Abstract
The concept of the care economy has garnered considerable international attention. Social justice arguments about decent work, the gendered nature of care work and the need to account for care, along with critiques of gross domestic product as an adequate metric for the wellbeing of nations, have all informed a call to place care on national agendas. The language of ‘care crisis’ underscores the urgency of accounting for care and for determining the social contract between society and family in the responsibility for providing care to those who are most vulnerable. United Nations agencies have called for the development of systems of long-term care, noting that families should not be held responsible for care.
In this article, we present a framework for the social care economy that aims to make care work visible. Care work remains undervalued in our societies and economies, and its workers often remain marginalised. We define the social care economy as that sector of the broader economy comprising paid and unpaid work provided to those needing assistance with daily functioning: young children, younger people with chronic conditions and disabilities, and older people with chronic conditions and disabilities. We specify data needs and identify gaps in determining the balance of state versus family responsibility for care and in documenting and making visible the work of paid and unpaid carers. We conclude with a discussion of how the framework might lead to insights into the wellbeing of carers and of the nations in which their care work is embedded.
Introduction
Care for those with chronic conditions and disabilities has become a global issue. Fuelled by population ageing and lengthening periods of chronic illness and disability across the life course, there is concern that neither families nor social care systems can meet rising needs (Age UK, 2014; Hall et al, 2020). Public funding for social care is eroding or unavailable (Spasova and Ward, 2019), while high turnover of care workers reflects their low levels of compensation and difficult working conditions (Moriarty et al, 2018). In turn, family care is seen as under threat because lower birth rates reduce the pool of adult-child carers (Wolff et al, 2018). Those who become carers often care alone with little respite and with negative consequences for their employment (Brimblecombe et al, 2018). Terms such as ‘care crisis’ (The Lancet, 2014; Dowling, 2021; Organisation for Economic Co-operation and Development – OECD, 2021) and ‘unprepared reality’ (Dokpeski, 2015) indicate the immediacy of the concern.
In this article, we present a framework that researchers and policy makers can use to consider these seemingly intractable challenges in social care and to fill knowledge gaps needed to address them.1 It is created to be useful across countries and contexts. It allows for examination of empirical questions, such as what proportion of care labour is done by family members, and policy questions, such as the extent to which the balance requires redress. In developing the framework, we reference social justice agendas from United Nations (UN) agencies that admonish governments to make both paid and unpaid care work visible and the contributions to the economy explicit. The framework is grounded in global conversations about the care economy.
A global agenda for social change
The UN has signalled the importance of care as a global agenda, urging governments to act. Across UN agencies, two main themes are apparent. The first is that care involves both state and family responsibility for those who are dependent. Directives to governments are to find a balance, avoiding family responsibility as the default position. A key directive that marked the launch of the UN Decade of Healthy Ageing (2021–30) states that governments should develop long-term care systems to support older persons, thus relieving families from full responsibility for care (Keating, 2022). Messages from the thirtieth anniversary of the UN International Year of the Family reflect this theme, adding a second care-dependent group: young children. In a 2022 report to the UN General Assembly, the Secretary-General of the UN Economic and Social Council points to the considerable responsibilities of families, especially women, for the care of both young children and older people (UN Secretary-General, 2022). He also underscores the importance of a state/family balance in responsibility for care, calling for formal systems of childcare and long-term care to support family carers to both groups. The International Labour Organization (ILO; Addati et al, 2018) states that policies to provide care to young children are particularly important since the amount of time dedicated by women to unpaid care work increases markedly with the presence of young children in a household. In cross-national research, they found evidence of large coverage gaps in care for young children but also in long-term care services for adults with chronic health problems and disabilities. They foreshadow the importance of thinking of a care economy when they state that care work is productive work that can become an important driver of economic growth (Addati et al, 2018).
Another theme is that carers are marginalised and their work undervalued. Directives to governments are to recognise care work as valuable through developing policies and programmes aimed at ensuring that care work is decent work. The ILO has led the decent work agenda, creating a focus at the UN level on the working conditions of both paid and unpaid carers. They argue that unpaid carers remain invisible, their work remains conflated with all domestic labour and their economic opportunities remain diminished (Addati et al, 2018: 28). Paid care workers also fare poorly with low status and pay, poor working conditions and lack of social protection. The UN World Social Report (UNDESA, 2023) argues that unpaid care work remains invisible because it is poorly measured, thus obscuring the true scale of caregiving and limiting proactive actions enabling support to unpaid caregivers, often women. That which is not measured is not seen or valued.
