The Care Economy

Review of: The Care Economy by Tim Jackson
Reviewed by: David Towell

This is my third review of books by Tim Jackson: together these books constitute a trilogy (hopefully to be extended) of critical contributions to our understanding of how to get off the capitalist growth escalator and what we should put in its place. The need is ever more urgent!

In Prosperity Without Growth (2009), Jackson redefines prosperity beyond material concerns to being about 'the quality of our lives and the health and happiness of our families; the strength of our relationships and our trust in the community; our satisfaction at work and our shared meaning and purpose; our potential to participate fully in the life of society.' I have subsequently quoted this definition a lot.

In Post Growth (2021), he seeks to deepen this vision of what it means for human societies to flourish, drawing on an impressive variety of sources and examples, an agenda emboldened by the Covid 19 demonstration that we could take radical action to live differently when the need for this was widely understood. Of course, just four years later we may wonder what happened to 'building back better'.

Now, The Care Economy sets out to refine these efforts through a detailed focus on care in its broadest sense: what would it take to organise our economies in ways that enable us better to look after ourselves, each other and the natural world of which we are part? And what are the barriers to achieving this that we will need to overcome?

Jackson presents his case very well. However the three books show some significant evolution in writing styles. The 2009 book would pass as an economics textbook (or perhaps better, an anti-economics textbook, like Kate Raworth's excellent Doughnut Economics). Raworth herself describes the 2021 book as 'economic wisdom wrapped up in poetry'. It turns out that Jackson also writes dramas, for example plays for the radio. 

These wider writing talents are fully deployed in The Care Economy: each of the 15 chapters reads like a short story, mixing personal experience, descriptions of the places where his thinking developed, literary sources dating back to antiquity, modern writers like Daphne du Maurier, and the occasional pop-star (among economists, William Baumol makes a significant entry; Taylor Swift gets to provide a chapter heading). If your preference is more for the earlier styles, Jackson brings the analysis together in the final two chapters, synthesising the core arguments and addressing 'what is to be done?'

The analysis is sometimes complex, drawing intelligently on philosophy, psychology, physiology and medicine, and their representation in fiction, as well as economics (although maybe not enough political economy). Let me draw out some key themes.

Distilling down the long quotation I include above, Jackson now suggests that human prosperity is essentially about health rather than wealth and, borrowing from the World Health Organisation, defines health as 'a state of complete physical, mental and social well-being' (later making a distinction between physical and symbolic health, the latter linking the mental and social). Accordingly the post growth economy should primarily be organised to care for our health: care being broadly defined as 'everything we do to maintain, continue and repair ''our world'' so we can live in it as well as possible'. Clearly this includes care for the planet that sustains us.

We are a long way from achieving this. Why? One starting point is how we understand the wisdom of the body. Evolution has equipped us with homeostatic processes through which the body regulates its internal environment (keeping it in balance) in the face of a continually changing external environment. 'Health' is our ability to adapt successfully. But contemporary capitalism imposes all kinds of stresses that overwhelm these processes: a global food industry whose pursuit of profit serves us all kinds of food that do us little good - witness the huge growth in obesity and diabetes. A global pharmaceutical industry that 'offers a pill for every ill' but symptom-focussed rather than part of an holistic effort to strengthen our own restorative capacities. Conditions of life and work that wear people out and leave them lacking power or dignity. No wonder there is an expanding burden of chronic diseases, not least in the 'richest' economies.

A second point draws on Baumol's economic insights. Labour productivity growth is a key dynamic of growth. But some activities like care (as well as craft and creativity) are both labour intensive and intrinsically demanding of human time and attention. They are naturally in the 'slow lane' when it comes to productivity growth - and so devalued in what passes for the mainstream economy.

But it's worse than that. The chapter heading provided by Taylor Swift is 'Fuck the Patriarchy'. (I have it on Jackson's authority that this is a new line in one of her re-issued songs.) In most societies, care - whether paid or unpaid - is mostly women's work. In the evolution of modern medicine, cure began to dominate care....and physicians were predominantly men. The gendered imbalances of power and reward in the wider society are reproduced in the provision of health care. This too is not good for the status of caring and the level of societal investment it attracts.

The 'diagnosis' reflected in these and other themes provides the basis for Jackson's answer to the question ‘What is to be done?’ For sure, this includes serious attention to a number of policy proposals so far more discussed than acted upon: improve pay and conditions for care workers; introduce Universal Basic Income as, among other things, an important way of supporting unpaid carers; localize the responsibility for care and socialize its provision, etc.

But Jackson argues that delivering these interventions requires more fundamental changes in societal structures and cultures, built on a new understanding of what would constitute the care economy. Care in its broadest sense needs to be an organising principle across the economy and a clear alternative to the pursuit of material growth. This broad view includes attention to ways of preventing ill health through strengthening the body's ability to heal itself. Good care gives us the freedom to engage fully in the life of society. Expenditure on care needs to be seen as an investment in building a better future.

And to achieve all this, we need to be able to look up and see that the cultural assumptions underpinning the growth economy are not 'givens' but just the socially constructed legitimations for a failing system. Together we have a major task of reconstruction! The Care Economy points the way.

The publisher is Polity. The Care Economy © Tim Jackson 2025
Review: The Care Economy © David Towell 2025