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Care As Belonging, Difference, and Inequality
Tatjana Thelen, University of Vienna
https://doi.org/10.1093/acrefore/9780190854584.013.353
Published online: 26 May 2021
Summary
The topic of care has inspired a vast and complex body of research covering a wide range
of practices. As an open-ended process, it is generally directed at fulfilling recognized
needs and involves at least one giving and one receiving side. Although care has mostly
positive connotations in everyday usage, giving or receiving it can also be a negative
experience or express domination.
Care evolves through complex arrangements of different actors, institutions, and
technical devices and at the same time transforms them. As human needs are not a given,
the process of care involves negotiations about who deserves to receive it and on what
grounds, as well as who should provide it. Because care is so deeply implicated in
articulating and mediating different moralities, it becomes central to constructions and
classifications of difference. In this way, care extends far beyond intimate relations and is
engrained in processes that establish belonging as well as various forms of inequality.
Researching care in intimate settings as well as in public sectors enables bridging
various communities of care and grasping how the distribution of care not only mirrors
inequalities but contributes to their (re)production or even intensification.
Keywords: care, social organization, belonging, inequalities, social reproduction, moralities,
difference
Subjects: Sociocultural Anthropology
The Field of Care
Delineating the vast field of care is not an easy task since research on the topic has exploded
since the 1980s. In addition, a review of this scholarship encounters issues of translation as
well as disciplinary and national traditions that research care in a myriad of settings. Some
focus on unpaid activities of social reproduction within households, while others also include
paid care in institutions. Research on care is also fragmented by orientation toward different
categories of care receivers, such as the elderly, those with disabilities and chronic illnesses,
or children (Thelen 2015a). Adding to the difficulty of developing a comprehensive approach is
a problematic normative shift in the conceptual use of care in academic discourse since the
1990s (Locke 2017). Against the background of various neoliberal policies that led to new
configurations of family, state, and the market for providing care, we have witnessed a turn
Tatjana Thelen, University of Vienna
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away from care as a fundamental element of social organization and toward care as a positive
activity compensating for the hardships caused by new gendered and global inequalities. In
the specific literature on the ethics of care, as well as within the body of studies focusing on
neoliberal reforms, the concept of care has increasingly been used for political critique. Both
lines of thought produced valuable insights that have fed into a wave of publications emerging
in the 2010s interested in care as not only reactive but also productive. This renewal of a
broad perspective on care as transformative and fundamental to social organization yields
insights into mechanisms of belonging as well as various forms of inequality (Aulino 2019;
Buch 2013; Goodwin-Hawkins and Dawson 2018; Ong and Steinmüller 2020; Thelen 2015a).
Ethics of Care
In the interdisciplinary literature on the ethics of care that has emerged since the 1980s, care
is explored as an alternative to capitalist exploitation, the ecological crisis, and global
inequalities. For example, Tronto (1993) labels all human pursuits that aim toward a better
world as care. In anthropology, it is specifically those branches with a strong leaning toward
psychology and phenomenology that attribute a positive value to care (Black 2018; Buch
2013). Often mapping vernacular understandings of care as a gentle practice of attending to
needs, studies within these lines of thought see care as a relational and intersubjective
experience leading to more inclusive or impartial ethics.
This positive approach to care as ethics has roots in feminist research, in which women are
often represented as better equipped to care selflessly for others. Starting with the work of
Gilligan (1982), the ethics of care have been seen as an alternative and essentially female way
of thought. In her book, In a Different Voice, Gilligan contrasts two modes of ethical reasoning
and shows that previous scholarship had privileged (male) abstract reasoning as an ethics of
justice over (female) moral deliberation situated in personal relationships of the ethics of care.
While this psychology-inspired scholarship was a historically important corrective to the
earlier thinking, it has also been criticized for essentializing female care work and assuming a
false universalism.
Biomedical institutions have been one prominent field of research on ethics that has reflected
a positive view on care. For example, Mol (2008) starkly distinguishes a logic of care and a
(neoliberal) logic of choice in her study of diabetes treatment in the Netherlands. The
difference between the two logics is, according to her, “irreducible.” She contrasts them along
several axes: definition of need, leading principles, involved actors, implied temporality and
aim. In a logic of choice, a consumer defines her need or desire, which is fulfilled by a
temporally limited monetary exchange for profit. In contrast, in the logic of care a patient’s
need is defined within a team (patient, doctors, nurses, and others) in an open-ended process
—which might fail. While Mol carefully avoids a simple dichotomy between passive/active
paralleled by state/market, she still idealizes care as a gift that is invariably met with
gratitude and where needs ultimately do not seem to be subject to negotiation. The question
of how the “care team” manufactures consent and compliance through power is left open.
