‘Sandwiched’ Caregivers Show Need For Improved Welfare State

This spring, Statistics Canada published an interesting report examining “sandwiched” caregiving. As the author of the study, Dana Wray, describes the issue, sandwiched caregivers are those, usually in middle age, who simultaneously provide care to both children and care-dependent adults.

The report, “‘Sandwiched’ between unpaid care for children and care-dependent adults,” shines a spotlight on the labour market impacts of dual caregiving, particularly for women. Wray’s findings suggest the need for much greater attention on the contributions of the “care economy,” and more importantly, the urgency of expanding public services to socialize a greater portion of care work.

As is well recognized, our economy and society are heavily dependent on unpaid care work, disproportionately performed by women. Indeed, as many socialist feminists have long argued, unpaid care work is the precondition for capitalist production. Without the unpaid inputs of care (i.e., the reproducing, raising and educating of new generations of workers) paid economic activity would be impossible.

In 2022, 42 per cent of Canadians aged 15 and older provided unpaid care to children under 15 years or to adults with long-term conditions or disabilities in the past 12 months. Roughly 6.4 million (20 per cent) people reported caring for care-dependent adults, while 8.8 million (28 per cent) provided care to children.

Although caregiving responsibilities are therefore widespread, they are anything but evenly distributed. Women remain more likely to report unpaid caregiving than men (44 per cent vs. 40 per cent), though the gender distribution of this work has improved over time.

As well, women continue to spend more time providing unpaid care than men. As Wray writes, “Women reported significantly more care time for both adults and children compared to men. Net of other sociodemographic and care factors, women spent 4 hours more caregiving in an average week for care-dependent adults compared to men, and 8 hours more for children compared to men.”

Consequently, women are more likely to report experiencing negative health and financial consequences resulting from unpaid care burdens. Among sandwiched caregivers, 93 per cent of women reported negative consequences, compared to 76 per cent of men.

As the report points out, most research treats care for children and adults separately without examining the unique consequences of their intersection. Using data from StatCan’s Canadian Social Survey from 2022, Wray finds that 6 per cent of Canadians report “sandwiched caregiving” in the past year.

Importantly, Wray’s study expands the definition of sandwiched caregiving to better capture the scope and range of caregiving responsibilities. In the past, dual caregiving has largely been characterized as providing unpaid care to both young children and elderly adults, typically one’s own parents. However, this construction is somewhat limited and often leaves out caring activities performed for other adults with long-term needs or disabilities.

For example, among older sandwiched caregivers, looking after grandchildren is increasingly common. As well, many of those ‘sandwiched’ between child and adult care are performing unpaid care work for a spouse or partner with a disability. In other words, both the providers and recipients of unpaid care vary widely, complexity that can be lost when the focus is too narrowly fixed on children and the elderly.

Of particular interest, the study finds that gender differences in care are driven by this ‘sandwiching.’ In other words, there were no differences in the shares of men and women providing unpaid care to either children or adults only. Instead, women’s great share of “sandwiched caregiving” (7 per cent vs. men’s 5 per cent) explains their overall greater caring responsibilities, as of 2022.

Racialized Canadians were slightly more likely to be sandwiched caregivers than the non-racialized population, whereas Indigenous people were more likely than the non-Indigenous population to be providing care to both children and care-dependent adults.

Sandwiched caregiving is most common among those who are prime working age (35 to 44 years old). Just under one-third (29 per cent) of all sandwiched caregivers are in this age range. Similar shares of sandwiched caregivers are in the 45 to 54 years and 55 to 64 years age ranges (20 and 18 per cent, respectively). This distribution is perhaps not surprising given patterns of childrearing and parental aging, but the crunch of providing dual care can be especially impactful on the labour force activities of core-aged workers.

Unsurprisingly, the study finds that the COVID-19 pandemic had a significant impact on caregiving responsibilities. Nearly half of sandwiched caregivers felt that the pandemic increased their caregiving time. Public health restrictions that closed daycares and limited access to other public services significantly increased unpaid care in private homes. And while COVID held out the promise of rethinking our approach to care and, more importantly, devoting the resources necessary to socialize more of its costs, this had largely failed to materialize post-pandemic.

Wray reports a range of negative social and economic consequences arising from the challenges of sandwiched caregiving.

First, there is the toll this additional unpaid care work takes on caregivers’ physical and mental health. At first glance, caregivers seem to report relatively low levels of overall physical and mental impairment. But when compared to non-caregivers, the picture looks less rosy. For instance, those caring for only adults (18 per cent) and sandwich caregivers (21 per cent) were more likely to report having fair or poor mental health compared to caregivers for children or non-caregivers (14 per cent).

Comparing sandwiched caregivers to those caring for children or adults only is also revealing. Fully 86 per cent of sandwiched caregivers reported at least one negative physical or mental health impact, compared to 74 per cent of caregivers for adults and 62 per cent of caregivers for children. Across a range of impacts — from being tired, to experiencing anxiety, depression, loneliness or disturbed sleep — sandwiched caregivers were more likely to report these harms than caregivers to adults or children only.

Especially troubling, over two-thirds of sandwiched caregivers reported their employment or job-seeking were negatively impacted by their caring responsibilities. Those with significant unpaid caring responsibilities can experience both short-term employment impacts, such as missed shifts or shortened work hours, as well as long-term effects, such as career interruptions or stalled progression. As the study reports, sandwiched caregivers were more likely than others providing care to reduce their work hours, tasks or work responsibilities, and were also more likely to give up better work opportunities due to care burdens.

Labour market impacts combine with other out-of-pocket costs to produce greater overall economic hardships for sandwiched caregivers. While about 22 per cent of non-caregivers reported finding it difficult to meet financial needs, 35 per cent of sandwiched caregivers did so.

Again, financial hardship among caregivers varies by gender, with women more likely to report difficulties. For example, 41 per cent of women said their caregiving responsibilities caused financial hardship in the last 12 months, compared to 28 per cent of men.

Wray’s study is yet more evidence of the need to expand the social welfare state to take on more of the work of care as a social responsibility. As the report notes, caregiving responsibilities, including of the ‘sandwiched’ variety, will only increase with an aging population.

It’s time to rethink our approach to care and social reproduction. In some ways, even framing the issue as a matter of expanding the “care economy,” as has become increasingly popular, mischaracterizes the issue. It’s not that more of the work of care needs to be rescued from ‘the hidden abode’ of the private home and recognized as part of the ‘economy’; but rather that we need to de-commodify more care work through the social welfare state.

From public child care, to free higher education, to elder care and disability support, the Canadian working class deserves a robust social safety net from cradle to grave.

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