Who will care for infants and toddlers? Who will care for six- and seven-year-olds when schools are not in session? How will adults keep their jobs while caring for sick children? In nations around the world, families are struggling to answer those questions, and to figure out how to earn a living while raising healthy children.

That is a key finding of the most comprehensive study ever conducted of work/family policies around the world, released today by Jody Heymann, M.D., Ph.D. of Harvard and McGill Universities. Forgotten Families: Ending the Growing Crisis Confronting Children and Working Parents in the Global Economy is the first truly global account of how the changing conditions of work threaten children, women, men and the infirm. It is based on more than 1,000 in-depth interviews, survey data from more than 55,000 families spanning five continents, and an analysis of policies in more than 160 nations.

Forgotten Families concludes that, in this era of rapid globalization, both developing and industrialized nations are failing to support working caregivers and that failure is threatening the next generation, exacerbating gender and income inequities, and undermining the world economy. Among its findings:

An estimated 930 million children under age 15 are being raised in households where all of the adults work.
An estimated 340 million of the world’s children under age six live in households in which all adults work for pay.
36% percent of families interviewed in-depth had left a young child home alone. 39% had left a sick child home alone or sent a sick child to school or day care. 27% had left a child in the care of another child.
In 66% of families where parents had to leave children home alone or in the care of an unpaid child, the children suffered accidents or other emergencies while their parents were working. In 35% of cases where children were left alone or in the care of another child, the children had suffered from developmental or behavioral problems.
Two-thirds of parents with income under $10 a day faced a choice of either losing pay because of their need to care for sick children or having to leave sick children home alone. 23% of parents interviewed took children to work, often under unsafe conditions.

“Shifts in labor, urbanization and economic globalization have caught working parents and their children in the eye of a perfect storm,” Heymann said. “At the same time that families face the greatest challenges, the ability of either workers or employers to address these problems alone has greatly diminished. We can help families and national economies survive the storm if we collectively address these problems and implement what is already known about potential solutions.”

Forgotten Families also found that:

Parents who had access to formal childcare were the least likely to have left a child home alone sick. 6% of those who used formal childcare had left their child home alone sick compared to 22% of those who only used informal care. 49% of women in the study had lost pay or job promotions or had difficulty retaining jobs because of the need to care for sick children compared to 28% of men. Poor families were less likely to be able to place their children in formal childcare centers (27% versus 52%), and it was more likely that children in poor families would be cared for in an informal setting by another child (21% versus 13%). Working conditions that allowed parents to take leave from work either due to paid leave or flexibility cut the risk of parents having to leave children home alone sick by half. 15% of parents who had either flexibility or paid leave for childcare had to leave children home alone sick, compared with 29% of parents who had neither paid leave nor flexibility.

“Nobody wins when parents are forced to make impossible choices between caring for their children and supporting their families,” said National Partnership for Women & Families President Debra L. Ness. “This study sho uld be a wake-up call for the world’s leaders, and for policy makers and employers around the world. If we care about protecting the next generation and securing our future, we cannot ignore the work/family challenges that shape life for workers throughout the world. It is past time for action. In the end, doing nothing will cost much more than finding real solutions.”

Forgotten Families offers dozens of powerful stories of individual families struggling to care for children and make ends meet. It compares social policies that have worked in rich and poor nations, identifying innovative and promising solutions.

Heymann is founder of the Project on Global Working Families and has been on the faculty at Harvard University for a decade. She currently holds a Canada Research Chair in Global Health and Social Policy at McGill University, where she is a Professor of Political Science and Epidemiology. This global research has received support from the Canadian Institute for Advanced Research, the Ford and Rockefeller Foundations.

NOTE: Sample chapters of Forgotten Families are available at http://www.mcgill.ca/ihsp/publications/.

Journalists may contact Myra Clark-Siegel to request a review copy of the book or to schedule an interview with Dr. Heymann.