Long-term care is facing rapid increases in worker demand as the result of an aging U.S. population. Shortages appear more severe in rural areas, with the outflow of younger people in search of employment and lifestyle supports. A large share of support for those who need assistance comes from families. However, the pool of potential family caregivers is shrinking due to smaller family sizes, lower marriage rates, and adult children living farther from parents. Moreover, the opioid epidemic has had a notable impact on older Americans, with increasing numbers of people whose adult children are suffering from opioid use disorder and a rising share of elders raising grandchildren.
This study will examine how local economic conditions and the opioid epidemic are affecting the availability of family and other caregivers, particularly in rural areas where jobs are scarce and opioid use disorder rates are high. We will analyze demographic and employment data over time using multiple data sources to track the size of the working-age population and size of the population that is at high risk for needing long-term care, employment patterns, and opioid use and misuse data. Data will be analyzed at the county level (or smaller) to the degree feasible. Analytic methods will be descriptive and also use panel data techniques such as multivariate random-effects regression.
Key Questions
- What is the ratio of working-age adults compared with older adults across U.S. counties? How has this changed over the past 20 years?
- Are there systematic patterns related to regions of the country or rural region?
- Are the ratio of working-age adults vs. older adults and changes in the ratio associated with changes in the availability of jobs?
- Is there evidence that regions with lower ratios have had a loss of younger adults due to job losses?
- Are the ratio of working age adults vs. older adults and changes in the ratio associated with overdose and opioid dependence rates?
- Are employment rates and numbers in long-term jobs associated with changes in the population ratio and opioid misuse?
For questions, contact: Joanne Spetz, PhD, Director, UCSF Health Workforce Research Center on Long-Term Care, [email protected]