Christopher Howard has written several excellent books on the welfare state. In this new book, written largely just before the pandemic, he widens his lens to analyze the social safety net in terms of what it says about the extent to which the United States is a caring society. His analysis is framed by relying very explicitly on feminist theorists of care, most especially Joan Tronto (Moral Boundaries, 1993) but others as well, including in particular Sandra Levisky (Caring for Our Own, 2014) and still others to a lesser extent such as Deborah Stone (The Samaritan’s Dilemma, 2008). This is to say that the book is thoroughly grounded in the relevant literature on the ethics of care. Howard shares with these theorists the perspective that caring is an important, if neglected, dimension of what holds any society together. Yet this is not a book about whether we should care and how. Instead, it is a book about the extent to which we do in practice, especially when it comes to our collective efforts to aid the most disadvantaged. Neither, does Howard want to argue about the theoretical issues concerning collective caring for the downtrodden. He wants instead to empirically document our collective caring efforts or lack thereof in society today. Inevitably, this documenting involves discussing in detail what the government does, since, as Howard correctly notes, most of the financing and spending comes from the government via its social welfare policies. But charitable institutions, including the churches are extensively analyzed as well. By the end we have read a book that is a compendium on the status of collective caring efforts in the United States today, one that demonstrates a yawing gap between our commitments to care for the disadvantaged and the extent to which we have fulfilled those commitments.

Howard uses Tronto’s four-part framing of care to organize the chapters about our actually existing caring beliefs, institutions, practices, and policies across the sectors of society, private as well as public, and those in-between. Tronto’s four-part approach distinguishes: 1) Caring About—as in how much attention we pay to caring about something; 2) Taking Care—focusing on who is responsible for the caring in question; 3) Caregiving—who is delivering the care; and 4) Care-receiving—as in who is serviced and how well, but also who is not. After this framing Howard examines in detail in the two main parts of the book first the evidence on the extent to which we indicate we care for others, but then in the second part also what we do to live up to those commitments. The first main section, on the extent to which we say we care about those among us who are needing assistance, Howard examines evidence regarding the public, business and labor, the churches and other charities, and public officials not just in terms of expressed opinion but also financing and related indicators of their commitment to caring for others. The chapters in the second main part of the book examine what we actually do to care for others regarding income, food, housing, medical care, and daily care. No stone seems unturned in the quest to offer what Howard calls a “bird’s-eye view” of our caring commitments to those in need and the extent to which we do or do not live up to them.

There is a ton of evidence in this book and it is impossible to fact-check it all. Even Howard says at the outset that if we find mistakes hopefully we will let him know in a “care-ful” way. Well, I would be hard put to say there are any errors at all regarding basic facts. The book is meticulously composed and documented and that in itself makes it compelling. Who Cares provides particularly important detailed evidence regarding who benefits from particular programs, especially those provided by the government for the poorest of the poor. It is most laudable that it is especially compelling in highlighting racial and ethnic disparities in accessing assistance.

Yet the assessments of our caring commitments to those in need and the extent to which we fulfill them is more open to debate regarding what we should make of these factual presentations. Who Cares is a work of empirical documentation and it should not be evaluated for its failure to engage in normative analysis. I get that. Yet, for people like me, the line between facts and norms is always fuzzy and the separation of understanding what is from what ought to be is never complete. Even Howard himself is at pains to not just highlight the extent to which the United States fails to fulfill its espoused commitments to care but that it should do better. In other words, it is no trifling fact that Howard shows that as much as we say we are committed to help the less fortunate in practice, we fall short of those aspirations and sometimes, in some areas more than others, to a devastating extent. Howard himself recognizes this and lets on his feelings about our failures especially regarding such matters as health care and nutrition assistance.

To take one example, among many, Howard’s discussion of various religious charities such as the Salvation Army struck me as somewhat circumspect. The Army has a long history of aiding the disadvantaged but also of deciding who it will serve and how. Homophobia has influenced its practices at various points, and its proselytizing to those it served has also been a flashpoint especially when using public funding. The extrinsic benefits of providing aid are undercut to some extent by the intrinsic way in which the Army delivers or does not deliver benefits. This does not get mentioned in Who Cares. In fact, the whole discussion of religious charities struck me as assiduously avoiding the issue of how religious charities have long histories of discrimination regarding who to serve (even when using public funding). Instead Howard emphasizes how religious leadership groups like the United States Conference of Catholic Bishops have consistently refused to speak in ways that reinforce the longstanding, if still persistent, invidious distinction between the deserving working poor and the undeserving nonworking poor. Their insistence in caring for all of those disadvantaged, working or not, is indeed laudable, but it does not absolve them concerning how their foster homes and other facilities have practiced discrimination and actually worse when it comes to the treatment of those they care for. Any empirical analysis, even a bird’s-eye view of our caring policies and practices inevitably must be written in a somewhat judgmental way or it is still incomplete.

Nonetheless, the “bird’s-eye” view of the social safety net as provided by Who Cares is for the most part quite edifying. In particular, by surveying caring commitments and practices across the public-private spectrum throughout society, the book’s detailed empirical analysis greatly helps to place our collective caring efforts to aid the disadvantaged in the United States into a robust context, actually making thorough assessment more possible. For this alone, the book is an important contribution to the scholarly literature and deserving of a wide audience among the broader public.