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Rotman Insights Hub | University of Toronto - Rotman School of Management Groundbreaking ideas and research for engaged leaders
Rotman Insights Hub | University of Toronto - Rotman School of Management

The future of care

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Laura Lam, Carmina Ravanera, Sarah Kaplan

The care economy — the economic sectors that involve paid and unpaid care, including childcare, elder care, and health care — is one of the fastest expanding economic sectors globally. A 2015 study of 45 countries by the International Labour Organization (ILO) found that there were 206 million people in care jobs, such as early childhood educators and long-term care providers, and they estimated that this figure would rise to 248 million by 2030.  But the complex work involved in this crucial sector tends to be poorly understood, undervalued, and unprioritized.

The COVID-19 pandemic has brought an increased focus on care, highlighting how the lack of support for care sectors and the increasing trend of financializing access to care have placed equality and health on fragile grounds during this crisis. In Canada, COVID-19 has highlighted the poor conditions in long-term care homes and the dearth of affordable and high-quality early childhood education, in part due to for-profit organizational models that have made caring into a business that only some can afford.

The pandemic has forced many to think about a new and more feminist ethics of care, where we see ourselves not as a collection of autonomous individuals but as many interconnected and interdependent relationships and communities.

Arundhati Roy has called the pandemic a portal through which we can see new possibilities. In April 2020, she wrote: “historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.”

The pandemic has exposed how care work is essential labour on which the economy depends. It has also shown that care work is devalued, disproportionately falling upon women, people of colour, and immigrants, and that risks are absorbed by vulnerable and precarious care workers. It has accentuated the existing global labour shortage in care. Care policies as well as care infrastructure have proved inadequate to address the needs of both caregivers and care receivers. Addressing the importance of care work as our society recovers from the pandemic is an opportunity to capitalize on changes needed to create a more equitable and sustainable economy. 

The pandemic is one example of a crisis that reveals the gaps in policy, infrastructure and systems. It has underscored where critical government spending and investments are needed and has emphasized the need for research to adopt an intersectional approach to understand how uncertainty and risk are experienced.

However, the pandemic has also brought about possibilities for more openness and awareness of how care work is an integral part of daily life. A potential silver lining of the pandemic comes from more overall exposure to the duties of care. One such area is within the workplace, where women and caregivers are making visible and vocalizing the challenges they encounter in their personal lives when negotiating work and care responsibilities. In one study, professional women with children reported revealing to coworkers more about their personal responsibilities than usual, a practice that challenges traditional workplace norms. Some women also reported that workplaces are now providing them with welcome structural support, such as by reducing the overall time spent in meetings. Thus, the pandemic has created an opportunity to contest existing narratives about work-family balance in which family obligations are seen to produce negative effects on women’s career paths.

Opportunities for technology and care

New technologies — including digital communication, automation, artificial intelligence, digital assistants, telepresence and robotics — are increasingly playing a greater role in care. The pandemic has showcased the potential benefits of this technology use, from digital health appointments that reduce human contact to socially aware robots in long-term homes. In certain care settings, technology is assisting with managing demands for care. For example, in Japan, care robots have been used to ease chronic care needs of an aging population.  Some people thus see technology as a solution to shortages of care workers and care facilities.

Yet, technology cannot be a catch-all solution for gaps in the care economy. Researchers have argued that care work is not “replaceable” by technologies because it is highly relational. As Mercer E. Gary wrote, it involves “[recognizing] the humanity of both the caregiver and cared-for through their essential interdependence.” A risk in the use of robotics and artificial intelligence is that it may bring about a loss of humanity as well as place further demands on caregivers who must manage both how the technologies deliver practical aspects of care and how they might meet the emotional or relational needs of care recipients. Researchers have therefore noted that care technologies are more likely to improve care interactions by assisting with certain duties rather than replacing them.

Some technologies that enable greater digital communication between care workers, caregivers, and care receivers can serve to shift the responsibility of care to others, and can ease concerns about safety and security for caregivers who have charged others with care responsibilities. Digital care platforms, such as Staffy or care.com, are examples of how the sharing of care duties — ranging from childcare and elder care to household duties — might be made more accessible through technology. A benefit of these labour platforms is that they facilitate trust between care workers and care receivers. However, such care technologies can be embedded with traditional norms and structures of inequality. Although these platforms help care workers to find work, workers still bear unequal safety risks and poor working conditions when using them because of a lack of employment protection: platform arrangements are usually informally negotiated between a care worker and a private care recipient. Research has shown that the technologies may reinforce or exacerbate asymmetries of power. For example, during the pandemic, some digital care platforms surveilled the health of care workers to ensure families were protected from COVID-19, but did not provide measures to ensure care workers had similar protections while they were working. 

Technologies have also blurred lines between personal and professional lives: flexible or remote work technologies facilitate caregivers such as working parents to simultaneously work and care for dependants, but having this ability can also disrupt time that caregivers intended to spend with families. 

New organizational models

The pandemic has highlighted problems with profit-driven models for care, as seen in the management and health outcomes of for-profit long-term care homes and the marketized childcare sector in Canada. During the pandemic, evidence emerged that for-profit long-term care homes provided inferior care and resulted in higher death rates compared with non-profit homes. Market-based childcare provision has also meant that childcare has been cost-prohibitive for families, preventing parents and especially mothers from paid work. These models financialize care, turning it into a service that is bought and sold and not taking into account its necessity for the economy and for all people’s well-being. Researchers and advocates have recommended prioritizing alternative business models and non-profit care to build more sustainable systems, create quality and decent jobs, and assure quality of care. 

Care advocates note the dearth of funding for care work in developing countries and are pushing to integrate care analysis into existing international development programs as well as a feminist approach to development funding. Yet, research suggests that development policies that aim to create more economic inclusion for women are doomed to be ineffective if the constraints imposed on women by the burden of care are not alleviated.

During the pandemic, researchers and advocates have brought forward many policy and research implications for care work in the recovery economy. At the same time, many questions remain for how care can achieve both quality and scale — and these connect to questions of whose caring labour is valued and considered. Hearing from those who perform the essential work of care is a necessary first step to achieving equality in both paid and unpaid care work. This must be matched with new measures to track the impact of care on well-being and on the economy. The pandemic has served as a portal for society to recognize how the work of care is intricately linked to social and economic outcomes. Thus, prioritizing care and the caring economy in future research and policymaking will ensure better outcomes in future crises.


This excerpt has been condensed from GATE’s “Care Work in the Recovery Economy: Towards a Caring Economy” report. Read the entire report here