation is not a guarantee, it sets a precedent that has been long lacking within the U.S. care work sphere. Implementation of these initiatives on any scale would prove beneficial to both the paid and unpaid care economy.
Earlier this month, the Hofstra Labor Studies and the Center for the Study of Labor and Democracy in collaboration with Long Island Jobs with Justice and A.L.L.O.W. (Advancing Local Leadership Opportunities for Women) conducted a virtual forum addressing care work in the context of COVID-19. This discussion emphasized the financial and mental health challenges associated with all types of care work during this pandemic, and the immense need to address and resolve these issues in order to assist with a fair and sustainable economic recovery. Although the discussion is focused primarily on Long Island and New York, the problems indicated are applicable to care work throughout the U.S.
There is anecdotal evidence to suggest that the unemployment or the stress of juggling work and home life as a result of the crisis has hit women much harder than men. This discussion utilized academia as an example of this, drawing upon data indicating that academic journal submissions have greatly increased among men since the beginning of the pandemic, but sharply decreased among women. For those working in academia, publishing work is crucial to professional advancement.
The pandemic has also shed a harsh light on the fragility of the overall childcare system in the U.S. Many families lacked adequate childcare even before the pandemic, forcing them to rely on unpaid care work. These existing issues paired with the recent closures of childcare facilities has exacerbated the problem.
Although the CARES Act did include childcare support, New York receiving $164 million going toward the childcare industry to provide protective equipment and cleaning supplies, the panel argues that while helpful those measures still did not provide adequate relief. The HEROES Act could potentially provide further relief for the care industry, but participants of this forum are less than optimistic about it providing the level relief needed.
The International Labor Organization estimates that three-quarters of unpaid care worldwide is provided by women. In the U.S. women provide 37% more unpaid care work than men on a daily basis. Among care providers in the U.S., Hispanic women do the majority of unpaid care and account for the biggest gap among men and women. Beyond traditional gender roles, this is largely tied to economics; oftentimes men have opportunities to make more money. But generally speaking, even when both parents work full time, women are still taking on more unpaid work even if they are earning more money than the male figure within the household.
There is also a societal tendency which expects care workers to be exceptionally giving. This is highlighted in the fact that even within paid care work positions, there is a fair amount of unpaid work being performed. For example, staying with an elderly person at their doctor’s appointment a couple of hours after the official workday has ended. This is a constant strain within the care industry, and COVID-19 has increased the pressure on this component of unpaid work within the paid care industry.
Additionally, the many racial and ethnic disparities within care work serve as a microcosm of larger racial inequities prevalent in society. For example, in New York, 80% of care workers are women, and a large majority of them are women of color. Furthermore, care workers in New York typically make minimum wage yet are still known to go above and beyond in their roles to ensure the best care is provided, regardless of whether or not it is part of their job description. This existing issue has been pushed to a new level due to COVID-19; now many of our care workers are putting their lives on the line.
Part of the reason that low wages are prevalent within the care sector is the historical association that care work is a “women’s job,” coming naturally and requiring little skillset. This sentiment in the U.S. is compounded by care work being viewed as the responsibility of the individual. The decision to have a family is viewed as a personal choice, therefore the basic needs of childcare are the sole responsibility of the parents, not something to be addressed via larger social safety nets.
New York is facing a particularly troubling dilemma within its care work industry. Despite the fact that a large majority of the workforce is comprised of immigrants, the guidelines that have been released outlining protection measures from COVID-19 are only available in English. This is concerning given that some workers may not yet possess the English language proficiency necessary to fully comprehend these guidelines.
In order to address these strains within the care work industry, political will and national policy are needed. The U.S. Department of Defense provides an exemplary model that could be emulated on a national scale. This government sector presently has one of the best childcare systems available in the U.S., operating on a sliding scale making it accessible to all those within the department that need it. This allows these federal employees to perform their duties with the comfort of this social safety net.
Furthermore, at the local level, immediate state, and county-level funding for care work can have a significant impact on the accessibility needed during this stressful time. Without swift action on the policy level, the issues discussed will continue and have detrimental effects on not only families, but economic recovery as well.
Even in a typical year, U.S. households are estimated to experience $31.9 billion in lost wages as a result of inadequate childcare and paid leave. Roughly 1 in 5 people living in the U.S. today incur caregiving expenses, and the need for care work is experienced in nearly every household at least once. Those who are professional care workers, disproportionately women of color, are underpaid and therefore susceptible to financial insecurity. Those insecurities have been exacerbated even further amidst COVID-19 and the resulting economic downturn.
In June 2020, the Aspen Institute Business and Society Program hosted a digital discussion “Paid Leave, Livable Wage, Affordable Care: Policies that Could Avert the Next Crisis” in conjunction a policy brief “The True Cost of Caregiving” that was released in May. Within this discussion, the panel focused on the fragility of the care system and the financial stability of those providing care, both paid and unpaid. The panel not only addresses these issues but seeks to re-imagine a system in which care is treated like a public good, examines the hierarchy of human value, delves into the historical context behind care work in the U.S., the vulnerability of care workers in the current pandemic, and the inefficiency of the current care economy within the larger economic system.
