At the Intersection of Urban and Care Policy: The Invisibility of Eldercare Workers in the Global City

Abstract

Demographic aging can alter physical and social infrastructures in cities, and reshape the broader dynamic processes that theories of urbanization seek to describe and analyze. We argue that both urban and eldercare policy often render paid reproductive labor and the workers who do it invisible. They are invisiblized in both policy and urban space. A neoliberal bias in urban policies, reconstructed in the rhetoric of global cities/creative cities, denies care needs. Normative approaches exacerbate this issue, as in gendered ideologies of home, care and familial responsibility. These approaches too often detach the delicate social problem of eldercare in itself from its feasibility and desirability as a site for paid labor. In that separation, the paid workforce typically disappears from the spotlight. We use comparative case studies and the concept of territorialization to refocus on the urban context of paid eldercare work in two “aspiring” global cities, Shanghai and Vancouver.

Keywords

migration/immigration political economy social and spatial exclusion work

Introduction

The global population is both urbanizing and aging. Consequently, urbanization as a set of processes and logics is coeval with demographic shifts and changing relations of social reproduction, including the growing need for paid caregivers for older people. Nevertheless, while feminist urban scholars and migration researchers have drawn much-needed attention to reproduction/care (Krueger and Savage, 2007; McDowell et al., 2009; Scarpa, 2016; Yeoh and Huang, 1998, 2014), bias in urban policy, reconstructed in the rhetoric of the global city, makes paid and unpaid reproductive labor invisible (Armstrong et al., 2008) and denies care needs. At the same time, the role of urbanization in shaping the labor market for paid eldercare work is often underexplored in research by scholars of care labor. The invisibility of especially lower-paid eldercare¹ work and workers, and their importance to “aging” global cities, thus often eludes both urban research and care research. This does not mean that policymakers do not “see” eldercare workers (labor shortages, for example, are often referred to), but rather that policy ignores their needs as workers and urban residents.

Normative approaches exacerbate this issue, as in gendered ideologies of home, care and familial responsibility (Folbre, 2012). These approaches too often detach the delicate social problem of eldercare from its feasibility and desirability as a site for paid labor. Such norms and ideologies may share common features, but they also vary historically and geographically. Yet analyses of eldercare policy contexts and mobilities often read unproblematically off Eurocentric scripts that assume particular histories of state provision and decommodification where state, market and family meet. In this sense, analyses of urban and demographic change share some important blind spots.

Making paid eldercare workers visible through comparative research on urban contexts thus contributes to understanding wider themes relevant to the study of care labor: precarious employment; urban neoliberalization and insecurity; and the social dimensions of urban sustainability. It also contributes to “experiments” in comparative urbanism that might “move beyond many of the ethnocentric assumptions currently embedded in urban theory […] by, at the very least, exposing analyses to insights from different urban experiences” (Robinson and McFarlane, 2012: 767). Our method and choice of case studies for our comparison of eldercare and urban policies – Vancouver, Canada, and Shanghai, PRC – pushes against the “strict methodological propositions of comparative research […] which have functioned to restrict comparisons primarily to cities that are already assumed to share certain specified commonalities” (Robinson, 2011: 2–3). Our goal is to explore the context of paid eldercare work where social and urban policy intersect. The concept of the aging city, which is slowly gaining policy traction (OECD, 2008), demands critical attention from scholars of care and urban theorists, but will yield narrow comparative insights if approached only within (rather than across) existing categorizations like care regimes. Moreover, a “trans-Pacific” approach (Doucette and Park, 2017) highlights deep and intensifying connections between “aspiring” global cities like Shanghai and Vancouver, shaped by reciprocal flows of people, commodities, capital and knowledge. In other words, not only can comparative work on urban and social care policies help foreground the elision of under-valued, often feminized and racialized labor in global cities, but it can help decenter “the West” or “the Global North” as the implicit starting point for such research.

Following our discussion of eldercare policies and their implications for lower-paid workers, we use the concept of territorial urbanization (Cartier, 2015) as a starting point for thinking through how urban policy, development and discourse interact with care policy to shape labor markets and conditions. Beginning with Cartier’s insights into the importance of territorialization for understanding urban transformation in China, we argue for a relational comparative framework for examining both policy logics and the process of territorialization itself. To do this, we build on recent contributions to critical comparative urbanism that expose discourses and policies that shape and justify urban planning priorities in “aspiring” global cities like Vancouver and Shanghai, from which care and social reproduction are often glaringly absent.

Eldercare Policy in “Aging” Cities: Vancouver and Shanghai

A common discourse is that demographic aging is creating crises of care in many places. Long-term care systems, and their categorization and analysis, often take place at national or regional scales – for example in analyses of care regimes (Bettio and Plantenga, 2004; Brennan et al., 2012). Policy-making also concentrates at the national and sub-national (state, provincial, and canton level) scales, even though infrastructure and services are inherently local – as are the lived experiences of aging and care. Cities are increasingly impacted by demographic aging and related crises of care, and are also shaping solutions through devolved responsibility for the planning, implementation and maintenance of social and physical infrastructures. Moreover, as migration both drives and offers “fixes” for crises of care, not only countries and regions but cities are increasingly linked by flows of people, investment capital and expertise (Doucette and Park, 2017).

Paid eldercare workers are thus both vital to and marginalized by “aging global cities”. Care policy, like urban policy (and when analyzed alongside it), offers insights into how urbanization and social reproduction are imbricated, but also how policy can work to conceal the reproductive labor that makes “care” possible in urban contexts. At the same time, however, localized and more generalized labor and skills shortages can trigger a policy focus on eldercare workers in specific geographic and occupational niches – especially in the context of skills, training and targeted migration programs – even when broad policy discourses gloss the importance of “low-skilled” homecare and support workers.

Eldercare Policy in China

Chinese policy-making rests on a government-driven framework with multi-level implementation. Under central one-party rule, Beijing issues policy documents as guidelines. It is up to the sub-national governments to implement those policies. In a policy environment in which economic development has long been central and non-negotiable, social policy is generally a crisis management tool. Thus, aging policy has responded to the government’s understanding of China’s demographic crisis, exacerbated by the now-abandoned one-child policy. The official Chinese understanding of senior care is based on Confucian family ethics, which presupposes that family members lead in senior care in a household setting, with care labor usually going unpaid (Yang, 2016). Senior care was not covered under the former “iron rice bowl” either. Long-term care outside the family was considered a normative anomaly. Thus the need for non-family eldercare assistance is associated with an underlying failure of care, and thus with social relief and poverty alleviation.