From a different starting point, Borneman (2001) adopts a similar positive view on care as
voluntary and noncoercive by using two examples of same-sex couples in Germany, and shows
how they responded to discriminatory legislation that withheld their right to care. In the first
case, care was expressed through an adoption that allowed the younger partner of a
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terminally ill man to inherit his estate. The second example concerns a set of “sham
marriages” that facilitated the cohabitation and mutual care of a lesbian couple across the
former West German–East German border. Borneman thus situates care as in opposition to
state restrictions and also as an alternative category to the bias toward procreative
heterosexuality in the anthropological study of kinship.
The literature on the ethics of care is grounded in Western Euro-American concepts and is
directed at policy debates. It has thus been criticized for neglecting other contexts and norms.
As a response, a range of ethnographic studies has introduced different cultural
understandings of good care. For example, in a study about care in the Arctic, Stevenson
(2014) applies a contrastive lens that opposes Inuit ideals to bureaucratic and anonymous
care. She argues that the care provided by the Canadian state for Inuit in face of the
tuberculosis epidemics and high rates of suicide is ignorant of their cultural understandings
and signals an indifference that produces suffering. Hashimoto’s (1996) comparative study of
senior citizens in Japan and America describes two distinct approaches to elder care.
According to her, the Japanese have adopted a “protective approach” based on the
expectation that need is an inevitable condition of old age. In contrast to this “will-need
script,” the Americans in her study follow a “might-need script” that assumes a fair degree of
independence up to a “critical” point in time—the “contingency approach.” Both approaches
produce insecurities.
The anthropological challenge is to acknowledge and respect different cultural values of care,
while at the same time resisting romanticism. As Aulino (2019) shows in the example of Thai
religious-inflected care values of harmony, merit, and pity, can serve oppressive patterns of
structural violence. In the very different context of Nicaragua, Yarris (2017) shows how the
political value of solidarity and the Catholic notion of sacrifice come together in motivating
grandmaternal care, while also stabilizing gendered inequalities. Ma (2020) demonstrates
how the Chinese concept of guan (parental control) can turn into coercive care by family
members. In each case the national history and the global context are important in how the
ambivalent nature of care ideals play out in practice and transforms or stabilizes
marginalization.
Care as Commodity or Love
Positive descriptions of care often rely on a model of selfless maternal care and are thus prone
to making moral judgments about “appropriate” care (Black 2018). As Read (2007) describes
in the context of Czech hospitals, good care is understood as an expression of love and
intrinsic concern that needs to be “gifted”—meaning not paid for—to make it “real.” Many
scholarly approaches to care rely on a similar binary division between care provided as a
commodity and care based on intimate relations. On one side, self-interest, coercion, and
profit are often represented by the state and market. The other side is marked by collective
interest, reciprocity, and altruism, which are often attributed to the less powerful. This
normative distinction has proved productive for research on the recurrent waves of neoliberal
and austerity policies that have reduced public spending on diverse care infrastructures such
as hospitals, nursing homes, or kindergartens since the 1990s.
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As it is so loaded morally, kin care is especially prone to discourses of seeing it as
contaminated by money, and the question of the relationship between paid care and intimacy
has proved especially unsettling. But informal or familial care is not without strategic or
monetary calculus. As Empson (2020) shows in the case of poor households in Ulaanbaatar,
much of the care given is based on financial strategizing through complex exchanges of loans
and debts. Han (2011) shows how women among the urban poor in Santiago, Chile, take on
credit to care for kin within wider networks of dependencies. If such care relies on ideals of
reciprocity, those who have nothing left to give might be easily excluded. As de Jong (2005)
describes, impoverished older women in Kerala, India, can easily fall out of local support
networks if they lack the resources to reciprocate.
