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This project proposes a redefinition of the concept of structural burden as experienced by caregivers supporting individuals with long-term illness. I argue that burden occurs in the navigation of care institutions and through caring in the absence of institutions. This work builds on macro theories of the gendered, racialized, and classed arrangements of care labor under neoliberal capitalism and existing approaches to theorizing the material and institutional structure of care in local situations. I analyze the impact of structural arrangements on care burdens through a thematic analysis of in-depth interviews (n=41) with Chicago area caregivers, care recipients, and mental health professionals who are mostly from communities of color. The analysis is informed by scholarship on care burdens and gender in the family. I find that racial minority and poor caregivers, who are predominantly women, experience institutional arrangements of care that create the need for supplementary care labor and can generate damage to caregivers’ personal relationships.