At the same time, accelerated urbanization; opening-up to foreign direct investment; demographic pressures, including the one-child policy; and rural to urban migration together have fractured and undermined extended family households and norms of familial care. This reality is only now sinking in among policymakers, and can run up against the government’s recent rehabilitation of Confucian norms for social policy (Chen, 2009). Only in the current Five-Year Plan (2016–2021) did the government propose to explore long-term care, and tellingly, no separate agency currently heads up its delivery (The National People’s Congress, 2016).

China’s State Council document #35 Some Opinions Regarding Speeding Up the Development of Seniors Care Service Sector (The State Council, 2013) has kick-started China’s seniors care service sector. As some of the provisions suggest, the current focus on aging policy is, if not a direct outgrowth of China’s twinned economic and urban policy fronts, certainly related to their consequences. Here the altered general context for private investment decisions is important. After the 1997 Asian financial crisis, real estate quickly became a key alternative investment. Accelerated urbanization was a key part of this strategy. By 2013, however, the domestic real estate boom had ended; the seniors care service sector is now considered a new growth engine. With policy support from State Council document #35, real estate and insurance companies in China have led the sectors investing heavily in seniors care. Top insurance companies such as China Taiping consider the senior care sector as the next big platform for investment by acquiring senior care facilities and linking selling life insurance with senior care. Top real estate companies such as Vanke, Sino Ocean, and Greentown are also turning to long-term care, but their clients are overwhelmingly wealthy. While both domestic and foreign private investment is encouraged in senior care, private facilities do not cover most seniors, who can neither afford private long-term care nor receive means-tested subsidies. Government promotes multiple sites of paid elder care provision with homecare taking up 90%; community care 7% (daycare and meal service); and institutional care 3% (seniors’ homes, and hospital care facilities with combined medical and eldercare services, including nursing and palliative care). The paid eldercare labor market thus has a mixture of private and publicly owned providers, but with services subcontracted out to private companies.²

Who pays for seniors’ care, especially long-term care, remains a thorny issue. Half of local charity lottery revenues now go to subsidize seniors’ care, and long-term care (LTC) subsidies are means-tested. The policy is increasingly to let the market lead in serving those who can pay, while government (at different levels) subsidizes care and provides preferential tax rates to encourage investment in the sector. Policy implementation is complex, however. Without a national welfare system, marked inequalities exist in pension and health care coverage, even among urban hukou holders.³ Adding complexity, the practical policy dilemmas surrounding the “aging city” are shaped by aging trends among residents with urban hukou (household registration); the latter are the main focus of demographic discourse and policy. Migrants with rural hukou are not counted in city registries or policy, even though their labor is essential to elder care. This leads directly to state policy distortions arising from the forced separation of patterns in the total population from patterns in the population with urban hukou.

The financing of welfare benefits has always been delegated in part to municipal authorities, and in part to individual workplaces or employers. Within this context, several cities (including Shanghai) have begun experiments with long-term care (LTC) insurance. As financing LTC is decentralized, different locales have different government and individual contribution schemes. Shanghai decided that during the trial period, its LTC scheme would be paid entirely from a health care surplus fund.

In turn, the payment/funding frameworks directly affect the high variation in low-paid care workers’ wages. The care workforce is composed of migrants, mostly women, over the age of 40; urban women workers who were unemployed; and rural women residents living close to urban areas, who lost their land. Recruitment agencies recruit migrant workers to work as paid eldercare workers. Community (urban government) staff recruits the unemployed to work as paid eldercare workers in agencies that are public or publicly owned, but operated by non-profit organizations. Migrants predominantly work as live-in care workers either at home or in institutional senior care facilities due to unaffordability of housing. Urban women and rural women who lost their land work as live-out care workers. In addition to lack of mobility as live-in care workers, migrants also do not enjoy government subsidies.⁴

Addressing this inequity, care workforce stability and professionalization are included in China’s Thirteenth Five-Year Plan. Like aspects of most plans, the terms of their inclusion in the central plan directly influence implementation at lower jurisdictional levels. In response to the plan, for example, Shanghai issued a policy document to build up the workforce in senior care. For “unskilled workers”, or those doing “body work” (e.g., lifting or moving patients), concrete measures included regularizing re-employment relations, providing free training, paying for transportation and income support for retraining, and providing economic incentives such as bonuses and moral incentives such as model labor rewards (Shanghai, 2017). These “investments” in low-paid eldercare workers should not be read as self-evident features of an inherently important policy area: instead, it acknowledges crisis and contradiction in Shanghai’s urban eldercare labor market.

Eldercare Policy in Vancouver

Eldercare policy in Canada is grounded in social relations that uneasily accommodate both a familial model of care and what Jane Lewis (Lewis and Gulliari, 2005) has called the adult worker model. While social care is a broad category of policy that encompasses eldercare, there is often an implicit sense that paid and/or institutional care is necessary because of the unavailability of familial care, or escalating and complex care needs that make unpaid care by family or friends unsustainable.

Healthcare and social care in Canada are delivered at the nexus of national, provincial and local (municipal or urban) levels of government. The broad framework is a public, universal insurance-based system for basic medical care within which each province has its own health insurance plan. Responsibilities for eldercare generally devolve to the provinces, although the 1984 federal Health Act covers acute and long-term medical needs as insured services that Ottawa funds. The rubric of eldercare covers a range of services and assistance that span the public/private healthcare divide (Longhurst, 2017), such as home and community healthcare, assisted living, residential care and hospital care. Homecare is uninsured under the Act, so eldercare delivered at home is not covered. Thus, while healthcare is part of the welfare state in Canada, eldercare occupies a more liminal position despite an aging population, and calls for a federal seniors strategy have gone largely unheeded.