Anthropologists have also challenged a generalized equation of care with emotional closeness
that does not involve material exchange by showing the historically and culturally specific
nature of what is perceived to be “care.” Han (2011) suggests that in Chile the urban poor
view monetary transactions as expressions of care toward others. In the context of fertility
clinics in Ecuador, care among female relatives included lending money and donating eggs
(Roberts 2012). In a study about everyday care in Thailand, Aulino (2019) challenges the
notion of care being driven by emotions of love and compassion, highlighting instead
hardships and ritual duty.
Shifting attention from caregivers to care receivers, ethnographic and, specifically, disability
studies have cast doubt on the positive outcomes that tend to be presented in the ethics of
care literature (Thelen 2015a). Even though care can signal recognition, receiving it can also
be experienced as humiliating and as limiting personal autonomy (Ma 2020). Moreover,
specifically kin relations can involve the obligation to show thankfulness in response to care
framed as a sacrifice. This care is often imbued with power, thereby challenging the
presentation of caregivers as always relatively powerless, both within families and within paid
work arrangements. This critique has been translated into political support for paid personal
assistants, which has resulted in criticism of these measures as neoliberal. Such discussions
again reproduce the strong dichotomy between care as gifted—a voluntary practice based on
altruism—and care as a paid service.
Other research has shown that the boundaries between carer and cared-for, between selfinterest
and altruism, and between money and intimacy are blurred in concrete care practices
(Buch 2013; Locke 2017). In light of these findings, a number of publications have challenged
dualistic notions of care as only “real” within private realms as well as the concentration on
care as unambiguously “good.” Insofar as much of the care literature places care “on the good
side,” it has often mapped (and continues to map) public discourses of “warm” kin care
against “cold” institutional care. But intimate care practices within families are deeply
ambiguous and can also produce negative effects, as Garcia (2010) shows with the example of
intergenerational care between drug users in New Mexico. Similarly to Stevenson’s study of
Inuit care, in Garcia’s study, care that is performed through sharing heroin is not even
necessarily directed at avoiding death. Nor is all care a pleasant experience; instead care can
be unpleasant, competitive, or even coercive. Brown (2010) describes how installing fear and
respect is part of the way Kenyan nurses care for mothers in childbirth. Bruckermann (2017)
shows how Chinese grandmothers’ wishes to provide childcare in order to fulfill their own
selfhood can verge on coercive. Receiving care can be experienced as stifling, as Roberts
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(2012) suggests in the context of Ecuadorian fertility clinics. Building on these insights, some
authors approach care not as a reaction to or expression of inequalities and power, but as a
central and transformative element in social organization.
Care as Social Organization
All human beings are dependent on others’ care at certain points in their lives. Indeed,
children learn their ideas about care ideals through embodied acts of caregiving that socialize
them into culturally distinct ways of being competent adult members of their respective
societies (Black 2018). The process of giving and receiving care is therefore inextricably
linked with personhood and morals (Buch 2013). Making care a critical concept beyond
political pragmatism requires a denaturalization by exploring the boundary work between
care and noncare as well as the normative claims, ideals, and ways deservingness is
legitimized and negotiated. Furthermore, and despite the tendency in anthropology to reduce
care to direct hands-on activities, it extends to other areas of life and has structural effects.
Weismantel (1995) describes how in highland Ecuador the acts of care that make Zumbagua
into parents are embedded within conditions of poverty and intensify marginalization.
Moreover, care is an open-ended process; it can result in positive experiences and stable
relationships, but the opposite as well: domination and the dissolution of ties (Thelen 2015a).
Thus, the negative sides of care, such as (re)producing partiality, oppression, and
marginalization, that have been left out of the ethics of care literature must be reintegrated
into research about care. The challenge is to get both sides of care—the good and the
oppressive—into the analysis simultaneously (Aulino 2019).
Processes of care that reproduce hierarchies often center around the negotiation of what is to
be understood as a legitimate need and who is a deserving receiver. Ideas about need and
deservingness may be different depending on the society, but they can also vary within a
society according to gender, age, ethnicity, and social status. Expectations of care are formed
over the course of an individual’s life and are associated with dominant notions of a “normal”
or “successful” life in a specific historical period. Bruckermann (2017) describes how the
efforts of Chinese grandmothers to care for their grandchildren are based in their historical
experience of failed reproduction during the famine period and difficulties during the strict
early versions of one-child policies. Using the example of different generations of immigrants
to the United States, Hareven (1982) demonstrates variations in expectations of future risks.