We see in these global discourses a social justice stance that reflects the vision of the Sustainable Development Goals for ‘a just, equitable, tolerant, open and socially inclusive world’ (UNDESA, 2015: 5). UN statements about carers focus attention on a group at high risk of exclusion. The Pan American Health Organization speaks of unpaid carers suffering disproportionately from negative economic outcomes and poor health (Armstrong, 2013). UN Women (nd) speak to injustice for women whose unpaid care supports economies and fills in for the lack of social services and whose reward is a lifetime of truncated economic wellbeing.
The UN vision for care speaks directly to these injustices. Its main principles are to ensure that paid and unpaid carers are part of a socially inclusive world and that the state is the main duty bearer (Arancibia et al, 2023). UN Women argues that public investments in care, including infrastructure, services, and recognition and remuneration for the time of paid and unpaid carers, are critical for realising rights and strengthening human capabilities. They have important multiplier effects in job creation and future fiscal revenue. The difficult question is how nations might take a ‘high road to care work’ (Addati et al, 2018: 287) should they wish to embark on such a journey.
Purpose of the article
The purpose of this article is to create a road map for understanding these global challenges in care. We present it as a foundation for examining the extent to which families are responsible for care and for making both paid and unpaid care work visible and their contributions to the economy explicit. The framework is grounded in global conversations about the care economy (for example, Wray et al, 2023).
There are three main goals:
to develop a conceptual framework to respond to UN calls for action on the distribution of paid and unpaid care and on valuing the work of care, thus addressing the social justice imperatives underlying the care crisis;
to operationalise concepts and specify indicators needed to provide evidence of the magnitude and distribution of care work and of its outcomes for carers, thus providing a mechanism for determining where data are available and where there are data gaps;
to set the framework for current discourses on care economies, emphasising wellbeing of carers and of the nations in which their care work is embedded, thus providing a basis for evaluating how context matters in creating pathways to sustainable care.
A conceptual framework for social care
Researchers have built an extensive body of knowledge on care work, its contribution to the economy and its outcomes for carers. They have long been engaged in providing evidence on the importance of care in supporting ageing populations (Pysklywec et al, 2020; Albertini and Prandini, 2021) and on the threats to the sustainability of care (Spijker and Zueras, 2020; Perkins and Repper, 2021). This work underscores the urgency of the global calls for action in UN declarations and emphasises the place of researchers in knowledge creation.
These calls for action are powerful and their social justice messages compelling. Yet, while features such as enhancing wellbeing of vulnerable groups make them broadly appealing, UN declarations are agreements in principle and are neither enforceable2 nor easy to enact. Jordan (2025: 2) speaks to the inherent tensions in care, noting that we are ‘drawn towards the powerful idea of care as part of what it means to be human and drawn away from it in resistance to its implications and its – sometimes frightening – demands’.
The body of knowledge on care is large, complex and fragmented. There is much to celebrate in the decades of research on care that has been undertaken by scholars across disciplines and settings. Yet the very richness and diversity of our knowledge about care also presents challenges in addressing the calls for action by UN agencies and the global concerns about sustainability of care. Which knowledge is most relevant? How do we understand care across global contexts? What core data do we need to document the state of care? What will be the compelling arguments that might lead to action?
We propose the social care economy as a framework for addressing these questions. It is focused on social care and the social contract around this care, on care workers and care work, and on the valuing of this work. In describing its components, we delineate its boundaries and provide definitions of its concepts. We highlight data needs and data gaps with the goal of facilitating the development of comprehensive, consistent and comparable statistics to support evidence-based decision making on care.