In Vancouver, services for older residents rely on an arrangement by which the province determines the funding it will provide for services outside the Canada Health Act (home support, residential care, prescription medications, community mental health, vision and dental care). It permits user fees and changes to eligibility criteria to limit access and control public costs (Ivanova, 2017: 42), a major issue for eldercare quality and availability. The overall funding structure thus articulates with a legislative and policy framework in which provincial health ministries develop, implements and monitors provincial policy, standards and guidelines governing the health authorities in several areas, including home and community care, as well as health planning. Health authorities are administrative bodies that oversee health-care delivery to local districts, which are geographically and administratively distinct from municipalities (but in some cases overlap with them). These must plan and deliver, either directly or through contracted service providers, the programs and services appropriate to the needs of individuals assessed as eligible for home and community care. Overall priorities are set by government, and become ingrained in the strategic approaches of individual health authorities.

In health policy, there has been a shift towards community and in-home care as more seniors seek to remain in their homes for longer: in this context the rising demand for home care is expected to continue to increase as baby boomers enter and move through their senior years, and although home care exists at the margins of Medicare it is emerging as a vital component of the health system (Baranek et al., 2004). Yet the policy priorities of both provincial and federal governments during the 2000s were closely aligned with a politics and discourse of “balanced budgets” and tax cuts, which constrained government spending and justified both public sector real-terms spending cuts and the increased role of the private sector in service provision. These priorities directly shape access to eldercare services and the planning priorities of the local health authorities responsible for delivering care, with significant implications for workers in the sector. While directly-employed healthcare workers in the public sector across Canada are often unionized and relatively well-paid, this has been undermined by privatization, outsourcing and contracting out (Armstrong et al., 2008) in many jurisdictions.

This “low road” approach to the Canadian labor market was reflected in the expansion of Canada’s Temporary Foreign Worker Program (TFWP) by the federal government during the same period. The flow of migrant workers into the caregiver stream (the Live-in Caregiver Program or LCP, now called the In-home Caregiver Stream) has attracted attention for reports of exploitation and abuse (Bakan and Stasiulis, 2012; Fudge, 2014). The caregiver stream is, however, more associated with domestic workers and nannies than eldercare workers per se, and the stream permits the recruitment of live-in migrant workers for the care of children, the disabled and the elderly, making it hard to track the number of migrant caregivers specifically engaged in eldercare. The available data on Labor Market Impact Assessments (LMIAs) show, however, that in 2015 3,983 positive LMIAs were issued for caregiver positions, of which 3,045 were in National Occupational Classification (NOC) classification 6474 – Babysitters, Nannies and Parents’ Helpers (Government of Canada, 2016).

Thus, while Canada’s TFWP may play a role in shaping the labor market for paid eldercare workers in B.C. and in Vancouver, the majority of workers in the sector are workers with the right of residence in Canada – for the most part racialized and immigrant women (on home support services, for example, see Cohen et al, 2006). Privatization, contracting out and temporary agency work shape the conditions of precarious employment for eldercare workers in B.C., especially following the election of a Liberal provincial government in 2002 that actively promoted contracting out and privatization. After the government effectively tore up the existing collective agreements with unionized healthcare support workers (i.e. housekeeping and food preparation staff), wages were almost halved for many; Longhurst (2017: 13) has argued that this change was directly related to increasing the role of the private sector and creating a market for seniors community health care. At the same time, frontline staff like home support workers have seen negative changes in their pay, benefits, conditions and terms of employment. As Sharman et al. (2008: 94) found:

With restructuring, home support work in BC has become more casualized … agencies are increasingly hiring CHWs in casual or on-call positions, with unpredictable shifts and hours as well as lower wages and few or no benefits. While agencies once hired the majority of CHWs as regular, full-time employees, they may now be hiring the majority as casual workers.

Access to publicly funded care was also restricted during this period. While the majority of residential care beds in B.C. today are publicly funded, availability of publicly funded seniors’ home support dropped 30 percent between 2001 and 2016, when access fell in the five health provincial health authorities (Longhurst, 2017: 11). At the same time, the B.C. Seniors Advocate found in a 2017 report that the vast majority of residential care facilities in B.C. do not meet recommended staffing levels, and that lack of staff and staff time is a major concern for care home residents (Office of the Seniors Advocate, 2017). Recent research suggests that B.C. residents who can afford it are increasingly turning to private services, while those with lower incomes or fewer resources must rely on unpaid care (Daly and Armstrong, 2016). This shift has occurred against the backdrop of a documented decline in access to home support services in B.C.:

From the 1960s to the mid-1990s, BC was considered a leader in Canada in the provision of home support services. Today, BC has some of the most restrictive criteria for accessing basic home support services (such as meal preparation and laundry) of any province in the country. (Ivanova, 2016: 46)

These issues have raised awareness of an acute shortage of workers in B.C. eldercare, with media (Johnson, 2017) amplifying the findings of the industry organization SafeCareBC (2017). Its survey found that a majority of workers in their sample experienced understaffing, with associated worries about turnover and burnout. Another report highlighted more qualitative dimensions of this shortage: increased caseloads for home support workers, inability of workers to provide social support due to a task-oriented focus, lack of continuity in care, and a shortage of workers in related positions (especially caseworkers) (Cohen and Franko, 2015). These findings support the broader literature on feminized, racialized, low-paid home support work (England and Dyck, 2011, 2012; Armstrong et al., 2008; Armstrong, 2009), increasingly precarious under neoliberal austerity.

Urban Policy and Territorial Urbanization in Shanghai and Vancouver: Comparative Cases

As the above analysis of eldercare policies suggests, there are some commonalities in policy trajectories between Canada and China, despite quite different social, political and institutional contexts for care. One is that a growing recognition of an impending “care crisis” is not translating into comprehensive and equitable services and programs, in part because of emphases on cost containment and the expansion of the role of the private sector. In addition, this latter trend is particularly concentrated in two areas: sub-contracted care services, in both institutional and household settings; and the provision of for-profit residential care and/or seniors’ living facilities.

We argue below that given the relationship between the ongoing trends of urbanization and demographic aging – and the growing awareness of global cities as “aging cities” – urbanization is both an increasingly important context for paid and unpaid care labor, and a force shaping policy solutions, especially at the intersection of financialization and speculative real estate development. Territorialization provides a lens onto how this intersection, and the involvement of the state at different scales in creating and adopting urban policy discourses, is an increasingly important factor in urban built environments (cities) that concentrate social inequality (Walker, 2016).

