The Value of Care. Hematological Cancers in Mexico: A View from Feminist Economics

INTRODUCTION
Care is an essential component for the survival and quality of life of people with hematological cancers—leukemia, lymphoma, multiple myeloma, myelodysplastic syndromes, and myelofibrosis—who often require complex and prolonged treatments such as chemotherapy, radiotherapy, targeted therapies, and even bone marrow transplants. People with these conditions also require strict hygiene and nutritional care, medical follow-up, and ongoing support, which are crucial factors for the adherence to treatments.

In Mexico, much of the responsibility of caring for sick people falls on families, and within them, on women. The traditional division of labor assigns men the role of economic providers and women that of caregivers. Women endure long hours of unpaid work, combining caregiving with domestic chores, which affects their access to free time and educational and employment opportunities, and impacts their physical and emotional health, as well as their economic autonomy. This article seeks to assess the burden and economic value of caregiving in hematological cancers from a feminist economics perspective, highlighting both its magnitude and the gender inequalities surrounding it.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

This article summarizes the findings of the study “The Value of Care and Support in Hematologic Cancers” (Prieto Rodríguez & Franzoni Lobo, 2025). This study aimed to generate evidence on the economic and social costs of caring for people with hematologic cancers—which are primarily borne by women—and to demonstrate its impact on those carer’s health, well-being, and autonomy. The study identifies the main support needs of caregivers and proposes public policies that promote a more equitable distribution of care, recognizing its value and relevance.

The central hypothesis holds that the unequal distribution of care work directly impacts treatment adherence among patients and negatively affects the physical and emotional health of those that care for them, perpetuating gender inequalities in the domestic, social, and economic spheres. This hypothesis is based on evidence that the feminization of caregiving, in addition to being a physical and emotional burden, restricts women’s development opportunities, consolidating a cycle of structural inequality.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

THE UNEQUAL DISTRIBUTION OF CARE WORK DIRECTLY IMPACTS TREATMENT ADHERENCE AMONG PATIENTS AND NEGATIVELY AFFECTS THE PHYSICAL AND EMOTIONAL HEALTH OF THOSE THAT CARE FOR THEM

METHODOLOGY
The study consisted of a mixed design that combined quantitative and qualitative analysis. The quantitative phase used national databases such as the National Survey for the Care System (ENASIC, INEGI, 2022), the National Survey of Demographic Dynamics (ENADID, INEGI, 2024), and the Satellite Account of Unpaid Household Work (CSTNRHM, INEGI, 2023). These sources made it possible to estimate the magnitude of unpaid work, its gender differences, and its economic value within the gross domestic product, providing a comprehensive overview of the social and economic impact of caregiving.

The qualitative phase complemented these findings through interviews and focus groups. 33 caregivers—23 women and ten men—were interviewed, along with four in-depth interviews with key caregivers and three interviews with healthcare professionals, including two hematologists and a social worker.

CONCEPTUAL FRAMEWORK
Caregiving is both a universal need and a human right. It encompasses not only basic subsistence activities—food, hygiene, and household cleaning—but also healthcare, emotional support, and assistance in daily life. Historically, it has been rendered invisible by being considered a “natural” extension of the female role, which has limited its economic, social, and political recognition.

Feminist economics challenges this invisibility and recognizes that care is essential for the reproduction of life and the economic system. Authors such as Nancy Fraser (2016) and Silvia Federici (2010) have pointed out that the devaluation of care perpetuates structural inequalities, particularly affecting women from different socioeconomic backgrounds. In Latin America, this debate has led to regulatory advances: Uruguay implemented the National Integrated Care System in 2015, and Ecuador approved the Organic Law on Human Care in 2023, which recognizes care as a fundamental right. In Mexico, initial steps have been taken with the 2020 constitutional reform that recognizes the right to care, although its effective application remains limited and fragmented.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

OVERVIEW OF HEMATOLOGICAL CANCERS IN MEXICO
Hematological cancers represent a growing public health problem. According to data from the International Agency for Research on Cancer (part of the World Health Organization; IARC, 2022), the most common cancers in Mexico are Hodgkin lymphoma, leukemia, and multiple myeloma. In terms of mortality, leukemias account for the highest burden, with more than five thousand deaths annually.

