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130 Monthly Lab. Rev. 20 (2007)
Caring for America's Aging Population: A Profile of the Direct-Care Workforce

handle is hein.journals/month130 and id is 860 raw text is: Caring for America's aging population: a profile of the direct-care workforce Direct-care workers constitute a low-wage, high-turnover workforce with low levels of health insurance; taking these characteristics into account guides the challenge of how to deal with the growing demand for long-term care by an aging US. population Kristin Smith and Reagan Baughman Kristin Smith is a family demographer at the Carsey Institute at the University of New Hampshire, Durham, NH; Reagan Baughman is an assistant professor in the Department of Economics at the same university. E-mail: kristin.smith@unh. edu or reagan.baughman@ unh.edu etween 1970 and 2004, the labor force participation of American women rose from 43.3 percent to 59.2 percent,1 and one of the consequences was the develop- ment of a category of workers paid to provide care for children and the elderly who had pre- viously been cared for in the home. Over the same period, the life expectancy of men grew by 8.1 years and the life expectancy of wom- en rose by 5.7 years,2 trends that increased the demand for both medical and personal care for the elderly. In 1999, 16 percent of Ameri- cans over the age of 65 required some form of long-term care, and the majority received that care in home- or community-based settings rather than in nursing homes.3 Today, direct-care workers provide the majorityofpaid hands-on care,supervision,and emotional support to the elderly and disabled in the United States. These paraprofessional workers hold a variety of job titles, including personal care assistant, home care aide, home health aide, and certified nursing assistant. They work in diverse settings, such as private homes, adult day centers, assisted-living residences, hospitals, and nursing homes. Depending upon their job title and the setting, a direct-care worker's tasks may include providing medical oversight, administering medications, and measuring vital signs; as- sisting with personal care activities, such as bathing, dressing, toileting, and eating; providing comfort and companionship; and shopping, preparing meals, and cleaning the house.4 As the baby-boom cohort nears retirement age, the question of how to provide necessary health care and personal services to a growing elderly population has become a concern in the United States and oiher industrialized nations. This article uses the 2006 Annual Social and Economic Supplement to the Current Population Survey (CPS), together with linked data from the 2005 CPS and 2006 CPS, to provide an economic and demo- graphic profile of the current U.S. direct-care workforce.' The resulting portrait is one of a low-wage workforce with correspondingly low levels of health insurance coverage and high levels of turnover.-he final section of the article discusses the potential implications of low pay and high turnover for the provision of long-term care to America's elderly population in the future. Demographic profile In 2006,2.7 million workers 19 years or older were employed in direct-care occupations, constituting 2 percent of the American workforce. The majority of direct-care workers are employed in long-term care settings rather than hospitals, and the largest occupational group is home health aides, who make up 42 20 Monthly Labor Review • September 2007