We begin by defining the social care economy as that sector of the broader economy comprising paid and unpaid work provided to those needing assistance with daily functioning. There are three main reasons why we have framed social care within the language of the care economy. First, it supports conversations about the contributions of social care to the overall economy. This approach challenges the positioning of publicly provided social care as a drain on national economies (ICF Consulting, 2018; The Health Foundation, 2022) and of family care as private family work that reduces public costs (Feng et al, 2020). Second, the framing of the social care sector brings together paid care work and unpaid care work, highlighting the contributions made by all carers. It raises anew questions of why both are undervalued – unpaid/family carers are not acknowledged in the System of National Accounts and their labour is not calculated as part of gross domestic product (GDP), and paid carers are relegated to work lives of precarity (Gie and Hoffman, 2023). Third, it provides the opportunity to address wellbeing of both groups, towards a world in which ‘unpaid carers can enjoy the rewards of care provision without paying social and economic penalties; and care workers have access to decent jobs that will set the foundation of quality care services’ (Addati et al, 2018: v).
Components of the social care economy framework
In this subsection, we provide a definition and rationale for each of the components of the framework (Table 1).
Definition of the social care economy and its components
| Concept | Definition |
|---|---|
| Social care economy | That sector of the broader economy comprising paid and unpaid work provided to those needing assistance with daily functioning |
| Care work | Activities and responsibilities involved in supporting those needing assistance with daily functioning |
| Care workers | People who do the work of care:
|
| Care-dependent groups | People needing assistance with daily functioning:
|
| Carer wellbeing | This includes:
|
Social care
In a policy article published shortly after the release of the World Health Organization’s (2015) World Report on Ageing and Health, Beard et al (2016) argued that the most important consideration for an older person is their functioning. This statement signalled a shift from healthy ageing as the absence of disease towards broader outcomes of wellbeing. Functioning focuses the lens on activities that assist people in ways that help them to be and do what they most value.
The term social care is used to describe support to people with limitations in daily activities (Glasby, 2017). With its grounding in social work, social care has a remit encompassing personal and community social services, including care for young children and for people with physical, developmental and psychiatric disabilities (Moscovitch and Thomas, 2018). The term has been used in the UK since the 1980s when Challis and Davis (1985) argued that case management is an appropriate approach to social work for those needing long-term care, including but not limited to older people. Social care’s wellbeing goals have been described as touching people’s lives (Glasby, 2017) and ‘unlocking the possibility of living the best life we can’ (Humphries, 2022: 4).
Within discourses on healthy ageing, long-term care is a term widely used to describe care regimes and settings that are meant to take care of people who have difficulty living independently (Kaye et al, 2010). Global conversations about long-term care have emphasised care provided to older people whose functional limitations are associated with chronic conditions and disabilities (Feng et al, 2020). We use the term social care to frame care because it includes a broader group of recipients than is typically thought of within long-term care, its language is congruent with social inclusion outcomes, and it highlights the distinction between social and medical care, the aim of the latter being amelioration of disease.
Care work
We define care work as activities and responsibilities involved in supporting those needing assistance with daily functioning. Needham and Hall (2024) describe two main elements of care work. The first is care as a specific set of tasks provided by people who are carers. This approach draws attention to the question of how the work of care is shared by those who are paid and unpaid. The second is grounded in beliefs that a just society is one in which there is ‘concern for others and their wellbeing, particularly children, disabled adults and frail older people’ (Needham and Hall, 2024: 5). This approach draws attention to the social contract of nations around the responsibility for care of diverse groups of people.
Social care activities have been addressed by researchers and policy groups who have specified the purpose and nature of care tasks. Care tasks are described as those that must be provided on a regular and frequent basis to meet the needs of those who need assistance with daily activities (Tuohy, 2021; Needham and Hall, 2024).
A long-standing approach is to view these tasks as basic physical activities of daily living (ADLs) – such as toileting, feeding, dressing and bathing (Katz et al, 1963) – and independent activities of daily living (IADLs), which require higher levels of problem-solving – such as using the telephone, shopping, food preparation, housekeeping, transportation and managing medications and finances (Lawton and Brody, 1969). ADL and IADL tasks were originally developed for understanding functioning of older people but have since been applied to people of all ages living with disabilities (Delgado-Lobete et al, 2021) and to young children who are not yet able to function independently (Stoffel et al, 2020; Barrios-Fernandez et al, 2021). We adopt this approach to defining care because it is focused on helping people live their best lives and it is measurable.
