The burden of informal care on women: how has it increased during COVID-19, and what are the implications for women’s working lives?
Unpaid informal carers have provided a key safety net during the pandemic, leaving them vulnerable to economic, physical and emotional harm. Research suggests that women carry out at least three times more unpaid care work than men – so how should this be accounted for in pandemic recovery plans?
The COVID crisis has emphasised the importance of care as a crucial form of life support. Furthermore, unpaid informal care has been an essential frontline aspect of the pandemic response across the globe, increasing exponentially as public services have been restricted.
This means, of course, that the many – often unappreciated – stresses involved in informal caregiving have been amplified as social supports have been minimised by the impacts of COVID-19. These stresses have been increasingly borne by a younger cohort, many of whom are also involved in paid work.
But most strikingly, women provide much more unpaid care, and also more intensive forms of care, than men. This is not always obvious from headline statistics, however, which tend not to differentiate gender patterns in the types or intensity of caregiving.
While data is scarce, surveys show that prior to the pandemic, women were carrying out roughly three times more unpaid care work than men – estimated at 76.2% of all unpaid care work. And the available data indicate that this has worsened during the pandemic. One key consequence is that women’s employment is shaped by care responsibilities in ways that men’s is not.
Informal caregiving tends be taken on ‘by default’ in response to need and a sense of duty, rather than by positive choice. Carers consequently often experience ‘role captivity’, a feeling of being trapped in an unwanted role and unable to shape their own life. This sense of captivity adds significantly to the stress of intensive caregiving.
A key driver of gender inequality
The marked gendered effects of the pandemic reflect differential access to employment and social protection – and this is in large part related to the gendered responsibility for informal care. Family members, often women and girls, find themselves obliged to provide informal care when welfare support is lacking. This is widely recognised as a key driver of gender inequality, affecting women’s labour force participation, education, income and health.
Furthermore, caregiving is most gendered at crucial stages of working lives – in young adulthood and during middle age – compounding the effects on women’s earning capacity and career development. While providing unpaid care in mid-life reduces women’s incomes, it does not have the same effect on men’s.
Long-term trends indicate that the need for care is growing as populations age. But with limited public funding, informal care is increasingly relied on to fill the gap between need and formal provision.
Informal care in the UK during COVID-19
In recent decades, care has been increasingly marketised and rationed, delivered on the basis of ability to pay or assessment of a limited range of needs – combined with reliance on informal care from family or friends. Long before the pandemic struck, informal care was estimated to be worth $US522 billion to the United States economy each year (2014), and £132 billion to the UK economy annually (2015). These estimates are likely to be significantly higher in 2021.
Across the UK, the restriction of health and social care services during COVID-19 has significantly increased the numbers of informal caregivers from 9.1 to 13.6 million. Of these, 62% now combine informal care with paid work, up from 48% before 2020.
Around 9% of the UK population has reported taking on additional unpaid care responsibilities for an elderly, disabled or ill person during the pandemic. Some of the burden of unpaid care has shifted to younger adults, who are disproportionately female (59%) and are 30% more likely to be in paid work than older adults. In 2020, 47% of all informal adult carers were aged below 45, compared with 32% pre-pandemic.
This presents a significant intensification of pressure on an already struggling labour market. Chronic exhaustion, isolation and illness raise the risk of exit from the labour market when supports to remain in work are not firmly in place.
One UK survey published in June 2020 found that 16% of informal carers were worried about having to reduce their involvement in paid work or leave jobs or education; 61% reported that providing unpaid care was negatively impacting on their ability to do their jobs.
Prior to the pandemic, a YouGov poll published in 2019 found that 2.6 million workers in the UK had left work to cope with unpaid informal care, a rise of around 300,000 from 2013. Women carers were both more likely to combine paid work with care, and to exit the labour market to cope with care.
The poll also suggested that 5% of the adult population of Northern Ireland had left work to care, and a further 4% had reduced their working hours. The impact of the pandemic on this pattern, or on levels of poverty among carers, is as yet unclear.
