COVID-19 highlights how caregiving fuels gender inequality

The COVID-19 pandemic increases the urgency of recognizing and valuing carers and reducing gender bias because it presents enormous and unexpected challenges associated with increased caregiving. For COVID-19 patients and their families, there will be a great need for palliative and end-of-life care, especially in settings where resources are constrained and many will not be hospitalized.

In addition, the shelter-in-place or lockdown provisions to contain the spread of COVID-19 put additional demands on families to care for children, the elderly and those who suffer from disease or disability. Carers are now faced with helping their loved ones without being able to rely on paid professionals in the home, school or daycare, placing layers of additional stress that most often fall on women. Some strive to combine caregiving with managing workplace responsibilities, while others join the growing ranks of the homebound unemployed.

Caregiving is an under-resourced, unpaid activity that falls disproportionately on women and girls worldwide. Those who care for a family member or loved one face an array of challenges as they juggle paid work, unpaid caregiving responsibilities, and their own personal needs and health – both of which are too often sacrificed. Yet, the work of carers is largely overlooked because it is not measured in traditional economic productivity indicators.

Research highlights that in the US there are over 65 million unpaid family caregivers supporting someone who is ill, disabled, or aged. Data from the European Quality of Life Survey show that in Europe alone there are about 100 million carers, 20% of the EU population. The Lancet Commission on Women and Health revealed that the real economic value of women’s paid and unpaid contributions to the global health sector is almost five percent of global GDP, which was equivalent to more than $4.2 trillion in 2018. About half of this unpaid work is caregiving. Overall, over 70% of global caregiving hours are provided by women and girls.

When it becomes difficult to balance caregiving with work, or if the demands of work come into conflict with one’s caregiving responsibilities, carers may be forced to cut back on their working hours or take a leave of absence. This impacts their ability to equally participate in the workplace.

Data from Europe show that the vast majority of men with caring responsibilities also work full-time, whereas only half of women carers are able to work full-time largely because their caregiving hours are about double those of men.

Carers also tend to put at risk their own health and wellbeing. Research shows that women who take on heavy caregiving responsibilities at home face higher physical and emotional stressors. Nearly half of family caregivers suffer from depression, and 45% did not have time to book or attend their own medical appointments as a result of their caregiving activities – thus putting carers at risk of falling ill and needing caregiving themselves.

Concentrating on the disproportionate impact of unpaid caregiving on women and girls is one of the key facets of gender inequality which is costly for them and for their families, health systems and economies. A recent study by McKinsey showed that enabling women to reach their “full potential” and play an identical role in labour markets to men would mean an increase of as much as $28 trillion, or 26%, to global annual GDP by 2025. Research from the World Bank demonstrated that if women were earning as much as men – equality in earnings – the total gain in human capital wealth would be over $25,000 per person in the 141 countries studied. This represents about twice the value of global GDP.

In the face of this unprecedented pandemic, it is more important than ever to recognize and appropriately support the pivotal role of providing unpaid care for family members and loved ones, to remove barriers, protect the health and wellbeing of the carer and to promote gender equality.

At Merck, we are developing evidence-based policies and practices that address women and carers’ unmet needs in the face of the COVID-19 pandemic. We lead Embracing Carers™, a global, collaborative movement of leading carer organizations from around the world, dedicated to increasing awareness and discussion about the often overlooked needs of caregivers as a global health priority. This organization can help us all to implement the physical distancing required to stem the tide of COVID-19, while developing novel ways of virtually embracing those who need care.

We are also the private sector leader of Healthy Women, Healthy Economies, which promotes national policies that improve women’s health for greater economic participation. The Healthy Women, Healthy Economies Policy Toolkit provides guidance on these policies, including how to implement changes in the workplace. Many of these are consistent with a stronger and more gender-informed approach to COVID-19. National income support programmes that are being put in place in response to COVID-19 can be be designed to improve gender equality by treating caregiving as an essential service and supporting all family members, regardless of their gender.

Policies are required that allow family members to take the necessary leave from paid employment, make adaptations to their working environments, and implement flexible working arrangements to meet caregiving needs. This will support individuals and families to create a better balance between work and caregiving.

We must assess the COVID-19 situation through a gender lens to address the unique challenges and unmet needs women and girls face to improve their overall health and wellbeing during this unprecedented time. We must drive transformative change for equality by addressing the paid and unpaid care economy as put forward by the United Nations in a call-to-action to put girls and women at the centre of COVID-19 recovery efforts.

Now, as the world grapples with COVID-19, is the time to turn crisis into opportunity – and identify and implement innovative solutions to transform the world of caregiving and promote gender equality in the home and workplace.