Cohorts who had similar experiences at a similar time in their lives (like food scarcity in
childhood, or migration, or phases of industrialization), might differ from other generations in
their ideas of need and of the norms of care.
The hegemony of certain ideals of care does not necessarily imply those ideals universal
acceptance or stability. On the contrary, ethnographic studies demonstrate that need for and
access to care resources, as well as to specific practices within care relationships, are
negotiated among kin as well as between clients and state employees or within specific
organizations. Even if constructions of need resemble each other, what is seen as an adequate
caring response can also vary. Rebecca Allahyari (2000) compares two charities in the United
States serving homeless persons that have different historical backgrounds and moral visions
of need. Their approaches translate into care practices that result in different aesthetics,
naming practices, and political subjectivities of volunteers. Negotiations of needs draw
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boundaries between deserving and undeserving subjects, simultaneously creating
communities of care and excluding others from access to care. Thus, such acts of care create
belonging but also difference.
Care: Producing Belonging, Difference, and Exclusion
Care as an activity directed at fulfilling needs can be extended to persons of different
categories, acknowledging someone as a relative, covillager or conational. In this process,
care can affirm membership in such collectives or deny it, creating hierarchies and exclusion.
In the most extreme cases, the denial of care can entail the rejection of shared humanity.
Care can not only attest to or deny belonging but also be transformative for different forms of
membership. This includes race, as Roberts (2012) describes in relation to health care and
becoming white in Ecuador. The investment in care (time, money, physical treatment) signals
to the recipients their changing belonging. Thelen (2015b) describes how the experience of
care outmigration led to a change in self-understanding in a Romanian village. In 1999–2000,
villagers were still convinced that in Germany people “gave the elderly away,” while Romanian
families “still” cared. In their representation of a good community, villagers thus drew a line
between “us” and “them” based on assumed care practices. Ten years later these
representations were inverted. Induced by the experiences of female care migration to
Western Europe and the working of a local care facility, a shift had taken place to an image in
which the West was seen as doing better by keeping the elderly at home. This development
cast doubt on their own community.
In order to care, institutions often rely on definitions of needy communities. Mason (2018)
shows how population health scientists understand their quantitative research as taking care
of vulnerable populations. Very much like feminist researchers who proved female
disadvantages through statistics, they attend to needy populations by making them visible
through caring by numbers. A commitment to helping the “deserving poor” thus reveals
inequalities and simultaneously creates belonging (and defines its borders), as well as
possibilities to translate that into care measures. Care discourses in both cases serve to
delineate communities: they mark boundaries through contrast or contribute to moral
positioning of self. A great deal of research on care has investigated such processes of care in
producing belonging and its boundaries across scales.
Care as Making and Unmaking Kin Belonging
Care is often explored as an aspect of the intimate and the familial. The widespread
conception of the family as the primary site of care has guided many anthropologists in their
research. Since the late 1970s, the idea of kinship prompting care was turned upside down.
Based on his research on the island of Truk, Mac Marshall (1977), early on described kinship
as taking care of and being cared for by others. His insights gained in popularity in the 1990s.
In an edited volume by Carsten (2000), several chapters described how relatedness is created
through diverse acts of care. In his contribution to that volume, Stafford (2000) finds that
female intergenerational care activities in China that rest on the concept of yang create kin
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belonging. However, as Bruckermann (2017) argues in the same context, such claims to care,
and with it belonging, are not always uncontested. She finds Chinese paternal and maternal
grandmothers competing for the right to give care that also signals belonging.
Creating belonging within families through care might presuppose an unmaking of belonging
within another formation. Because of the concentration on processes of creating kin through
feeding and other forms of care, the dissolvement of belonging has received less attention.
Care practices can create personal relationships but also interrupt or devalue them, as Rasell
(2020) shows in her study of state care in late socialist Hungary. The emphasis placed on
parent-child relationships restricted other possible ties for children in care, particularly to
siblings, friends, and neighbors, but also to the institutional caregivers. Papadaki (2018)
investigates the dissolution of kin belonging in one of the largest public maternity hospitals in
Athens, where nurses and social workers evaluate the quality of maternal care provided by
young mothers to their infants. In their decisions on whether the newborn infants should be
taken into state care, they follow care scripts that neither the local poor nor undocumented
migrants typically understand or comply with. State agents become gatekeepers in decisions
about kin belonging through parental care, and at the same time state care grants these
children a new (Greek) political belonging.