Care workers
This component of the framework refers to those who do the work of care. It reflects the centrality of workers to the sustainability of social care. We specify two main groups of carers: those whose care work is paid and those whose care work is unpaid.
There has been remarkably little work devoted to understanding the scope of the care labour force. This is due in part to how each is positioned within the economy. Paid care work is counted as productive labour that contributes to GDP, placing it within the formal economy (OECD Health Division, 2018; Duffy and Armenia, 2021). Unpaid care remains firmly in the informal economy despite its positioning by feminist scholars as being productive and valuable (Folbre, 2006; Elson, 2017; Schmitt et al, 2018; Peng, 2019) and the considerable evidence of the magnitude and intensity of care tasks of unpaid carers, who are mostly family members (Bianchi et al, 2006; Folbre, 2006; Hielscher et al, 2019; Keating et al, 2019).
Patriarchal ideology asserts that care out of love is better than care for money; hence the initial preference is family care. As the demand for paid care in the current care regime is low, so are wages. Patriarchal stereotypes of womanhood render skill and emotional labor invisible in care work and dictate that ‘any good woman can do it.’ The distortion of skill recognition makes the formation of a shadow care economy easily acceptable for caregivers and buyers.
In order to map the work of these carers and to illustrate their relative responsibility, we need to identify them and collect comparable data on their care work.
Care-dependent groups
This component of the framework refers to those groups of people who need support with ADLs to live as independently as possible. We include three groups: older people with chronic conditions and disabilities; younger people with chronic conditions and disabilities; and young children.
Scholars, practitioners and policy experts have argued that social care is for people of all ages who have care needs (Daly and Lewis, 2000; Yeandle et al, 2017). Research and practice have reflected this assumption, although areas of work are distinct. For example, care to older people has emphasised the inadequacy of formal care services (Daly, 2023) and heavy responsibilities placed on family carers, especially in contexts of deprivation (Ananias and Keating, 2023), underscoring the urgency of creating systems of long-term care. Care to young children also has drawn attention to limitations in the formal service sector (OECD, 2019). Childcare responsibilities restrict women’s labour force engagement, particularly when women have care responsibilities to older generations too (Wray, 2024). Relatively less attention has been paid to social care needs of people living with disability or chronic mental health challenges (Perkins and Repper, 2021). This means that the long-term care needs–services gap is underestimated as it is silent on the growing group of people of all ages living with disability (Kaye et al, 2010; Humphries, 2022).
Empirical research across care workers has begun to illustrate the commonalities in their experiences (Keating et al, 2021). Bringing these together adds to our ability to understand the work of care across the social care economy and to respond to UN declarations about the importance, challenges and value of care work.
Carer wellbeing
Wellbeing of paid and unpaid carers contributes to the sustainability of the social care economy. High levels of job turnover of paid care workers (Lim, 2021) and the burden of unpaid carers (Lindeza et al, 2020) have been cited as indicators of the crisis in social care. The emphasis on wellbeing is consistent with the ‘beyond GDP’ movement, which argues for a shift in the way a nation’s health is measured – away from using economic production as a metric to using measures of the wellbeing of people (Stiglitz et al, 2009; UNDESA, 2023) – and also calls for valuing the work of care.
Based on these imperatives, we include carer wellbeing as a component of our framework, using a multidimensional approach to determine how they are doing in their lives (McGregor and Pouw, 2017). This considers three domains: material wellbeing, which is the resources available to the carer; relational wellbeing, which is based on the carer’s embeddedness in positive relationships; and subjective wellbeing, which is the carer’s assessment of how well they are managing in their life.
Knowledge of wellbeing outcomes across the three domains is uneven. There is evidence of paid carers’ precarious financial resources resulting from low wages and poor benefits (Afzal et al, 2018; Ophir, 2022), while unpaid carers incur lost income and out-of-pocket expenses (Duncan et al, 2020; Gutiérrez-Robledo et al, 2022). In the area of relational wellbeing, disrespect and discrimination are pervasive across the work settings of paid carers (Braedley et al, 2018; Cooke and Baumbusch, 2022), while unpaid carers experience changes in relationships with family members, friends and co-workers (Keating and Eales, 2017). We know little of carers’ views of their ability to live the life they most value (Cunningham et al, 2018; Keating et al, 2021).
