International Women’s Day Special: The Unseen Burden of Care Workers
Undervaluing care work has consequences, including higher patient mortality, poor care delivery, and increased poverty for women. Canada needs to direct targeted investments towards its care economy.
Harshini Ramesh and Alison Clement
THIS INTERNATIONAL WOMEN’S DAY we ask Canada to reflect on its commitments to gender equality. While lauding itself as a champion of women’s empowerment, Canada continues to undervalue care work — a profession disproportionately represented by women. This is particularly true in the healthcare sector, where women are overrepresented in care roles, while receiving inadequate compensation and limited legal protections for their labour.
Care workers are essential to our healthcare, social, and economic landscapes — and policy action should recognize this and respond accordingly, by:
Formalizing and credentialing care work
Supporting the physical and emotional burdens of labour
Responding to inequities faced by women of colour
Women’s Role in the Care Economy
A long history of underpaying care work is closely aligned with the disproportionate representation of women in this profession. The role of gendered care is often seen as a presumed sacrifice for the “greater good”, where women are expected to provide unpaid and undervalued assistance at home, work, and in their communities. COVID-19 has exacerbated this presumed sacrifice. Women working at the frontline of the pandemic faced higher rates of infection, experienced increased job losses, and lived through sustained periods of financial hardships to make ends meet.
An estimated 67 percent of the global health workforce are women. Women of colour bear the brunt of this responsibility. Black and Filipino women are overrepresented in long-term care work, receiving the lowest pay and benefits, while facing additional issues such as exploitation and deregulated work arrangements. Immigrant care workers in Canada are also more likely to be on the frontlines facing greater inequalities than their counterparts.
Consequences of Undervaluing Care Work
The global health sector has been subsidized due to the unpaid and underpaid labour of six million women. In Canada, women perform two-thirds of all unpaid care work. Emerging research suggests that by 2030, the global healthcare system could be short of 13 million nurses. These labour shortages can result in higher patient mortality and poor care delivery.
Care workers are experiencing record high levels of stress, with 40 percent facing burnout and 1 in 2 intending to leave the profession entirely. These factors result in lower lifetime income for women, reduced access to social and health benefits, and increased poverty for women in older age.
Inadequate compensation and protections for healthcare workers also have broader societal implications. The average income gap for care occupations in Canada is 19 percent — this simply captures full-time work. Globally, women in the health and care sectors experience anywhere between a 15 to 24 percent pay gap. This gap would be far wider if the full volume of work by unpaid female workers were included in labour market research.
A root cause of gendered poverty is the pay gap; healthcare workers are not immune to this challenge. At the height of the pandemic, many care workers serving in long-term homes juggled multiple jobs to earn a liveable wage, while exposing themselves and other patients to potentially high rates of infection. The gender gap is still largely unexplained by factors that drive wages in the labour market. Differences in age, education level, years of work experience, and gender representation in both public or private sectors, only addresses part of the problem.
The wage gap and poor working conditions are symptoms of a larger issue: the failure to recognize how vital care work is in “propping up” or in facilitating the “smooth functioning” of our society. Underfunding care work is a form of injustice which does not end with erasing pay disparities.
So what should Canada prioritize in order to strengthen the care economy? Valuing care work will require investing in social and physical infrastructure for women, which can allow them thrive in their work environments. Tackling this deep-rooted challenge will require a coordinated suite of policies that address the economic and social lives of our care workers.
Towards an Equitable Care Economy
It is critical to first acknowledge and formalize care work. Appropriate credentialing is a step in ensuring healthcare workers are paid and receive benefits that match their qualifications and experience. Healthcare workers deserve adequate and appropriate resources that compensate them for the physical and emotional labour involved in care work, as well as the skills and expertise required to provide quality care.
Addressing healthcare burnout is a critical step to maintain the resiliency of our healthcare system and workers. Overtime work has increased since the pandemic, overburdening personnel and straining health systems across the country. Building in flexible hours, and family and childcare friendly policies will build a healthier workplace environment for caregivers. In addition, providing accessible mental health services tailored to the realities of working in the care sector is vital.
Finally, mitigating risks for those disproportionately burdened by care work is necessary to achieve gender equity. We are dependent on women of colour and immigrants for their essential care work. Providing them with protections such as quality workplace standards, removing barriers for seeking legal support and resources, and immigration pathways to settling in Canada are necessary.
The care economy plays a critical role as Canada's primary economic driver and presents the most effective route to a resilient healthcare system. Only second to real estate in terms of GDP, the care economy is the fastest expanding sector — outpacing manufacturing, oil and gas, and finance when measuring economic impact. Despite care work’s economic and social importance, Canada has yet to adequately invest in the people who are the bedrock of our society. Moving forward, the government must look towards long-term strategies that values and respects all care workers’ labour.
Harshini Ramesh is a Master of Public Policy Candidate with the Max Bell School of Public Policy at McGill University. She is interested in climate and environmental policy, as well as advancing innovative solutions that reimagine policy and governance responses to climate change.
Alison Clement is a Master of Public Policy Candidate with the Max Bell School of Public Policy at McGill University. She has an interest in social policy, specifically in the areas of advancing the social and economic rights of women.