Health, Well-being, and Supportive Services for Caregivers by Rural-Urban Location

Informal caregivers (sometimes called “unpaid” or “family” caregivers) make up the vast majority of all care provided in the U.S., yet their labor often goes unseen and undervalued. Such caregiving takes many forms, including caring for an older adult requiring long-term services and supports, caring for an adult with a long-term disability, or caring for children, especially those with special health needs. As of 2020, an estimated 21% Americans (53 million) are currently caring for a loved one; this is an increase over the previous five years, and the actual number is likely even higher.

In a 2017-2018 University of Minnesota Rural Health Research Center project focused on the health and well-being of caregivers, we found that rural and urban caregivers alike report relatively high levels of caregiver burden and poor health. Yet, rural caregivers had unique challenges to accessing supportive services and those who were employed also had less access to flexible work policies and supportive services through work. Rural residents have higher rates of disability and chronic conditions, older age structure, and fewer formal direct care workers per capita, all of which can lead to increased need for informal caregiving support in rural areas relative to urban areas. The COVID-19 pandemic likely exacerbated these issues, and more updated information on the health, well-being, and access to services for rural caregivers is urgently needed to inform policy, programs, and resource allocation.

Building on our prior caregiving project, this project will answer the following research questions:

1. Are there differences between rural and urban caregivers in socio-demographic, health, and well-being characteristics, as well as in their access to, interest in, and use of supportive services? 1a.) Do rural caregivers experience different health outcomes depending on the type and extent of care they provide?
2. Do caregiver characteristics and access to services differ by state-level rurality?
3. What new and emerging models are available to support the health and well-being of rural caregivers?