Measuring the social care economy
According to Addati, ‘transforming care work starts by accurately defining and measuring care work – because what we measure matters’ (2021: 150, original emphasis). We began this project with the belief that theory should be practical. To the best of our ability, we have created a framework that makes social care visible and which is measurable, thus creating the basis for addressing knowledge gaps on the distribution of paid and unpaid care, the value of the work done by carers and their wellbeing outcomes.
In this section, we discuss data requirements for measuring the social care economy, highlighting examples of existing datasets. Datasets and data availability differ considerably across global contexts. We include examples from surveys that are used widely around the world, and we also draw on national survey data from Statistics Canada that reflects the national context of the authors. Together, these show what types of data are available and the areas where there are data gaps. Table 2 summarises the data requirements and measurement challenges for each of the components of the social care economy.
Social care economy: data requirements and challenges
| Components of the social care economy | Data requirements | Data challenges |
|---|---|---|
| Care work |
|
|
| Care workers |
|
|
| Care-dependent group |
|
|
| Carer wellbeing |
|
|
Data sources for components of the social care economy
Care work
We recommend operationalising care work as assistance with ADLs and with IADLs as these are widely used measures of functioning. The original sets of tasks were developed based on needs of older people (Katz et al, 1963; Lawton and Brody, 1969). Researchers working with ADL and IADL checklists have suggested modifications for use with persons of all ages (LaPlante, 2010) and in specific regions (Pashmdarfard and Azad, 2020). Specifying care tasks allows for determination of total hours of care and its economic value. In the best of all worlds, researchers would agree on the list of tasks, thus allowing for comparison among paid and unpaid carers to different groups of care receivers and across countries and regions. Statistics Canada’s General Social Survey of Caregiving and Care Receiving is an example of a national survey, conducted approximately every five years, that has extensive information on care tasks, care time and duration, and carer outcomes (see Statistics Canada, 2018). A notable limitation is that the survey collects data on care provided by unpaid carers only.
Care workers
We have specified two groups of carers: those who are paid and those who are unpaid. As a starting point, we adopt the ILO approach to distinguishing between these groups, which is based on whether or not the carer receives a monetary reward (Addati et al, 2018: 1). However, we note that the paid–unpaid dichotomy may be most relevant in countries where most people work in the formal economy, with paid carers being those who receive wages or income for their work. In low- and middle-income settings, approximately one third of people work informally, undertaking activities that have market value and would add to tax revenue and GDP if they were to be recorded (Deléchat and Medina, 2020). Further discussion may be warranted around how best to distinguish family carers from others in settings in which no monetary reward is received for care work and under what circumstances the distinction between paid and unpaid care is relevant.
Care receivers
The three groups of care receivers specified in the framework all need assistance with tasks to support their daily functioning. There are several data challenges in specifying and collecting data on these groups. Researchers will need to determine whether distinguishing between older and younger persons with chronic health problems and disabilities is useful in application, such as in policy settings where age is a criterion for receiving or ageing out of benefits or services. Adding age of recipient as a variable allows for this distinction to be made should there be a specific policy or practice goal.
Specifying age of children allows for similar distinctions and for determining whether ‘young child’ refers to only those who need the most intensive assistance with both ADL and IADL tasks or also includes older children who may not be fully capable of undertaking all IADL activities. A particular challenge is that although social care includes support to people of all ages, data on all groups is rarely found within a single survey.
International surveys collect elements of data needed to document social care knowledge gaps. Time use surveys collect data on daily activities of respondents, typically employing a 24-hour diary as the data collection instrument. They have the advantage of being widely used and being sources of information on care to people in the three main groups of interest, including young children (UNDESA, nd). As with all omnibus surveys, they also have limitations. International definitions of unpaid domestic work and care work place several ADL tasks, including food preparation and cleaning, within domestic work, potentially leading to underestimation of care provided to household members (UN Statistics Division, 2024). Time use surveys do not reliably identify the care dependence of adults as it is not clear for whom the care is provided. In addition, there are no data on care provided by paid carers or on wellbeing outcomes of carers in time use surveys.