Territorialization and Urban Growth in China

Carolyn Cartier argues that, in contrast to capital-centered theorizations of urbanization in capitalist economies, the Chinese party-state is of paramount importance in the theorization of China’s urbanization. Cartier thus examines the “city as an administrative division and the administrative divisions within cities” (2015: 304). City status in China is an administrative category, based on centrally managed administrative hierarchies (Liu et al., 2012). Cities also fall into discrete, hierarchically arranged sub-categories: centrally directed cities, equivalent in rank to provinces; prefecture-level cities; and county-level cities. The higher a city stands in these hierarchies, the more power it receives, the more resources it controls and the more competitive advantages it enjoys in China’s “administrative territorial economy” (Liu and Lin, 2015: 10). The system of administrative categorization of cities is an important mediating factor in shaping and guiding urban growth and urbanization. Crucially, this bureaucratic process virtually ignores social reproduction issues, such as eldercare and (thus) eldercare workers, even though it strongly shapes them, and in turn is shaped by them.

Administrative territorial economy arose from China’s transition from central planning. It is an important feature shaping a market economy in which local state agencies, empowered by the central state, become chief economic actors in their locale. Local state agencies monopolize resources such as land, raw materials and capital (the latter through state-run banks), and intervene directly in promoting local growth.

Since economic reforms in 1979, administrative divisions are increasingly governed by a profit-driven logic, whereas in the Mao era “politics was in command”. “As administrative boundary is the precondition for the spatial administrative organization of all social and economic resources, administrative divisions directly determine the spatial arrangement of territorial interests” (Liu et al., 2012: 30). Given the nature of China’s territorial urbanization, the concept of “global city” may “elide the reality that the city executes urban and economic development plans under the authority of and designated by the central government” (Cartier, 2015: 302).

In China’s administrative hierarchy, Shanghai is a city the central government governs directly. Shanghai thus occupies an important position in national economic, political and social development strategies (Liu et al., 2012: 2), and its urban policies must therefore fulfill a national mission, not merely a local one. To cite but one example, Shanghai’s Pudong New Area (1990) was established as fulfilling the national mission of turning Shanghai into an international financial center (Cartier 2015: 314).

Given Shanghai’s strategic position in China’s economic, social and political development, we situate its urban policies in China’s broader urbanization. The latter is still broadly state-led and land-based, unlike the capital-led urbanization that scholars generally assume in analyzing older capitalist economies (Cartier, 2011, 2015; Lin and Yi, 2011; Wu, 2015). Land-based urbanization rests on the local state’s continued ownership of underlying title to urban land, and its active orchestration of that title in support of rapid economic growth. Land-based urbanization means an urbanization arising from the intentional expansion of urban boundaries, specifically by converting rural land to urban for building infrastructure. It does not arise passively from urban demographic growth, because the hukou system continues to prevent migrants from becoming officially urban, and thus the objects and drivers of urban policy. China’s internal migrants continue to experience the city as a place for work alone, and not as a place to live and to raise a family. They are, however, a vital source of urban labor, including in the elderly care sector, in which migrant women often work after aging out of or being made redundant from industrial (manufacturing) work.

China has no private ownership of land. To facilitate land transfers to attract foreign investment, the central government amended the Constitution in 1988 so that land use rights can transfer by law. The Land Administration Law was subsequently amended to provide a legal base for the land and housing market (Han, 2000). China’s fiscal decentralization since 1994 has meant that subnational governments – cities and counties in particular – had to rely on land for their revenues. The urban government will first secure the transfer of the rural land to urban use before it sells the use rights to developers. Further, once the land is transferred for urban use, urban government can also use land as collateral to finance its infrastructure development by borrowing huge amounts of money from state banks (He et al., 2016: 440). While this parallels the development revenue (fees charged to developers) that feeds municipal finances in North American cities like Vancouver, the nature of land tenure in China and the direct role of the local Chinese state in land use decisions through land transfers are distinctive. Land-related revenues there made up about 49.6% of local government income in 2004, 33.5% in 2008, and 47.3% in 2012 (Saich, 2015: 239).

One consequence of land-based urbanization has been a massive and sustained real estate boom; this profits the commercial and residential long-term leaseholders and key interests associated with local state actors (Saich, 2015: 236). The spatial reorganization and representation of cities during successive reform phases demonstrated visually the shift of cities from centers of production to centers of consumption. Urban planning reflects place-promotion and image-building to attract foreign direct investment, professional workers and tourists. Cities are no longer built for workers to work and live. Mega-events such as the Olympics (Beijing) and World Expo (Shanghai) provided opportunities to finance massive infrastructure building.

For specific reasons, land-based growth in China is residential as well as commercial (Wu and Gaubatz, 2013: 85). The establishment of a formal housing market in China in the early 1990s also called for “housing insurance, finance and loan systems that would enable market-based housing development and distribution” (Wu and Gaubatz, 2013: 205). In the 1990s, the country introduced housing security schemes, but because access to most social services beyond the workplace rests on formal hukou status rather than on actual housing location, these programs are not available to the burgeoning internal migrant population.

Local government generates revenues by demolishing so-called “dilapidated housing” and urban villages where most migrants live, and by selling the cleared land at high prices to developers. At the same time, such actions generate huge demand for more housing. Developers generate massive profits by emphasizing the construction on these sites of luxurious condominiums that only wealthy urban residents can afford. Demolition generally happens in the name of urban renewal/beautification; however, such renewal/beautification tends to deprive migrants of cheaper rental housing (He, 2014). This has led to the paradox of ghost cities and vacant buildings alongside housing that is unaffordable for many urban residents and migrants (Ahuja et al., 2010; Wu, 2009; Zhang et al., 2016; Zheng et al., 2009). These processes have clear resonance with the “condo boom” in Vancouver and the contested demolition of lower-cost low-rise rental units through the redevelopment of mixed-use sites in Vancouver’s adjacent municipalities, often involving state–capital partnerships.

