Research Alert: November 28, 2022

Who Will Care for Rural Older Adults? Measuring the Direct Care Workforce in Rural Areas

Direct care workers are an essential part of supporting an aging rural population, particularly as more individuals favor aging in place over nursing homes and require in-home assistance with activities of daily living. Aging in place generally refers to older adults remaining in their homes and communities as they age, rather than relocating or moving into an institutional setting.

The purpose of this policy brief is to examine existing disparities in the supply of home health aides and nursing assistants in rural areas compared to urban areas. Using Occupational Employment and Wage Statistics data, researchers estimate the ratio of home health aides and nursing assistants relative to the population of adults (age 65+) across rural and urban areas in the U.S.

Key Findings

• There are, on average, 32.9 home health aides per 1,000 older adults (age 65+) in rural areas and 50.4 home health aides per 1,000 older adults in urban areas.
• Additionally, there are, on average, 20.9 nursing assistants per 1,000 older adults in rural areas and 25.3 nursing assistants per 1,000 older adults in urban areas.
• These findings indicate that the ratio of home health aides in urban areas relative to the older adult population is about 34.7% larger than the ratio in rural areas, and the ratio of nursing assistants in urban areas is 17.4% times larger than the ratio in rural areas.

Additional Resources of Interest:

• More information about the University of Minnesota Rural Health Research Center
• More information from the Rural Health Information Hub's topic guides: Healthcare Workforce, Home Health Services, Long-Term Care Facilities