Labour force surveys are the main data source for identifying care work performed as employment (ILO, 2023). They gather data on paid workers, including job tenure, job quality and job descriptions. Occupational classification systems are beginning to delineate jobs in social care, however. For example, the Canadian Labour Force Survey has an occupational grouping described as providing ‘personal care and companionship for seniors, persons with disabilities and convalescent clients’ (Statistics Canada, nd). These occupations focus on the provision of support to adults for ADLs but do not include higher-level tasks supporting IADLs. Care time is not captured.
Carer wellbeing
Each of the three domains of wellbeing has specific data requirements. Some data are found in carer and other surveys that gather demographic information and data on income and outcomes, such as loneliness and life satisfaction.
A key indicator of material wellbeing of carers is their economic resources. Data on wages of paid carers address questions of how well they are reimbursed for their care work, while the economic resources of unpaid carers indicate the extent of their labour force engagement. We are not aware of existing surveys that collect income data on both groups of carers. A question that needs to be resolved is whether indicators of material wellbeing should be more expansive. For example, out-of-pocket expenses of unpaid carers may reduce their material resources, and immigration status may be a proxy for employment precarity of paid carers.
Relational wellbeing is an indicator of the social embeddedness of carers. Quality of relationships, relationship tensions and loneliness are frequent sources of wellbeing failures for paid and unpaid carers. Loneliness is a common measure across social surveys. Scales such as the De Jong Gierveld Loneliness Scale and the UCLA Loneliness Scale are widely used (Penning et al, 2014).
Data on subjective wellbeing provide the opportunity to determine carers’ views of their ability to live the life they most value. Life satisfaction is the most common measure of the degree to which a person believes they are fully functioning (Ryan and Deci, 2001; Becchetti and Pelloni, 2013). It is used almost exclusively across OECD countries (Mahoney, 2023).
Regional surveys such as the Survey of Health, Ageing and Retirement in Europe (SHARE) have comprehensive measures of wellbeing of family carers across material, relational and subjective domains (Brandt et al, 2023). SHARE covers all European Union member countries with harmonised data and linked studies in other world regions (Börsch-Supan et al, 2013). However, its broad set of topics on the life course and situation of people aged 50 and older means that data on care tasks and frequency are not as comprehensive as in surveys devoted exclusively to care. Paid carers are not systematically included.
This brief overview of data sources illustrates that data on components of the framework are fragmented. There are good data available on unpaid care, particularly to older persons. However, gaps in comprehensive accounting of unpaid care to young children and to others with functional limitations across the life course means there is likely an underestimation of the extent of care responsibilities, especially for women. Data gaps for paid carers – on time spent on caring, tasks carried out and outcomes – underscore their invisibility. While there are tools that measure domains of carer wellbeing, they are not connected to care time and care tasks for either paid or unpaid carers.
Discussion
In the introduction to this article, we highlighted widespread discourses of a crisis in social care and growing alarm about the sustainability of the social care sector. We illustrated the UN’s view on the global import of this crisis by summarising its calls for action to find a balance between state and family responsibility for those who are dependent and to reduce the marginalisation and devaluing of carers. We framed these imperatives as the social care economy, arguing that working towards solutions requires a bold approach.
Perhaps only a group of academics and data managers such as us would think of a conceptual framework as either bold or solution oriented. But we believe that it is not until we see that we are positioned to act, and that the lens that we use determines what we see. The social care economy framework allows us to see care and carers in a way that invites questions and creates pathways to action.
People working in social care are viewed as a sector of the overall economy, regardless of whether they receive remuneration. Seeing carers in this way alerts us to the ambiguous boundaries between paid and unpaid carers, including those working in shadow economy of care. It alerts us as well to gaps in our knowledge about the size and membership of the care labour force.
Social care work is defined as activities that support people needing assistance with daily functioning, thus distinguishing social care from healthcare. Delimiting social care provides a basis for determining the amount of work undertaken by all carers within the sector and the social contract around the apportioning of care responsibility.