Shanghai shifted from a center of production to a center of consumption in the 1990s, with a massive outflow of manufacturing capacity and a rapid economic shift to finance, recreation and services. Under these pressures, Shanghai shifted to developing the tertiary sector, ultimately becoming China’s largest trade and shipping center. These moves have enjoyed considerable success on their own.

These different dimensions of Shanghai’s urbanization suggest that territorialization and urban policy are complementary but not reducible to one another. The idea of urban policy mobilities was devised to understand the institutional channels that people use to facilitate the flow of ideas and objects in the course of realizing particular material interests and with the result that particular outcomes are achieved (McCann and Ward, 2011: xxiv). The idea also helps shed light on how policy discourses develop, evolve and move through flows and networks shaping urbanization beyond the national and regional scales. Moreover, policy mobilities resist neat “silos” between inter alia urban, environmental, economic and social domains. In his work on urban policy and global circuits of knowledge, McCann (2011, 2008) argues for broadening the gaze beyond the state and capital, to recognize how practices and discourses of varied actors at multiple scales produce relational geographies of expertise, knowledge and policy. The latter shape how “the urban” is defined and governed. Critical attention to these processes also highlights who counts as the “experts of truth who create powerful narratives of cities’ relationships to each other” (McCann, 2011: 5). In this sense, the aspirations of elite actors in Shanghai and Vancouver draw them into policy circuits that emphasize top-down visions of creativity and sustainability associated with gentrification and displacement (Park, 2016), in which low-paid migrant and immigrant workers are vital but largely invisible.

Vancouver, Development and the Sustainability Agenda

At first glance, the drivers of urbanization in Vancouver seem very different than in Shanghai. Canada is a federal state, and administrative territorial economy is therefore less tied to a nested administrative hierarchy with central government at its apex. Instead, power is divided constitutionally between the federal and provincial governments, and [some] provincial powers devolve under provincial law to municipalities, especially those associated with urban planning and development. This federal system does represent (and produce) a spatial hierarchy of administrative units (federal-provincial-municipal), but not a straightforwardly nested distribution of state power, in which power “flows” from higher to lower levels. Moreover, certain domains, including transport, health and social care, and trade policy, cross jurisdictional boundaries. Processes of urbanization therefore imbricate different levels of government and scales of governance.

As David Ley (e.g. 1980, 2001; Ley and Lynch, 2014) has shown in detailed analyses of Vancouver’s urbanization, local political cultures and histories matter in the context of urban planning priorities and approaches, but still link to regional, national and global flows and processes. In particular, the tensions between aesthetic, socio-cultural and environmental priorities that manifest in “liveable” and “sustainable” city discourses on one hand, and market logics associated with pro-development boosterism, on the other, are not unique to Vancouver. But they do exhibit particular valences in the context of Vancouver’s geography and hierarchical position nationally and globally.

Consequently, urban territorialization bears on the process of urbanization in Vancouver, but differs in form from Cartier’s (2015) territorial urbanization – “party-state territorialization” – in China’s recent history. In Vancouver, for example, municipal actors sought federal and provincial support for major redevelopment of formerly industrial False Creek when real estate capital stood aside uninterested (Ley, 1980). This creation of new neighborhoods and districts contributed to a process of realizing a liberal vision of the liveable city by transforming urban planning priorities and practice with minimal reliance on market logics.

Cartier’s article does not delve into the epistemology of territorialization, describing problems of theoretical fit as a matter of research design, but describes it as: “[p]owers to name, embedded in party-state power relations and their hierarchies, are strategic technologies of territorialization through which the state produces, differentiates and ranks political-economic space among the administrative divisions” (2015: 302, emphasis added). This describes the relations between territory, politics and the governance of administrative divisions (2015: 297). But here, revisiting briefly some of the theoretical bases of territory in different disciplinary contexts helpfully reveals the range of forms that territorialization takes, and through which comparative “experiments” can be articulated.

Territory is tied conceptually to the spatiality of state power and, thus, to sovereignty (the nation) and citizenship (its polity). Yet understandings of territorialization vary in their relation to the processes through which state power is “fixed” in place. As Raffestin (2012: 126) notes in a summary of his own and other approaches to territory in different traditions, territoriality evolved as a critique of “political territory, its rigid delimitation, and the state control that is coextensive with it”, which has led critical human geographers to displace “territory” with “place”. In this sense, territorialization (alongside de- and re-territorialization) involves the social production of space, which includes but is not limited to the exercise of state power. Territorialization is related to urbanization insofar as urbanization produces, among other things, the agglomerations we call cities and related, often distinctive forms of governance. Cartier argues that this process matters distinctly in China because it is, in a sense, inverted; territorialization produces urbanization.

In the history of urbanization in Vancouver as Ley, Hutton (2004) and others view it (e.g. Holden, 2012; Rosol, 2015), territorialization arises from both capital-driven development logics and evolving local place-based politics. These often involve articulations of sustainability, liveability and participation but may be ambivalent or negative with respect to social reproduction and the needs of low-paid, often racialized, workers. The analysis of urban policy, which guides and reflects urban territorialization, spotlights these tensions and contradictions. Large-scale redevelopment in Vancouver did not end with the end of the liberal municipal regime in the late 1970s – when the federal Liberal Party also lost office. That regime’s prioritization of “social, cultural and political initiatives” (Ley, 1980: 257) over economic development may have given way to a more pro-growth agenda on the threshold of the neoliberal era. But the discourse of liveability mutated and evolved alongside the ups and downs of a real estate “market” that has seen the consistent (and contested) involvement of political actors at multiple scales (federal funding, and then de-funding, of social housing and incentives for rental apartments being salient examples). The massive and accelerating “creative destruction” of Vancouver’s inner neighborhoods and their stock of single-family housing, as well as the boom in financialized residential development, have occurred along with Vancouver’s “global” and “green” aspirations.