The complexity of these conditions lies in the fact that they require prolonged and expensive treatments, frequent hospitalizations and, in many cases, bone marrow transplants. This procedure, although potentially beneficial, entails serious risks, such as Graft-versus-Host Disease (GVHD), and has higher postoperative mortality rates than in developed countries or advanced economies. The impact is not limited to the clinical dimension. Constant travel and expenses for medications and accommodation place families in situations of debt and vulnerability, making of care an individual, collective, and structural challenge.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

MEASURING CARE WORK IN MEXICO
The economic measurement of caregiving allows us to gauge its importance. According to the CSTNRHM (INEGI, 2023), unpaid work represented 24.3 percent of GDP in 2022, a figure that exceeds sectors such as manufacturing and commerce. Women provide almost three-quarters of the total time dedicated to caregiving, with an average of 40 hours per week, while men dedicate less than half. Furthermore, 28 percent of female caregivers have had to leave or change their jobs, compared to eight percent of men. The impact on health is also evident: more than a third of them report anxiety, insomnia, or severe stress.

In the case of hematological cancers, interviews reveal that caregivers can spend up to fourteen hours a day, which exacerbates physical and emotional strain. Although the right to care was constitutionally recognized in 2020, the creation of the National Care System is still pending.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

COSTS OF PAID CARE
If the work of caregivers for people with hematological cancers was paid, it would range between 12 and 20 thousand pesos per month and could reach up to 30 thousand pesos in situations requiring intensive care, such as bone marrow transplants or GVHD management. This care includes administering medications, monitoring clinical signs, providing emotional support, and coordinating medical attention. For most households, hiring specialized personnel is inaccessible, which deepens the feminization of poverty.

SOCIODEMOGRAPHIC PROFILE OF CAREGIVERS
The profile of the caregivers interviewed confirms the feminization of caregiving. Most are women between 40 and 50 years old; mothers, wives, or sisters of the patient. More than half have had to leave their jobs or reduce their hours, affecting household income. While women work up to fourteen hours a day, male caregivers dedicate between six and eight hours, often maintaining their role as economic providers. The emotional impact of caregiving is profound, and female caregivers report elevated levels of anxiety and social isolation, while men express difficulties balancing caregiving with paid work.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

CAREGIVERS’ EXPERIENCES
Caregivers describe exhausting days, and many report having had to leave their jobs and, without their own income, rely on family support. Their main needs include direct financial support, specialized respite care that allows them time to rest, and psychological support to manage emotional exhaustion.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

PUBLIC CARE POLICIES
Several Latin American countries have made progress in recognizing care as a right. Uruguay implemented a national system in 2015, and Ecuador passed a law in 2023 recognizing it as non-transferable and non-waivable. These experiences show that it is possible to build co-responsible models that involve the State, the market, communities, and families.

In Mexico, the 2020 constitutional reform represented a crucial step, but the implementation of the National Care System faces problems such as insufficient coverage, a lack of funding, and institutional fragmentation.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

DISCUSSION AND RECOMMENDATIONS
Analysis confirms that hematological cancers intensify the burden of caregiving, which falls primarily on women, with consequences for their health, economic autonomy, and well-being. The invisibility of caregiving in public policies maintains a cycle of inequality that limits the quality of life of both those with illness and those who care for them.

In response, several lines of action are proposed:

1. Implementing public financial compensation policies for caregivers based on statistical and qualitative data.


2. Creating public care services with temporary stays and respite programs.


3. Establishing healthcare training and certification programs that improve the employability of caregivers.


4. Guaranteeing free psychological support and promoting the organization of community support networks.


5. Allocating a specific and sustainable budget to the National Care System, also involving the private sector.

Image from the exhibition: Living with hematological cancers: stories of resilience
Picture: Unidos Pro Trasplante de Médula Ósea

CONCLUSIONS
Caring for people with hematological cancers in Mexico constitutes a complex phenomenon that transcends the medical field. It is deeply marked by gender and class inequalities, with women enduring most of the burden and sacrificing their health and autonomy.

Although care work represents more than a fifth of GDP, it remains unrecognized and uncompensated. The high cost of paid care makes it inaccessible to most households, reinforcing dependence on unpaid care. Mexico faces the challenge of moving from formal recognition of the right to care to the effective application of a National System that incorporates a gender perspective. This requires investment, political will, and a comprehensive approach that places the well-being of people with cancer and their families at the center, while reducing structural inequalities.

Recognizing care as a right and collective responsibility is essential for moving toward a more just, equitable, and sustainable society, where sick people and their caregivers receive comprehensive support without women being solely responsible for a task so vital to society.

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