A number of important questioned are addressed such as:
– How to quantify the benefits of paid leave, livable wages, and affordable care policies?
-What are feasible policy responses to COVID-19, in both the short term and long term, that can lead to better systems of caregiving in the U.S?
-What does an inclusive and equitable care system could look like?
-Who bears responsibility for building this system?
Further, this panel brings to the table the idea that care work should be invested in collectively as a nation, as opposed to being looked at as an individual burden; which puts increasing downward pressure on those who are already disadvantaged in the U.S. due to race and gender.
Policies that address these concerns could assist in not only building a more equitable system of care but have the potential to aid in averting future crises like that which the care economy finds itself in today.
Policymakers should be thinking—and worried—about how COVID-19 is expected to disproportionately affect women and girls. Gender inequality can come into even starker focus in the context of health emergencies. With COVID-19 continuing to spread, what do we see so far—and what can we expect in the future—in terms of the impacts on women and girls?
Wenham, Smith, and Morgan discuss gendered impacts in their article, “COVID-19: the gendered impacts of the outbreak,” in the Lancet. Women appear to be less likely to die from COVID-19: “Emerging evidence suggests that more men than women are dying, potentially due to sex-based immunological or gendered differences, such as patterns and prevalence of smoking.” But keep in mind that “current sex-disaggregated data are incomplete, cautioning against early assumptions.” In other research, data from 1,000+ patients in China show that “41.9% of the patients were female.” (Guan and others 2020). But beyond these direct effects, most of the other impacts affect women negatively and disproportionately.
Wenham, Smith, and Morgan highlight that women will be more affected in places with more female health workers. In an analysis of 104 countries, Boniol and others (2019) show that women form 67 percent of the health workforce (see the figure below). In China, “an estimated 3000 health care workers have been infected and at least 22 have died” (Adams and Walls 2020). As the pandemic spreads, the toll on women health workers will likely be significant.
Figure. Gender distribution of health workers across 104 countries
Source: Boniol and others (2019)
Here are other areas highlighted by Wenham, Smith, and Morgan:
– School closures are likely to have a differential impact on women, who in many societies take principal responsibility for children. Women’s participation in work outside the home is likely to fall. (My colleagues Minardi, Hares, and Crawfurd have written about other impacts of school closures during an epidemic.)
-Travel restrictions will affect female foreign domestic workers. Of course, they also affect male migrants. The distribution will vary by country. Research by Korkoya and Wreh (2015) found that 70 percent of small-scale traders in Liberia are women, so domestic travel restrictions during the Ebola outbreak disproportionately affected women.
-Health resources normally dedicated to reproductive health go towards emergency response. During the Ebola outbreak in Sierra Leone, for example, the “decrease in utilization of life-saving health services translates to 3600 additional maternal, neonatal and stillbirth deaths in the year 2014-15 under the most conservative scenario” (Sochas, Channon, and Nam 2017). In my own research (with Goldstein and Popova), we found that the disproportionate loss of health workers in areas that had few to begin with would likely lead to higher maternal mortality for years to come.
-When women have less decision-making power than men, either in households or in government, then women’s needs during an epidemic are less likely to be met.
Here are four additional concerns:
-Sexual health: During the school closures of Sierra Leone’s Ebola outbreak, “a reported increase in adolescent pregnancies during the outbreak has been attributed largely to the closure of schools.” (UNDP 2015). Bandiera and others find that in villages highly disrupted by Ebola, girls were “10.7 percentage points more likely to be become pregnant, with most of these pregnancies occurring out of wedlock.” A United Nations report gives an even higher estimate of 65 percent. The absorption of health resources by emergency response may also lead to disruptions in access to reproductive health services.
Many girls didn’t return to schools once they reopened, and there were increases in unwanted sex and transactional sex. (Notably, Bandiera and others also find that girls in villages where there were established “girls’ clubs”—safe spaces for teenage and young adult girls to gather and get job and life skills—before the epidemic experienced fewer of these adverse effects.)
-Intimate partner violence rises in the wake of emergencies: Parkinson and Clare document a 53 percent rise in the wake of an earthquake in New Zealand and nearly a doubling in the wake of Hurricane Katrina in the United States. Mobarak and Ramos find that in Bangladesh, increased seasonal migration reduces intimate partner violence, at least in part because women spend less time with the potential perpetrators of that violence. Travel restrictions may be expected to have the opposite effect.
-The burden of care usually falls on women—not just for children in the face of school closures, but also for extended family members. As family members fall ill, women are more likely to provide care for them (as documented during an Ebola outbreak in Liberia, with AIDS patients in Uganda, and in many other places), putting themselves at higher risk of exposure as well as sacrificing their time. Women are also more likely to be burdened with household tasks, which increase with more people staying at home during a quarantine.
-As Mead Over and I have discussed, health crises can trigger economic crises. Economic crises affect women disproportionately, particularly in low-income countries. Sabarwal and others found that men’s labor force participation remained largely unchanged during economic crises, whereas women’s labor force participation rose in the poorest households and fell in richer households.
