# Care as a Central Concept: Dimensions, Inequalities and Challenges in Chronic Care in Contemporary Societies: A Narrative Review

## TL;DR

This paper explores how care, especially in chronic healthcare, is shaped by work, emotions, and power, and argues for policies that recognize and redistribute care as a collective responsibility.

## Contribution

The paper introduces a transformative feminist analysis of care, emphasizing its material, subjective, and political dimensions in chronic healthcare systems.

## Key findings

- Care is a structural and political phenomenon that sustains life and healthcare systems.
- Chronic care requires addressing the material, emotional, and political aspects of care simultaneously.
- Global care chains reveal persistent inequalities based on gender, class, and race.

## Abstract

What are the main findings?
Care is a structural, political, and transnational category that sustains life and healthcare systems.A transformative analysis of care must address its material dimension (as work), its subjective dimension (including emotional bonds and moral responsibility), and its political dimension (shaped by power relations).

Care is a structural, political, and transnational category that sustains life and healthcare systems.

A transformative analysis of care must address its material dimension (as work), its subjective dimension (including emotional bonds and moral responsibility), and its political dimension (shaped by power relations).

What are the implications of the main findings?
Advancing towards policies of social co-responsibility is essential, not only by promoting caring masculinities but also by strengthening public services, professionalizing the care sector, and formally recognizing care work.Further research is needed to promote the recognition, redistribution, and socialization of care, which are essential for social justice and for safeguarding the dignity of both caregivers (predominantly women) and care recipients.

Advancing towards policies of social co-responsibility is essential, not only by promoting caring masculinities but also by strengthening public services, professionalizing the care sector, and formally recognizing care work.

Further research is needed to promote the recognition, redistribution, and socialization of care, which are essential for social justice and for safeguarding the dignity of both caregivers (predominantly women) and care recipients.

Background/Objective: Feminist theories and feminist economics have contributed to making visible the structural relevance of care work in sustaining capitalist societies and social reproduction, arguing that care must be addressed as a political phenomenon rather than a merely domestic issue. This perspective is particularly pertinent in contemporary healthcare, where chronic care represents one of the major public health challenges in a context of population ageing and increasing prevalence of chronic diseases. The aim is to contribute to a critical understanding that can support the development of public policies recognizing care as a fundamental pillar of socio-healthcare provision and as a matter of collective responsibility. Methods: A narrative literature review with a critical feminist approach was conducted using PubMed/MEDLINE, Scopus, and Web of Science. Results: A total of 299 records were identified, of which 30 studies were included following screening and eligibility assessment. Care is an essential element for sustaining life, although it has historically been rendered invisible, feminized, and relegated to the private sphere. Chronicity requires simultaneous consideration of the material dimension of care (as work), the subjective dimension (including emotional bonds and moral responsibility), and the political dimension (shaped by power relations). Global care chains reveal persistent inequalities related to gender, class, and race. Conclusions: Care is a structural, political, and transnational category that sustains life and healthcare systems. In the field of chronic care, the recognition, redistribution, and socialization of care are essential for achieving social justice and for safeguarding the dignity of both caregivers—predominantly women—and care recipients.