Care as Producing Multiple Political Belongings and Exclusion
Care not only creates kinship but generates membership in numerous social formations,
including the nation and humanity at large (Thelen and Coe 2019). Historically, the
introduction of the policies of a “caring state” was meant less as a measure of solidarity with
impoverished classes than to produce political legitimacy. Ong and Steinmüller (2020)
describe how different actors in the autonomous Wa State in Myanmar create communities of
care that ultimately result in a fragile but still consistent sense of political belonging. While
various actors, including nongovernmental organizations (NGOs), local “big men,” and
paramilitary units use different logics within different relationships, care results in a new
community that is transformed into “our people.”
The ways in which the state provides care can become signs of political belonging but also
exclusion. Although care was introduced as a substitute for workers’ solidarity that would
prevent revolution and thus construct a political community—the nation—the state’s
withdrawal from providing it at the turn of the twenty-first century is ironically seen as a loss.
The considerable amount of research that interprets this situation as a failure of solidarity
mostly blends out studies of governmentality that stress how state care institutions not only
complement punitive institutions but are also themselves policing and an extension of state
power (Donzelot 1979; Borovoy and Zhang 2017).
Specifically, studies on volunteering and humanitarian care have demonstrated how some
individuals or groups are singled out as suitable objects for care while others are excluded.
Muehlebach (2012), for example, describes how, by simultaneously criticizing and embracing
the Italian politics of referring responsibility for elders to civic organizations, an ethical
citizenship emerges that excludes migrant care workers, who are seen as “only” performing
physical care and not the emotional care that only Italian volunteers can do. Ticktin (2011), on
the other hand, describes fallacies of care in France regarding migrants. She proves again
how essential the negotiation of need and deservingness of care is within these processes that
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ultimately result in exclusion. Undocumented migrants have to fit specific criteria to become
seen as deserving special care. For example, “modern slaves” have to be young, female,
uninterested in the economic gains from migration, and not engage in voluntary sexual
relations in order to distinguish them from “illegal” migrants and transform them into suitable
subjects for care. Giordano (2014) describes similar ways of constructing victims of human
trafficking within institutions that seek to care for women seeking asylum in Italy as
collaborative acts of translation. In relation to international humanitarian help, McKay (2018)
traces two health care projects in Mozambique, arguing that the sudden shifts in provision
shape inequalities. This literature thus delineates how care by NGOs reproduces racial and
gendered inequalities.
Care becomes imbued with expectations that form an important element in not only creating
but also dissolving political belonging. For example, a new state-sponsored home care
program for elders in Hungary excluded Roma men living alone: the local social worker
thought they did not need help because of their extended kin networks. This differentiated
delivery of state care, based on assumed differences, contributed to the reproduction of
exclusion and ultimately dis-belonging in the local and national community (Thelen and Coe
2019). In their work on northern England, Goodwin-Hawkins and Dawson (2018) show how
industrial cultures are intertwined with different moralities of care linked to constructions of
need. Contrasting a former garment and textile manufacturing community with a former
mining one, they identify an imperative for self-care in the former and an ideal of communal
care in the latter, and point out that both have ambivalent consequences for the lives of
individuals. Moreover, they show how performances of caring well (either for oneself or
others) mattered and resonated with broader narratives of belonging within these
communities.
Care: Bridging Diverse Communities of Belonging
Despite much lay and scholarly stress on the separation between public and private, intimate
and institutional, paid and given, care bridges these domains and creates cross-cutting
belonging in kin, local, and national communities. State care builds upon assumptions about
obligations on families and reinforce these norms. In his study on China, Stafford (2000)
describes how the kin created through care complements the rules of patrilineality and state
bureaucracy. Bundgaard and Olwig (2018) investigate how the overlaps between parental and
public day care in Denmark teach children what it means to be “proper” citizens and
cultivates feelings of either belonging to or exclusion from Danish society.
