2.2.3 Households and the state

Buurtzorg, meaning "neighbourhood care" in Dutch, is an innovative community-based approach to long-term home healthcare in the Netherlands. Buurtzorg is an example of how the state can effectively support household care.

Buurtzorg employs small nurse teams who collaboratively organise their work. These nurses form lasting, close relationships with patients, providing personalised care and taking time to listen to their needs. The Dutch government supports Buurtzorg by funding it and creating supportive regulations, though Buurtzorg is not itself a state institution. This partnership strengthens household care. The short video below describes the Buurtzorg model.

The state, covered in detail in Topic 5: The state, is a provisioning institution that provides essential services and regulates economic activity, though a state’s ability to do this varies from place-to-place. In turn, households provide some funding to the state through taxes and shape the relationship between households and the state through civic participation (Figure 1).

State support for households

States support households in a number of important ways:

• provider: states may offer universal basic services to everyone such as education, healthcare, and child- and eldercare. These services improve wellbeing and reduce the time and money households spend on caregiving, enabling caregivers to take paid work or support their communities, and thereby also strengthening markets and the commons;

• distributor: states can provide financial support to households who need it, or even a universal basic income to everyone, a strategy now being tested globally. States can fund these investments through progressive taxation on wealth and/or income, borrowing, reallocating funds, or in some cases by creating money (Topic 5: The state). Financial support for household members ensures a basic level of financial stability. Financial stability reduces household stress, allowing members to focus on caregiving and reducing economic inequality. This stability and greater economic equality improves social cohesion and can reduce wasteful aspirational consumption.

Significant state support reduces economic inequality and environmental damage while increasing human wellbeing. Countries with higher levels of state support tend to rank higher in happiness.

Conversely, minimal state support leads to less resilient households. In the United States, for example, where the state's role has been reduced since the 1970s, households are less resilient. The lack of universal healthcare means many households lack necessary care, have little savings, and experience declining life expectancy despite high average incomes and overall healthcare spending in the economy.

A notable example is the civic engagement for paid family leave in California, USA. Grassroots campaigns used advocacy and protest to convince the state to pass the country's most comprehensive paid family leave policies. This policy allows workers to receive part of their wages while on leave for family or medical reasons, directly benefiting household care and wellbeing. Civic participation can shape state policies to support households.

Concept: Systems

Skills: Research (information literacy)

Time: 30-40 minutes

Type: Individual, pairs or small group

Your state may have a range of strategies to support households, commonly referred to as social welfare or social services. 

• Do some quick research on the internet to find out how your state supports households OR

• Ask some adults in your school or community what kinds of support they get, or could get, to support meeting human needs in their households.

• Do you think that the level of state support is adequate to support households? What other strategies are being suggested in the country, or region, where you live to strengthen households?

Ideas for longer activities and projects are listed in Subtopic 2.5 Taking Action

Gender Awareness & Public Policy | Feminist Economics Part 4 - Feminist economist Jayati Ghosh explains gender is so important to consider in countries’ economic policies. Part of the video discusses how state cuts to essential services put pressure on households as a social shock absorber. Difficulty level: medium

Tronto, J. C. (2013). Caring democracy: Markets, equality, and justice. New York University Press.

Institute for New Economic Thinking (INET). (2021). Gender Awareness & Public policy: Feminist economics part 4. YouTube. https://youtu.be/cWAqtlmtrC8?list=PLmtuEaMvhDZaFEkdkLr9YTaUqKNdYGLj8

Link to Quizlet interactive flashcards and terminology games for Section 2.2.3 Households and the state

care: the act of providing what is necessary for the health, welfare, upkeep, and protection of someone or something

state: a system that provides essential public services, and also governs and regulates other economic institutions

household: a system where people living together care for each other and do domestic work, often termed the 'core economy'

regulation: a rule that guides individual or group behaviour and enforced by an authority

institution: human-made systems of rules and norms that shape social behavior

provisioning institution: a group of people and their relationships as they try to meet human needs and wants

economy: all the human-made systems that transfer and transform energy and matter to meet human needs and wants

tax: payment from individuals or organisations to the government, used to provide public infrastructure and services

universal basic services: a form of social welfare where all people receive access to free, basic services, like education and health care, funded by taxes and provided by the state

universal basic income (UBI): financial support from the state in the form of recurring payments to everyone to meet basic needs

investment: money spent for the enhancement of human or physical capabilities

progressive tax: a tax in which the tax rate increases as the taxable amount increases

wealth: the total value (stock) of someone’s assets such as money, house, or investments

income: money received from work or investments

economic inequality: unequal distribution of income and opportunity between different groups in society

social cohesion: the extent to which people in society feel connected to one another and share common values

aspirational consumption: buying products in order to increase self-esteem and social status

labour market: the market where household members sell their labour to firms who pay a wage

parental leave: time off of paid work used to care for children; can be paid or unpaid by the employer or state

subsidy: a payment made by the state to a business or individual to encourage certain behaviour

infrastructure: large scale physical systems that a society needs to function (roads, railways, electricity networks, etc)

energy: the ability to do work or cause change

resilient: able to recover after a disturbance

universal healthcare: a situation where everyone in a country has access to healthcare regardless of ability to pay

civic engagement: all the ways that people take action together to address issues of public concern

advocacy: when a person or a group expresses support for or recommends a particular policy or action

commoning: when a group of people self-organise to manage shared resources

grassroots campaign: collective action from people at a local level to get change at the local, regional, national, or international levels

system: a set of interdependent parts that organise to create a functional whole

market: a system where people buy and sell goods and services for a price.

planetary boundaries: the limits of Earth systems to absorb the impact of human activity and continue to function