Can COVID spark a care revolution?
This essay was originally published in “What do we do after the pandemic? Ideas for beneficial systems change” by the Wicked Problems Collaborative in 2021. Editing by Chris Oestereich and Jonathan Cohn.
What if we started with care? What if we built a world that honored care work as a central human enterprise? What if we provided care with material support both to care providers and those who need care, in such a way that it bolstered the vital relationship between them?
The pandemic has cast a sober light on society’s inequalities. We can see things anew and have learned harsh lessons. We have learned what a “K-shaped recovery” is: the super-wealthy become super-wealthier, while poor people suffer. We have learned that “essential workers” are the ones society forces into harm’s way, proving just how essential they are. We have learned that a virus does not discriminate, but a disease will, and the result is affliction and death based on race and class and disadvantage.
But one of the biggest lessons has been that the edifice of care is built on a firmament of sand and that, once shaken, it collapses on women. Very quickly, the care economy in the US contracted under the pandemic. Schools and childcare centers closed. Home-based care services were discontinued. Elder care facilities went into lockdown — too late, unfortunately, to prevent devastating COVID outbreaks. Accessing care services has been difficult or impossible through the pandemic. And the result has been enormous added responsibilities, work, and stress that have largely landed on women. As Jessica Calarco said, “Other countries have social safety nets. The US has women.”
When the pandemic struck, closing public venues, including schools and childcare centers, was the right thing to do. But as time passed, pressure to reopen bars, restaurants, and gyms grew. Governments decided to expend the effort, and often invested public resources into partial reopenings, or more. Meanwhile, schools and childcare centers have been much slower to return to operation in many places. Only 40% of childcare centers stayed open through the pandemic. Of those closed, 25% have remained closed. Attendance overall is only half of pre-pandemic levels.
The damage done to the care economy may be long-lasting. The business of care has low margins and an underpaid workforce. While the care economy relies on nurses, health aides, nannies, domestic workers, childcare workers, and teachers, their jobs and careers have always been tenuous. But when “slim support” becomes “none,” women in households are forced to pick up the slack. To be fair, men in households have increased their contribution to unpaid care and domestic work. But women’s unpaid care and domestic work has increased more. Men think they are doing about the same as women. Women disagree.
The formal economy does not place value in care, yet it could not exist without it. The care economy complements and supports the formal economy. There is no GDP without care; indeed, there is no human society without care. Care was a central part of human existence long before money, or jobs, or fiscal policy. However, care work barely registers in GDP totals because the overwhelming majority is not paid. Feminist economists have described care as the “reproductive economy”: the production and maintenance of humans and their relationships to one another that is central to social reproduction. It is fundamental to the “productive economy” and yet invisible to most measurement and incidental to most policy.
For women, however, the formal economy and the care economy have always been in competition. Paid work competes with unpaid work for women’s time and effort. During the pandemic, the reproductive economy has been winning the contest for women’s time and labor. So millions of women have been leaving the paid workforce, especially mothers with young children.
There is no good reason that care should be gendered, nor that the care economy be mostly populated by women. Men and boys can do this work as well as women and girls. But why is it so that in every country, women do more care work, both unpaid and paid, than men?
There are systemic drivers. For example, women are paid less than men in jobs. This is both a cause and effect of women prioritizing unpaid care work. When women take time out of their careers to care for children and other family members, they lose status in their field and miss opportunities for advancement. They may seek more flexible or part-time paid work, at lower wages, in order to balance their care responsibilities with their jobs. At the same time, households may jointly decide that women will take on more household care responsibilities and less paid work to maximize household income, because women’s employment pays less. There’s a chicken and an egg. It’s a system.
Other historical, cultural, and social norms push women to take on more unpaid care work. But there is also a question of ethics. As illuminated by the ground-breaking work of Carol Gilligan, women often embrace a different or competing ethical perspective than men, what Gilligan described as an “ethics of care.” Embracing care ethics means the practical prioritization of care in all contexts: identifying care needs and responsibilities and giving priority to care relationships and functions over other demands. Care ethics imply prioritizing care in decision making and resource allocation. Care ethics aren’t inherently gendered, but prioritizing care has historically and culturally been the role of women in households and society.
The insight that ethics underlie decisions and that an ethic of care will imply different decisions is important. It is why some people de-prioritize income, autonomy, and even personal happiness in favor of providing care. It is an ethical decision. But if care ethics apply to individuals and households, why not to governments and politicians? Policymakers, like economists, are mostly care-blind. And that has been true through much of the pandemic.
The first stimulus package provides relevant examples. The federal relief payments excluded adult dependents from eligi bility (anyone over 16 years old), even though these individuals are often living with a disability and need special care. Families of more than 2.6 million disabled adults received nothing for their dependents. Relief payments were also less generous to families with children and even less so to single-parent families. A family of two adults received $2400, while a family of one adult and two children received $2200. In the latest COVID relief package, single parents were treated less generously than two parent families with the new child allowance, despite having the same care responsibilities and childcare costs that are likely higher.
Enormous resources were allocated to support the reopening of businesses like bars, restaurants, and gyms. At the same time, comparatively little was dedicated to returning childcare centers and schools to operation.
Care providers who take care of their own family members — a disabled adult or elder — have been ineligible for vaccines even while other care workers, like nurse home workers, have been prioritized. Family care providers often do the exact same tasks as professional carers, but without compensation and, under COVID, with added risk.
If families must prioritize care, then policymakers should too. The pandemic has shown some of the gaps and weaknesses of our care economy. It has generated a societal discussion about childcare and the balance of unpaid labor within households. It has forced conversations about what counts as work, and what is not counted. It has generated a new appreciation for care workers, who are some of our most essential workers. The latest COVID relief package is a major improvement over the early efforts in recognizing and supporting care. The “American Res cue Plan,” included $40 billion to support childcare providers, increased Medicaid to help people with disabilities and elders, and expanded the child tax credit. However, we have barely scratched the surface of what a care-centered policy could be.
Such deeper policy change will require a shift in the way we view care work. Advocates are working to reframe our thinking about “infrastructure” to go beyond roads and bridges to include care work. Such work allows parents to participate in the labor market, supports economic growth, and creates wider social benefits. If this effort is successful, it could do a lot to reduce the drudgery and cost of care, while improving accessibility and convenience.
Pursuing policy in support of care has instrumental value: it improves labor-force participation, generates jobs and economic growth, improves education outcomes, and reduces other burdens, like health care costs and absenteeism. But the deeper issue is that care has value in and of itself. The COVID pandemic has helped expose this truth, or maybe it has helped us remember it. It’s a truth that many of us always carry and which provides an ethical filter for daily life.
In all things, the question is, will this help or hinder my ability to care for my loved ones? Mothers ask this question. Children of elderly parents do the same. Families who have members with disabilities do as well. It is time for politicians and the government to hold this question in mind as a filter for any policy. Care ethics should inform public policy, rather than be confined to personal decision-making.