The idea that children deserve special care by their (biological) parents is embedded in
various legal regulations, including inheritance laws that stabilize inequality. The recognition
of (biological) fatherhood similarly is not only an expression of ideas about kin belonging but
also about equal rights to receive and give paternal care. In contrast to the United States,
several European countries ban full disinheritance by parents, seeing it as unfair. Thus,
naturalizing kin care is embedded in different historical trajectories and entangled with
biopower. Ma (2020) shows this entanglement and in fact dependence of state biopower on
intimate practices of kin care with the example of Chinese psychiatry.
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Due to demographic aging that is linked to anxieties about a “care crisis,” much scholarship
explores elder care as bridging state, community, and kin belonging. In Namibia and New
York City, for example, older people used state-provided resources in their ongoing exchanges
with kin members and neighbors (Freidenberg 2000). In contrast, the lack of such resources
can render older persons vulnerable and contribute to their exclusion from other forms of
belonging as well. Social privilege, difference, and hierarchy are created and maintained
through state care, both interpersonally and more broadly. Making claims on state care
reveals ideals about what political belonging should be. The ability to negotiate commitments
and make claims to reciprocal exchanges is also a sign of political power that involves the
recognition of being in a position to legitimately make and break commitments (Thelen and
Coe 2019).
It is not only state-supported care but also direct state care that faces such dilemmas. When
should state care be delivered to all potentially deserving citizens on the basis of universalist
ideals, and when should difference be recognized in culturally targeted care? Combinations of
“partial” kin care and “universalist” state care also reinforce each other. Moral discourses on
“insufficient” maternal care feed into practices of state care, which in turn feed back into kin
care when state care is seen as “inappropriate” (impartial or cold). McKay (2018) calls this
overlapping of multiple relations between unequal actors and their competing modes of care
between public and nongovernmental, market, and private a multiplicity. While constantly
bridging these different communities of belonging, care as boundary object is implicated in
their separation.
Care: Reproducing Boundaries
Representations of “good care” are predicated on images of the “proper” domains of kin
responsibilities, as well as “proper” civic and state engagement. Anthropologists have
increasingly explored how care is implicated in such domaining through boundary work.
As Rasell (2020) describes in the case of Hungarian state care, the institutions showed an
intense investment in separating the worlds of “family” and “state” by reducing the possible
emotional and relational dimensions of the latter. She describes how one director ended a
friendship between a care giver and a child because emotional connections were not seen as
appropriate in state care. Such approaches to care build upon the established dichotomy that
defines emotional closeness as a quality of private households rather than relations within the
state sphere.
Thelen, Thiemann, and Roth (2018) explore how images of state as an entity and as distinct
from the domain of the family within elder care initiatives in Serbia are transgressed in care
practices. Despite this blurring, processes of becoming kin between state-paid care workers
and their clients reproduce of the state-kinship boundary. Read (2014) delineates similar
processes regarding images of care and boundaries of the state and civil society in Czech
health care. Lammer (2017) investigates how urban middle-class members of consumer
associations in China interpreted practices of state officials, agri-entrepreneurs and rural
citizens as either caring or uncaring. These interpretations as either legitimate acts of care or
illegitimate acts of greed and corruption in turn shaped who was perceived as belonging to
the domains of “community” or “politics” and “economy.”
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The importance of the negotiation of care for boundaries becomes especially clear in
situations of accelerated change and crisis. Under these conditions, care practices are
reworked, and in the process, simultaneously form emerging social formations. Such
situations occur, for example, after major political upheavals such as the transformation of
socialist countries (Ma 2020; Kay 2007; Yarris 2017) or when new actors appear with new
ideas on who should be cared for and how (Mc Kay 2018; Amrith 2017). This research thus
investigates those situations in which actors explicitly deploy legitimizing arguments about
who is in need of care and who should deliver it. Ideas about and ideals of care
responsibilities are central to our understanding of what constitutes a “good” society and thus
become important markers of difference. Shifting evaluations of need can create overlapping
categories of people and positions (Ong and Steinmüller 2020). This research already points
to the way in which care produces sameness (as recognition of the other), but this means that
someone else might be denied the same recognition.
Care: Legitimizing and Reproducing Inequalities
As Marxist anthropologists have long argued, the labor of care generates structural forms of
inequality. Because the capitalist economy depends on the production of new labor, it rests on
a base of unpaid care within the domestic sphere. The unequal distribution of care labor is
critical in sustaining structured and global inequalities defined by gender, race, and class
(Nakano Glenn 2010). Institutionalized care within welfare structures not only reflects but
also reproduces and intensifies these inequalities as they remain completely unpaid or only
nominally paid, with poor working conditions and minimally institutionalized social security.
