Caring During COVID-19: A Study of Intersectionality and Inequities in the Care Economy in 16 Countries

Author:

Musolino Connie1ORCID,Baum Fran1,Flavel Joanne1,Freeman Toby1ORCID,McKee Martin2,Chi Chunhuei3,Giugliani Camila4,Falcão Matheus Zuliane5,De Ceukelaire Wim6ORCID,Howden-Chapman Philippa7,Huong Nguyen Thanh8,Serag Hani9,Kim Sun10,Dardet Carlos Alvarez11,Gesesew Hailay Abrha1213,London Leslie14,Popay Jennie15,Paremoer Lauren16,Tangcharoensathien Viroj17,Sundararaman T.18,Nandi Sulakshana19,Villar Eugenio20

Affiliation:

1. Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005, Australia

2. Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, WC1H 9SH, UK

3. Center for Global Health, Oregon State University, Corvallis, OR 7331, USA

4. Social Medicine Department, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2400 CEP 90035-003, Porto Alegre, Brazil

5. Health Law Research Centre, University of São Paulo, Av. Dr. Arnaldo, 715 - 211 - Cerqueira César, São Paulo, SP 01246- 904, Brazil

6. Médecine pour le Peuple, Brussels 1000, Belgium

7. Department of Public Health, University of Otago, Wellington, 6042, New Zealand

8. Faculty of Social Science and Behavior, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam

9. Department of Internal Medicine, University of Texas Medical Branch (UTMB), 301 University Blvd., Galveston, Texas, 77555, USA

10. People's Health Movement South Korea, Seoul, South Korea

11. CIBERESP, Center for Research in Epidemiology and Public Health, Public Health Research Group University of Alicante, Madrid, Spain

12. Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia

13. College of Health Sciences, Mekelle University, Mekelle, Ethiopia

14. School of Public Health, University of Cape Town, Cape Town, South Africa

15. Division of Health Research, Faculty of Health & Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, UK

16. Political Studies, University of Cape Town, Cape Town, South Africa

17. International Health Policy Programme, Ministry of Public Health, Nonthaburi, Thailand

18. People's Health Movement, Puducherry, India

19. Public Health Researcher, Ebertsgade 6, 2300 Copenhagen, Denmark

20. Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, San Martín de Porres 15102, Peru

Abstract

Carers were disproportionately harmed in the COVID-19 pandemic. Despite facing an increased risk of contracting the virus, they continued in frontline roles in care services and acted as “shock absorbers” for their families and communities. In this article, we apply an intersectional lens to examine care work and the structural factors disadvantaging carers during COVID-19 through a comparative case study analysis of 16 low-, middle-, and high-income countries. Data on each country was collected through a qualitative framework during 2021–2022. We found that while carers everywhere were predominantly women with low incomes and precarious employment, other factors were at play in shaping their experiences. Moreover, government responses to mitigate the direct impact of the pandemic have created local and global disparities affecting those working in this sector. Our findings reveal how oppressive social structures such as race, class, caste, and migration status converged in contextually specific ways to shape the gendered nature of care within and between different countries. We call for a better understanding of the multiple axes of inequalities experienced by carers to inform crisis mitigations, coupled with long-term strategies to address social inequities in the care economy and to promote gender equality.

Funder

Australian National Health and Medical Research Council Investigator Fellowship

Publisher

SAGE Publications

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