These dynamics are apparent in the evolution of Vancouver’s urban policy foci. The particular combination of boosterism, real estate-led economic development, and sustainability discourse that has shaped urbanization in coastal Western Canada also needs to be understood where territorialization and urban policy mobilities intersect. Here, the spatial and geographical forms that urbanization takes, and the urban-political crises these precipitate, articulate with struggles over who count as “experts of truth”. These contradictions are part of what Meg Holden (2012: 540) has identified as a movement from environmental to social sustainability in urban policy discourse in Vancouver, or what she tentatively labels “a concerted repoliticisation of the local work of sustainable development” in the greater Vancouver context. Holden notes that Vancouver’s urbanization has generated contradictions that in turn have produced a political shift from an exclusive discursive focus on environmental sustainability (despite Vancouver’s ongoing “Greenest City” Action Plan – see City of Vancouver (2015) – to a recognition that urban sustainability must incorporate social welfare dimensions. Yet the integration of social welfare policy, urban policy, and strategies of urban territorialization remains contingent and at times conflictual.

This lack of integration in Vancouver policy arises in part from care labor – paid and unpaid – being often elided in policy discourses that address both urban and social policy objectives. At the same time, epistemologies of territorialization often neglect considerations of labor, as Raffestin (2012: 128) has stressed: “We have nearly always taken account of the productions that result from the projection of labor, but never labor as such. Labor is a constitutive category of territoriality, because it lies at the origin of power.” His critique is enabled by a broad conceptualization of territoriality that emphasizes “the ensemble of relations that humans maintain with exteriority and alterity, with the assistance of mediators, for the satisfaction of their needs, towards the end of attaining the greatest possible autonomy” (Raffestin, 2012: 139). This definition can encompass, but certainly exceeds, processes of state power within its ensemble of relations.

Thus, problems of social sustainability in cities and in social care clearly overlap, but the needs and concerns of workers are often secondary in both. Relatively little urban policy addresses wages and working conditions, which are the jurisdiction of higher levels of government (on one hand) and individual employers or market forces (on the other). Vancouver’s social infrastructure plan is an example, currently in the planning phase (City of Vancouver, 2017). Social infrastructure “refers to facilities and services that help individuals, families, groups, and communities meet their social needs, maximize their potential for development, and enhance community well-being” (City of Vancouver, 2017). This would seem to include many kinds of social care. The goals of the plan are to “develop recommendations for how we can meet the needs of a dynamic city in a more strategic and sustainable way”. But it explicitly excludes services like affordable housing and hospitals which fall under other jurisdictions. And it does not address labor as a social infrastructure of urbanization and urban life, especially the paid and unpaid care labor that an aging society requires.

Conclusion

Social care work (paid reproductive labor) is among the fastest growing sectors in many urban labor markets. Much of this work is low-paid, feminized, and performed by migrants and immigrants. The workforce itself is aging: in both China and Canada, most eldercare workers are over 40. Labor and skills shortages are often the issues most visible in policymakers’ approaches to the labor market for paid eldercare. At the same time, in the context of increasing privatization and marketization, workers and their advocates point to low pay; a lack of security, benefits and adequate hours for part-time and casual workers; high rates of injury; and the pressures of heavier workloads and multiple job-holding.

Yet this sector is heavily influenced by state intervention and state policy. As our comparative relational framework illustrates, eldercare worker precarity is not simply an outcome of the recommodification of formerly public services, but rather of the market-making activities of different levels of the state, which overlap with processes of territorialization that take different forms. Urban real estate development and financialized investment in eldercare service providers are two key fronts that impact the labor market for paid eldercare work, as the recent takeover of Vancouver-based Retirement Concepts by the Chinese giant Anbang Insurance illustrates. Much more research is needed on the impacts of financialization and real estate-led accumulation strategies on the eldercare sector. Comparative case studies that also conceptualize territorialization relationally illustrate how the state, capital and workers play different roles in the form of territorialization that prevails, depending on specific configuration of local policy contexts. This argument compliments Cartier’s insights in the specificity of Chinese territorial urbanization, suggesting that struggles over definitions of sustainability in Vancouver also involve struggles over territorialization. In urban policy, the need for – and needs of – eldercare workers is largely absent, even in policy on aging cities (OECD, 2015).

As the literature on urban policy shows (MacLaran and Kelly, 2014; McCann, 2008, 2011; and on China, see Chan, 2010), territorial strategies and the production of urban space do not occur in a discursive or political vacuum. Cartier (2011) notes that comparative research on urban policy is essential to understanding variations in neoliberal urbanization, and that the importance of administrative divisions to strategies of territorial urbanization in China do not negate the discursive-political role of urban policy in that country. Likewise, urban politics in Vancouver have coalesced in recent decades around a number of urban policy “fronts”, of which control over real estate development and house price inflation are one, and urban sustainability (to which the livable cities agenda that Ley describes is related, but not reducible) is another.⁵ Sustainability and “greening” are thus key concepts to understanding the discursive strategies that accompany territorial expressions of local state power in Vancouver. Yet, “social sustainability” as still a nascent discourse and approaches to social infrastructure often ignore the role of labor.

Global policy mobilities influence the discursive framing of urban strategy, even when concepts like “sustainability” and “liveability” have distinct local valences. Thus territorializing strategies privilege particular kinds of urban economic development, for example under the rubric of “creative cities”, which exclude and sometimes displace low-paid care workers. These workers provide the care labor that both urban and care policies implicitly rely on but seldom explicitly address. More research at the intersection of urban and care policy can help expose these gaps and their implications for workers, and those who depend on their care. It can also help challenge the politics of knowledge production that determines “who counts” in urban and eldercare policy.

Footnotes

Funding

Research for this work has been supported by Social Sciences and Humanities Research Council of Canada (SSHRC) Insight Grant (#435-2016-0872).

Notes

References

Ahuja

Cheung

Han

Porter

Zhang

(2010) Are Housing Prices Rising too Fast in China? Washington, DC: International Monetary Fund.

Armstrong

(ed.) (2009) A Place to Call Home: Long-term Care in Canada. Halifax: Fernwood.

Armstrong

Scott-Dixon

(2008) Critical to Care: The Invisible Women in Health Services. Toronto: University of Toronto Press.

Bakan

Stasiulis

(2012) The political economy of migrant live-in caregivers: A case of unfree labor? In: Legislated Inequality: Temporary Migrant Workers in Canada. Montreal: McGill-Queens University Press, 202–226.

Baranek

Deber

Paul

(2004) Almost Home: Reforming Home and Community Care in Ontario. Toronto: University of Toronto Press.