As Ferguson (2015) has argued in relation to South Africa, distributive demands are often
framed precisely in terms of such inequality, with the state understood as having care
responsibilities while simultaneously representing the basis of legitimate political authority.
Buch (2013) describes how paid home care in Chicago not only shapes individual
subjectivities but also the embodiment of social hierarchies. Poor women of color working in
home care incorporated the values, habits, and sensory histories of their clients without
expecting the same from their clients. We can see similar experiences between processes of
intimate and personal visions in Olha’s Italian Diary, a documentary about an Ukrainian care
worker. Within these processes of intimate and embodied care, inequalities come to be seen
as moral and legitimate.
In her study of kindergarten in Vienna, Austria, Ellmer (2020) shows that although these
institutions are largely framed as an instrument of generating equality and integration in
public discourse, concrete institutional child care practices, in fact, produce and perpetuate
differences that might even intensify inequalities. In their everyday interactions with clients,
state-mandated child care givers evaluate familial care practices. By tracing how staff sees a
five-year-old boy as embodying “problematic Muslim masculinity” and his adult sister an
innocent victim through gendered kin care, Ellmer points out that decisions about who is
deserving of institutional care and who is not are closely entangled with the perception of
specific children and their families as culturally different.
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Care is not only reflected in a gendered ethics but also built into individual life courses,
generating structured inequalities. Hareven (1982) shows how gendered care commitments
are constituted in individual biographies. For example, she describes how in an industrial
community in New England, parents of several daughters discouraged one from marrying,
thereby setting her up to be their own future care giver. In case of transnational migration,
migrating daughters often designate their mothers as care givers (Yarris 2017).
Research has pointed to an underacknowledgment of male caring activities resulting from
gendered ideas within earlier feminist research on the ethics of care. Consequently,
ethnographic research has turned to uncovering male caring and to the difficulties of men
articulating their activities in a language of care. Kay (2007), for example, demonstrates how
in Russia a pervasive discourse on uncaring men makes them almost invisible in welfare
structures and continues to describe care by single fathers. Thelen (2005) has shown how,
after unification, grandfathers in Eastern Germany took on the bulk of care work for their
grandchildren to enable their daughters’ shift work but barely spoke about it.
A significant area of research since the 1990s has been focused on transnational care
migration in relation to class, gender, and race. Amrith (2017), for example, traces how
Filipino nurses understand their care work and the intimacy, but also hostility and hierarchies,
in their relations to the people they care for in Singapore. Hochschild (2000) coined the term
“global care chains” for the transfer of care labor and resources from poor to rich countries in
migration of women from to Global South to work mainly as nannies, nurses, or in elder care
in the Global North. Researchers have investigated the important ramifications for the
constellations of care not only in the families of migrant care workers but also in the receiving
countries. As a conceptual framework this research has concentrated on problematizing
global inequalities, as it is mirrored in the distribution of care labor, as well as the ideological
notions that underpin these processes (Yeates 2009). One key area of research has
concentrated on migrants’ mothers and how they experience giving care in spite of separation
from their children. This framework has been criticized as overly schematic and ignoring
more complex experiences and shifts. In addition, like the ethics of care literature, focusing
on transnational motherly care risks reproducing naturalized notions of female caring and
Western ideas of the nuclear family. As such the male caring activities within these
constellations have been rendered invisible, which is why follow-up research has also started
to investigate transnational male caring activities and their effects (Locke 2017).
In relation to transnational migration, Coe (2015) argues that this can lead to asynchronicities
in the coordination of care. With the example of Ghanaian care workers in the United States,
she demonstrates how these workers have to reconcile different cultural expectations of care
in relation to different temporalities. Their temporal strategies require flexible adaptations to
the temporal orders of state law and attention to the individual biographies of other
generations. Such processes can span generations as David and Liebelt show in their
documentary Circles of Care (2011). The film demonstrates how care labor abroad on the one
hand becomes an intergenerational circle in which women from the Philippines work under
great insecurity in Israel and their daughters “inherit” their job. On the other hand, it
becomes obvious that care labor abroad is also transformative and challenges gendered
expectations of personal autonomy and old age.
