Rural parts of the U.S. have roughly 35% fewer home health aides to assist their aging populations than urban areas do.
This is according to research from the University of Minnesota as cited by the Population Reference Bureau (PRB), a private nonprofit research organization that receives funding from the U.S. Census Bureau. Researchers found that rural areas average 32.8 home health aides per 1,000 older adults, while urban areas average 50.4 of these workers per 1,000 older adults.
Rural parts of the country not only have higher concentrations of older citizens, but they lack the professionals that will be needed to help these older adults age in place in their homes according to a July report from the PRB.
“Further, rural areas have just 20.9 nursing assistants per 1,000 older adults compared with 25.3 in urban areas — a 17% gap,” the report stated. “These differences underscore geographic inequities in the availability of care, which may constrain who is able to age in place.”
The researchers have several potential explanations for the gap, including lower wages, job quality issues and a lack of investment “in the direct care workforce, such as job training programs and financial incentives for workers.”
The degree to which the population is aging has also played a role in the availability of care, since some regions have higher numbers of older residents than others.
“Regionally, New England, home to some of the oldest states in the country, has among the lowest ratios of home health aides and nursing assistants — in both rural and urban areas,” the report explained. Co-authors of the original research attribute this to “population demographics” which are “driving their direct workforce supply.”
Some states have initiated efforts to increase the size of the direct care workforce to address these kinds of shortages, including “wage increases, health insurance options, and free and accessible training,” the report explained.
The lack of a direct workforce supply has resulted in friends and family members of older residents in these parts of the country aiming to fill in the gap.
“The United States has experienced profound demographic changes — in marriage, partnering, fertility and family size, stepfamilies, and kinlessness,” the report said. “These trends affect the number and type of family members who can care for Americans as they age.”