How does the UK’s approach compare with the rest of Europe?
Policy approaches across European welfare states also tend to treat care as a morally motivated activity – an expression of love rather than a form of work. However, Denmark provides a notable exception, where care is a universal right supported by comprehensive and free social provision.
While family care is possible in Denmark, it is not treated as a moral obligation and is not commonly relied upon – and strikingly, there is a very small gender gap in the distribution of caregiving. Family caregiving is formalised through an employment contract which specifies the job description, payment, working hours and other conditions. Local government is responsible for covering costs and regulating quality. In this model, family caregivers are public employees, entitled to full employment rights, including health and accident insurance, unemployment and sickness benefits, annual leave, pension, and redundancy rights. Furthermore, if a care recipient dies, the caregiver must be offered equivalent work elsewhere for the duration of the contract.
Other European societies have tended instead to reinforce family-based informal care to varying degrees, with some relief available through cash-for-care schemes. Reliance on the market, while providing users with some control over the type of care they receive, has also reduced state involvement. Without careful governance, this can exacerbate gender inequalities, creating a low-paid, low-skilled care market characterised by exploitation and poverty.
Where state support is low, the gender gap in the distribution of both formal and informal care tends to be high. As a result, informal carer access to full social rights, including minimum wage income and social security entitlements, tends to be compromised.
The long-term costs on women and girls
As the care burden grows and has been exacerbated by COVID-19, informal unpaid caregivers are increasingly juggling care and paid work. Even where public provision is generous, informal carers generally shoulder responsibility for coordinating what is often a fragmented care system.
Those who provide long-term or complex medical care live with constant vigilance, chronic stress and financial hardship. The ‘quiet suffering’ and ‘sheer human misery’ involved is amplified by periods of intensified caregiving, such as during deadly pandemics. But while it seems that women have taken on additional responsibility for more time-consuming care tasks such as cleaning during COVID-19, data tracking how this has developed through the pandemic is lacking.
The UN has noted that the long-term economic, health and educational costs of pandemic responses which overburden women and girls in order to patch up gaps in social protection and public services will be enormous.
Key policy considerations for a gender-sensitive recovery
NGOs and academic analysts who have examined the gender consequences of informal care during COVID-19, both globally and locally, make the following policy recommendations:
- Focused social protection is essential for a gender-sensitive pandemic recovery. However, support for long-term care has comprised only 1-2% of social protection measures introduced globally in response to the pandemic. At the very least, contingency planning for caregiving during a future public health emergency should aim to protect informal carers from the stress and trauma commonly experienced during this crisis.
- If the aim of care policy is to reduce gender inequality, public investment is needed. Ensuring the Carers’ Allowance does not fall below comparable benefits is one essential protection against poverty. Full support for respite care, and the provision of social support for informal carers, are also essential welfare protections.
- Beyond that, generous social provision of long-term care will avoid role captivity for family members, relieving them of a moral obligation to provide care, and relieving care recipients of the ‘burden of gratitude’ for the unpaid care they receive.
- A gender-sensitive employment policy should take the increase in informal family caregiving into account. Conditions which avoid disadvantage for carers and provide social security is essential. Unpaid or low-paid informal care creates financial dependency and removes caregivers from sources of social security accessible through decently paid work. Combining informal care with work is a struggle, and informal carers tend to cut working hours, refuse promotions, or resign in order to cope with the demands of care.
- Improving the availability of affordable childcare is one important support for the younger cohort of informal carers the pandemic has created. Strengthened entitlement to flexible working is also crucial for enabling informal carers to remain in employment. Entitlements to take personal calls at work, work remotely, access paid carers’ leave, and take career breaks have all been highlighted as essential employment supports for informal carers.
Dr Lisa Smyth is a Senior Lecturer in the School of Social Sciences, Education and Social Work at Queen’s University, Belfast