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Conclusion: Care as Critique and Critical Anthropology of Care
Despite the massive increase in anthropological research and publications on care, this
concept has not featured prominently in theoretical discussions. This is partly the result of
care being used as a concept of critique of neoliberalization, migration policies, and gendered
and global inequalities to argue for a seemingly more inclusive or impartial ethic of care. For
the purpose of political critique, many studies imbue care with positive value and base their
critiques on a firm distinction between market and society, between the economy and
morality, and between money and love. Thereby they run the risk of underestimating its
productive force for legitimizing partialities, difference, and inequality. Care plays a key role
in articulating and mediating different moralities; therefore, the political goal is
understandable, but this usage has left the theoretical potential of care underexploited. A
critical anthropology of care needs to denaturalize it and pay attention to its transformative
force as well as its downsides.
While care is directed at fulfilling human needs and thereby creates belonging, it also
produces differences in access to care and thereby marginalization. As a part of habituation
and subjectification, care is transformative. As such, care not only expresses inequalities but
also shapes them. Overlapping local and state ideas about ethnicity, gender, and other
differences informing their translation in differentiated forms of care can reinforce
classifications that result in ambivalent inclusion, but also marginalization. Processes of care
bridge on the one hand boundaries between state, civil society, family, and economy and on
the other hand contribute to their very production. Situated at the intersection of many
important social processes, including demographics, increasing mobility, medicine, and
gender, care has a broad potential for scholars across various subfields of political and
economic anthropology, kinship studies, and science technology studies. A critical
anthropology of care has a specific potential to bridge the gap between questions of global
inequalities and political economy with intimate encounters and embodied experience.
Scholars working on globalization and inequality may find it equally fruitful as those working
on the state and medicine. Care plays a critical role in a myriad of processes of political
belonging and exclusion—it is fundamental to the study of social organization.
Links to Digital Materials
Cycles of Care . 2011.
Documentary by Lizza May David and Claudia Liebelt, 52 min.
Olha’s Italian Diary . 2018. Directed by
Olena Fedyuk, 52 min.
Lecture by Joan Tronto on Ethics of care .
Lecture by Eva Feder Kittay .
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Further Reading
Caldwell, M. 2007. “Elder Care in the New Russia: The Changing Face of Compassionate Social
Security.” Focaal 50 (2): 66–80.
Danely, J. 2016. “Affect, Infrastructure, and Vulnerability. Making and Breaking Japanese
Eldercare.” Medicine Anthropology Theory 3 (2): 198–222.
Deneva, N. 2012. “Transnational Aging Carers: On Transformation of Kinship and Citizenship in
the Context of Migration among Bulgarian Muslims in Spain.” Social Politics 19 (1): 105–128.
Dossa, P. 2018. “From Displaced Care to Social Care: Narrative Interventions of Canadian
Muslims.” American Anthropologist 120 (39): 558–560.
Hromadžić, A., and M. Palmberger. 2018. Care Across Distance. Ethnographic Explorations of
Aging and Migration. New York: Berghahn.
Kelly, J. A. 2001. State Healthcare and Yanomami Transformations. A Symmetrical Ethnography.
Tucson, AZ: University of Arizona Press.
Leinaweaver, J. 2015. “How Internationally Adoptive Parents Become Transnational Parents:
‘Cultural’ Orientation as Transnational Care.” In Anthropological Perspectives on Care: Work,
Kinship, and the Life-Course, edited by E. Alber and H. Drotbohm, 117–135. London: Palgrave
Macmillan.
Liebelt, C. 2011. Caring for the Holy Land: Filipina Domestic Workers in Israel. New York:
Berghahn.
Livingston, J. 2005. Debility and the Moral Imagination in Botswana. Bloomington, IN: Indiana
University Press.
Nguyen, M. T. N., R. Zavoretti, and J. Tront. 2017. “Beyond the Global Care Chain: Boundaries,
Institutions, and Ethnics of Care.” Ethics and Social Welfare 11 (3): 199–212.
Risseeuw, C., R. Palriwala, and K. Ganesh. eds. Care, Culture and Citizenship: Revising the
Dutch Welfare State. Amsterdam: Het Spinhuis.
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Black, S. P. 2018. “The Ethics and Aesthetics of Care.” Annual Review of Anthropology 47: 79–
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