Bettio

Plantenga

(2004) Comparing care regimes in Europe. Feminist Economics 10(1): 85–113.

Brennan

Cass

Himmelweit

Szebehely

(2012) The marketisation of care: Rationales and consequences in Nordic and liberal care regimes. Journal of European Social Policy 22(4): 377–391.

Campanella

(2008) The Concrete Dragon: China’s Urban Revolution and What it Means for the World. New York, NY: Princeton Architectural Press.

Cartier

(2011) Neoliberalism and the neoauthoritarian city in China – contexts and research directions: Commentary in conversation with Jennifer Robinson’s urban geography plenary lecture. Urban Geography 32(8): 1110–1121.

10.

Cartier

(2015) Territorial urbanization and the party-state in China. Territory, Politics, Governance 3(3): 294–320.

11.

Chan

(2010) Fundamentals of China’s Urbanization and Policy. China Review 10(1): 63–93.

12.

Chen

(2009) Shehui bianqianzhong de yanglao he xiao guannian yanjiu [Filial piety and the elderly support in transition China]. Beijing: Zhongguo Shehui Press.

13.

City of Vancouver (2015) Greenest City 2020 Action Plan Part Two: 2015–2020. Vancouver: City of Vancouver. Available (accessed 27 February 2018) at: http://vancouver.ca/files/cov/greenest-city-2020-action-plan-2015-2020.pdf

14.

City of Vancouver (2017) Social Infrastructure Plan. Available (accessed 27 February 2018) at: http://vancouver.ca/people-programs/social-infrastructure-plan.aspx

15.

Cohen

Franko

(2015) Living Up To The Promise - Summary Report. Vancouver: BC Health Coalition. Available (accessed 27 February 2018) at: http://bchealthcoalition.ca/sites/default/files/uploads/Living%20Up%20To%20The%20Promise%20-%20Summary%20Report%20-%20press.pdf

16.

Daly

Armstrong

(2016) Liminal and invisible long-term care labor: Precarity in the face of austerity. Journal of Industrial Relations 58(4): 473–490.

17.

Doucette

Park

(2017) Urban developmentalism in East Asia: Geopolitical economies, spaces of exception, and networks of expertise. Critical Sociology. Epub ahead of print 28 August 2017. DOI: 10.1177/0896920517719488.

18.

England

Dyck

(2011) Managing the body work of home care. Sociology of Health & Illness 33(2): 206–219.

19.

England

Dyck

(2012) Migrant workers in home care: Routes, responsibilities, and respect. Annals of the Association of American Geographers 102(5): 1076–1083.

20.

Folbre

(ed.) (2012) For Love and Money: Care Provision in the United States. New York, NY: Russell Sage Foundation.

21.

Fudge

(2014) Feminist reflections on the scope of labor law: Domestic work, social reproduction, and jurisdiction. Feminist Legal Studies 22(1): 1–23.

22.

Fudge

Strauss

(2014) Migrants, unfree labor, and the legal construction of domestic servitude: Migrant domestic workers in the UK. In: Costello

Freedland

(eds) Migrants at Work: Immigration & Vulnerability in Labor Law. Oxford: Oxford University Press, 160–179.

23.

Government of Canada (2016) Annual labour market impact assessment statistics 2008–2015 – Caregiver occupations. Available (accessed 27 February 2018) at: https://www.canada.ca/en/employment-social-development/services/foreign-workers/reports/2014/lmia-annual-statistics/caregiver.html?

24.

Han

(2000) Shanghai between State and Market in Urban Transformation. Urban Studies 37(11): 2091–2112.

25.

Zhou

Huang

(2016) Fiscal decentralization, political centralization, and land urbanization in China. Urban Geography 37(3): 436–457.

26.

(2014) Chengshihua de Zhongguodaolu [Urbanization with Chinese characteristics]. Beijing: Dongfang Publishing House.

27.

Holden

(2012) Urban policy engagement with social sustainability in metro Vancouver. Urban Studies 49(3): 527–542.

28.

Hutton

(2004) Post-industrialism, post-modernism and the reproduction of Vancouver’s central area: Retheorising the 21st-century city. Urban Studies 41(10): 1953–1982.

29.

Ivanova

Iglika

(2017) Poverty and Inequality Among British Columbia’s Seniors. Vancouver: CCPA.

30.

Johnson

(2017) ‘I can’t live like this anymore’: B.C. woman requiring home support hasn’t had bath in weeks. CBC News, 6 February. Available (accessed 27 February 2017) at: http://www.cbc.ca/news/canada/british-columbia/home-care-inhumane-calls-for-national-strategy-1.3962687

31.

Jane

Lewis

Giullari

Susanna

(2006) The adult worker model family, gender equality and care: the search for new policy principles and the possibilities and problems of a capabilities approach, Economy and Society, 34:1, 76–104

32.

Krueger

Savage

(2007) City-regions and social reproduction: A ‘place’ for sustainable development? International Journal of Urban and Regional Research 31(1): 215–223.

33.

Ley

(1980) Liberal ideology and the postindustrial city. Annals of the Association of American Geographers 70(2): 238–258.

34.

Ley

(2001) Immigration in gateway cities: Sydney and Vancouver in comparative perspective. Progress in Planning 55(3): 119–194.

35.

Ley

Lynch

(2014) Divisions and disparities in Lotus-Land: Socio-spatial income polarization in greater Vancouver, 1970–2005. Available (accessed 9 August 2017) at: http://site.ebrary.com/id/10813199

36.

Lin

GCS

(2011) Urbanization of capital or capitalization on urban land? Land development and local public finance in urbanizing China. Urban Geography 32(1): 50–79.

37.

Liu

Lin

(2015) Zhongguo Xingzhengqu Jingji yu Xingzheng Quhua [China’s administrative economy and administrative division]. Nanjing: Dongnan Publishing House.

38.

Liu

Xiong

(2012) Zhongyang Zhixia Shizhengqu Kongjian Zuzhi yu Zhidu Moshi Tanzi [Exploring spatial organization and models of centrally-directed municipalities]. Nanjing: Dongnan Publishing House.

39.