-Last week, the World Health Organization declared that “this is the first pandemic caused by a coronavirus.” There have been more than 168,000 confirmed cases and more than 6,600 deaths in 148 countries as of publication of this blog. The impact of this pandemic will be felt for years to come. As women are often disproportionately affected by the follow-on effects of the disease, we have to make sure that we keep women’s rights and needs front and center in our responses. A first step in doing that is making sure that women are a central part of the teams designing those responses.
Contributed by David Evans, senior fellow at the Center for Global Development, working on education, health, and social safety nets.
Original blog published on Center for Global Development website March 16, 2020, see here for the original posting
Reposted with permission from David Evans, senior fellow at the Center for Global Development
“Shelter in place” mandates in the early stages of the U.S. Covid-19 pandemic required many people to stay home, cook their own meals, school their own children, and entertain themselves. Unpaid work served not only as a social safety net, but also as an automatic stabilizer. While it didn’t dampen fluctuations in official Gross Domestic Product, as did unemployment insurance, it clearly helped stabilize consumption.
Just imagine what would have happened if most people had not had refrigerators, stoves, and computers—or just read reports of the plight of homeless people.
By mid-March 2020, many states and localities shut down restaurants for any services other than take-out. Home-produced meals increased of necessity. Many such meals probably consisted of convenient processed foods that could be popped into a microwave oven, but a renaissance of home cooking also became apparent, along with reliance on long-lasting, easily stored items such as rice and beans. Analysis of Google Search terms showed a sharp spike in questions concerning food preparation and storage. As one newspaper put it, America began baking its heart out. Yeast suddenly became as hard to come by as toilet paper.
In 2018, according to the American Time Use Survey, adult civilian women spent an average of .8 hours a day, and their male counterparts .4 hours a day in meal preparation. How much more did they spend in the months of March and April, and what was the monetary value of this unpaid labor, based on what it would have cost them to hire someone to plan, cook, and clean up? How much did they save on eating-out?
Many childcare centers and schools were closed, leaving parents with responsibility for home-schooling, supervising children, and keeping them from going confinement-crazy. The American Time Use Survey averaged the amount of reported time that married mothers and fathers living with children under the age of 18 spent in primary activities of caring for and helping household children over the 2013-2017 period—an average of 2.6 hours per day for mothers not employed and 1.4 hours for fathers not employed.
Under sequestration, both active care and supervisory care (defined as the time in which an adult reported that a child under the age of 13 “in their care” ) ballooned. How much did these two forms of childcare increase? How much did households save on childcare costs?
Video streaming and gaming increased dramatically, especially during afternoon hours, and people began to rely more heavily on streaming for instruction and exercise as well as entertainment. So, while they spent less money (and less travel time) on entertainment away from home, they substituted forms of entertainment that were probably less expensive, on average. How much less expensive?
Between March and May, average household income plummeted as a result of job furloughs and unemployment. The increase in time devoted to household production buffered this loss to some extent—but without answers to the questions above, we can’t know how much. Most recent impromptu household surveys have focused primarily on women’s unpaid work relative to men’s—an important, but different topic.
For years, I have protested economists’ lack of interest in total consumption—defined as the sum of money expenditures and the consumption of home-produced services.
Let me will repeat one example that I have written about in more detail elsewhere: Compare two couples, each with two small children, each earning $50,000 after taxes. Conventional measures treat them as having exactly the same income. Yet one couple may include an adult earning $50,000 and a full-time homemaker/caregiver, while the other includes two adults earning $25,000 each and obviously has less time to devote to unpaid work. If we assigned any positive value to unpaid work, the first household would obviously be better off in terms of both income and consumption.
Market income is just not a very good indicator of total consumption among households with differing inputs of unpaid work. Also, the value of unpaid work is greater in households with more than one person, because of economies of scale in food preparation and childcare. Standard equivalence scales used to adjust household income for household size and composition completely ignore these issues.
Obviously, the additional unpaid work performed while sheltering in place was a source of great stress, especially for those simultaneously telecommuting, zooming, or otherwise trying to fulfill paid employment responsibilities at home. Yet, it’s hard to deny that this work also “added value,” enabling an important form of social provisioning.
The worst-case scenario for a household with children was almost certainly one in which all adults (e.g. mother and father) were essential workers, required to keep working (often at risk to their health) but unable to work from home. Federal and state agencies tried to provide “resources” for these workers, but no guarantees were forthcoming.
In many cases, one of the adults (probably the mother) was forced to quit or take a leave of absence from paid employment. While new federal legislation gives states flexibility to pay benefits where an individual leaves employment to care for a family member, not all states do so.
Such a policy is effectively a paid family leave—something that most states have shied away from for years, making this country an international outlier. The complexity of the new legislation, plus the difficulty of actually filing for and receiving unemployment benefits, has probably kept take-up pretty low even in states that allow this option.
Just one more reason to consider policies such as federal paid family and sick leaves and a universal basic income that could help the stabilizers known as households do their job.
Original blog published on CARE TALK: FEMINIST AND POLITICAL ECONOMY on May 19th, 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.