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

Int J Soc Determinants Health Health Serv. 2025 Jan;55(1):16-32. doi: 10.1177/27551938241269198. Epub 2024 Aug 11.

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.

Keywords: COVID-19; care economy; gender; health inequities; intersectionality; race.

MeSH terms

  • COVID-19* / epidemiology
  • Caregivers* / economics
  • Caregivers* / psychology
  • Developing Countries / economics
  • Female
  • Healthcare Disparities
  • Humans
  • Male
  • Pandemics
  • SARS-CoV-2*
  • Socioeconomic Factors