Longhurst

(2017) Privatization and Declining Access to BC Seniors’ Care: An Urgent Call for Policy Change. Vancouver: Canadian Centre for Policy Alternatives BC Office. Available (accessed 1 March 2018) at: https://www.policyalternatives.ca/sites/default/files/uploads/publications/BC%20Office/2017/03/access_to_seniors_care_report_170327%20FINAL.pdf

40.

MacLaran

Kelly

(eds) (2014) Neoliberal Urban Policy and the Transformation of the City. London: Palgrave Macmillan. Available (accessed 1 March 2018) at: https://link-springer-com.web.bisu.edu.cn/10.1057/9781137377050

41.

McCann

(2008) Expertise, truth, and urban policy mobilities: Global circuits of knowledge in the development of Vancouver, Canada’s “four pillar” drug strategy. Environment and Planning A 40(4): 885–904.

42.

McCann

(2011) Urban policy mobilities and global circuits of knowledge: Toward a research agenda. Annals of the Association of American Geographers 101(1): 107–130.

43.

McCann

Ward

(2011) Mobile Urbanism: Cities and Policymaking in the Global Age. Minneapolis, MN: University of Minnesota Press.

44.

McDowell

Batnitzky

Dyer

(2009) Precarious work and economic migration: Emerging immigrant divisions of labor in Greater London’s service sector. International Journal of Urban and Regional Research 33(1): 3–25.

45.

Mostafa

Wong

Hui

(2006) Relationship between housing affordability and economic development in Mainland China: Case of Shanghai. Journal of Urban Planning and Development 132(1): 62–70.

46.

Office of Cultural Affairs (1999) Creative City. Available (accessed 26 September 2017) at: http://vancouver.ca/files/cov/creative1999.pdf

47.

OECD (2008) Aging OECD Societies. Paris: OECD.

48.

Office of the Seniors Advocate (2017) Every Voice Counts. Victoria, BC: Office of the Seniors Advocate. Available (consulted 1 March 2018) at: https://www.seniorsadvocatebc.ca/app/uploads/sites/4/2017/09/Provincial-Results-Final-HQ.pdf

49.

Park

(2016) Urban cultural strategies in East Asia. Cities 56 (Supplement C): 130–131.

50.

Raffestin

(2012) Space, territory, and territoriality. Environment and Planning D-Society & Space 30(1): 121–141.

51.

Ren

(2014) The political economy of urban ruins: Redeveloping Shanghai. International Journal of Urban and Regional Research 38(3): 1081–1091.

52.

Robinson

(2011) 2 Urban Geography Plenary Lecture—The travels of urban neoliberalism: Taking stock of the internationalization of urban theory. Urban Geography 32(8): 1087–1109.

53.

Robinson

(2011), Cities in a World of Cities: The Comparative Gesture. International Journal of Urban and Regional Research, 35: 1–23.

54.

Robinson

McFarlane

(2012) Introduction experiments in comparative urbanism. Urban Geography 33(6): 765–773.

55.

Rosol

(2015) Governing cities through participation—a Foucauldian analysis of City Plan Vancouver. Urban Geography 36(2): 256–276.

56.

SafeCareBC (2017) New strategy is needed to address shortage of continuing care workers. SafeCare BC. Available (consulted 1 March 2018) at: http://safecarebc.ca/media-release-new-strategy-needed-address-shortage-continuing-care-workers/

57.

Saich

(2015) Governance and Politics of China. Palgrave Macmillan.

58.

Scarpa

(2016) Immigration policy regimes, welfare states and urban inequality patterns: A comparison between Malmo and Genoa. European Urban and Regional Studies 23(4): 862–877.

59.

Sharman

McLaren

A. T.

Cohen

Ostry

“”We Only Own the Hours”: Discontinuity of Care in the British Columbia Home Support System.”

Canadian Journal on Aging / La Revue canadienne du

60.

South China Morning Post (2017) China’s property developers face struggle for profits in eldercare. Available (accessed 19 October 2017) at: http://www.scmp.com/business/article/2083525/chinas-property-developers-are-learning-hard-way-eldercare-doesnt-add

61.

Shanghai (2017) Guanyu Jiakuai Tujin Benshi Yanglaohulirenyuan Duiqujianshe de Yijian [Opinions on How to Speed up the Building up of Eldercare Labor Force]. Available (consulted 4 March 2018) at: http://www.shanghai.gov.cn/nw2/nw2314/nw2319/nw12344/u26aw51017.html

62.

The National People’s Congress (2016) Outline of the 13th Five Year Plan for the national economic and social development of the People’s Republic of China. Available (accessed 13 October 2017) at: http://news.xinhuanet.com/politics/2016lh/2016–03/17/c_1118366322_17.htm

63.

The State Council (2013) Guowuyuan guanyu jiakuai fazhan yanglaofuwushiye de ruoganyijian [Some opinions regarding speeding up the development of seniors care service sector]. Available (accessed 13 October 2017) at: http://www.cadf.org.cn/html/about/gongsidongtai/527.html

64.

Vandergeest

Peluso

(1995) Territorialization and state power in Thailand. Theory & Society 24(3): 385–426.

65.

Walker

Richard A.

“Why Cities? A Response.”

International Journal of Urban and Regional Research 40, no. 1 (January 1, 2016): 164–80.

66.

(2009) Land development, inequality and urban villages in China. International Journal of Urban and Regional Research 33(4): 885–889.

67.

(2015) State dominance in urban redevelopment. Urban Affairs Review 52(5): 631–658.

68.

Gaubatz

(2013) The Chinese City. London: Routledge.

69.

Yang

(2016) Zhongguo changqizhaohu de zhengce xuanze [China’s long-term care policy choice]. Available (accessed 13 October 2017) at: http://info.bjxwx.com/a/OlderWorld/OlderIndustry/IndustryNews/2016/1223/34054.html

70.

Yeoh

BSA

Huang

(1998) Negotiating public space: Strategies and styles of migrant female domestic workers in Singapore. Urban Studies 35(3): 583–602.

71.

Zhang

Jia

Yang

(2016) Housing affordability and housing vacancy in China: The role of income inequality. Journal of Housing Economics 33: 4–14.

72.

Zheng

Long

Fan

(2009) Urban villages in China: A 2008 survey of migrant settlements in Beijing. Eurasian Geography and Economics 50(4): 425–446.