All people who need social care are included, regardless of their place in the life course or the nature of their functional limitation. This inclusive approach to those in need of social care complements the inclusive approach to carers, thus articulating the full set of providers and receivers of social care. It provides a basis for determining the extent of carers’ multiple care responsibilities as well as the policies and programmes that would address their needs.
Finally, wellbeing of carers is one of the key indicators of the sustainability of the social care sector. Building wellbeing into the framework focuses attention on both positive and negative carer wellbeing outcomes that can inform perspectives on what constitutes decent work.
Having undertaken this conceptual work, including an initial look at data sources, we are left with the conclusion that in the face of a crisis in social care, we have a limited understanding of who are the social care workers, the work are they doing, who are they caring for and how are they faring. This seems a rather shaky foundation on which to build sound social policy for the future. Yet promising directions in data development, carer strategies and wellbeing agendas suggest that perhaps the time is right to see and to measure, and to take action.
Data initiatives in various world regions are beginning to address evidence gaps in social care. Two examples come from the UK and from southern Africa. The recently developed UK data strategy on social care features bringing social care data into administrative datasets and implementing complementary surveys: a social care workforce survey to understand wellbeing among the formal social care workforce and a survey of unpaid carers to broaden the scope of information on this group (Department of Health and Social Care, 2023). A team of researchers in Botswana, Malawi, Namibia and South Africa is creating knowledge of material and relational wellbeing outcomes of family carers and of the impact of familialist policies on care (Family Caregiving, nd). While none of these data initiatives alone can fill all of the evidence gaps, they are addressing key areas that can address risks to the sustainability of social care.
At the same time, carer strategies across regions and within countries are framing policy agendas in social care. The European Care Strategy (European Commission, 2022) is a comprehensive policy framework inclusive of childcare and long-term care with the goal of better supporting paid and unpaid carers, and with funding commitments to do so. A number of country-level initiatives are setting the development of their carer strategies within the care economy. India (PIB Mumbai, 2024) has argued for a care economy that addresses growing needs for childcare and care to older persons, and that reduces gender gaps in care work. The Government of Canada (2024) has made similar arguments, stressing the importance of paid and unpaid care work to the economy. Providing social protection for care workers and parental leaves to support family carers are central tenets in a planned road map and action plan for the care economy in Indonesia (ILO, 2023).
The development of carer strategies such as these are consistent with a global agenda that urges governments to go ‘beyond GDP’. The argument is that while GDP is the most widely used economic indicator, it does not include productive activities that may be important to people and nations. There is concern that ‘if the measures we rely on are out of synch with how citizens experience their lives, lack of trust in government will develop’ (Stiglitz et al, 2018: 21). Policy choices by government are immensely important to individual and collective wellbeing, and must be measured (Aitken, 2019).
Governments are beginning to incorporate the language of wellbeing into their discussions of the national economy. The Wellbeing Economy Governments partnership (Wellbeing Economy Alliance, nd) is an example. It is a collaboration whose goal is to create economic systems that focus on the collective wellbeing of current and future generations. Their priorities include allowing citizens to realise their full potential and contribute to society, reducing inequalities, challenging the persistent undervaluing of women’s contribution to the economy and transforming the sectors where low pay or precarious work are most prevalent.
In sum, we see promise in these initiatives for action on social care and for increasing the centrality of global conversations about the sustainability of social care. Tremendous challenges remain, including encouraging governments to act on social measures, fund social research and allocate resources to social as well as curative care (Marier and Revelli, 2024). Addressing inequalities both within individual countries and on a global scale remains a priority (Jordan, 2025).
Notes
This article is dedicated to the memory of Professor Janet Fast, whose pioneering work on the economic value of unpaid care provided an important foundation for our framing of the social care economy.
The UN Charter sets out the constraints on enforcement: ‘Nothing contained in the present Charter shall authorize the United Nations to intervene in matters which are essentially within the domestic jurisdiction of any state or shall require the Members to submit such matters to settlement under the present Charter’ (UN, nd).
Funding
The authors received no financial support for the research, authorship and/or publication of this article.
Data availability
This manuscript does not report on data.
Ethics
This conceptual project did not involve personal interaction with research participants. No ethical clearance was required.
Conflict of interest
The authors declare that there is no conflict of interest.
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