In the U.S., more than 43 million family members or friends provide unpaid care to an ailing adult or child. In addition to those responsibilities, many informal caregivers work full- or part-time, which can lead to work-family conflicts and produce stress, strain, and poor health outcomes, including depressive symptoms in these individuals. A new School of Public Health study shows the situation could be even more difficult for informal caregivers in rural areas, who often lack the workplace flexibility and support they need to juggle their many responsibilities.

The study, which was led by Assistant Professor Carrie Henning-Smith, was recently published in The Journal of Rural Health.

“The U.S. population is getting older and care needs are increasing, especially in rural areas. Meanwhile, lower birth rates, higher divorce rates, lower marriage rates, and greater workforce participation all lead to fewer available caregivers,” says Henning-Smith. “In rural areas, where resources are more scarce, the challenge of balancing work and caregiving is heightened, making it important to look at rural-urban differences in caregiver support.”

To learn more about those differences, Henning-Smith analyzed survey responses from 635 people living in rural and urban communities across the country who both work and care for a loved one.

The study showed that:

• 15 percent of employed rural caregivers have access to supportive programs, such as employee assistance programs through their workplace, compared with 26 percent of employed urban caregivers.
• Less than 10 percent of rural caregivers are able to work from home or telecommute, compared with 25 percent of urban caregivers.
• 18 percent of rural caregivers have access to paid leave, compared with 34 percent of urban caregivers.

“These findings should raise concern about the well-being of employed rural caregivers who are juggling multiple roles with less support from their workplaces,” says Henning-Smith. “As caregiving needs rise — especially in rural areas — it will become increasingly urgent to find ways to support all caregivers.”

Henning-Smith said that employers who create more supportive work environments for employed caregivers will help a large number of people, and could see greater workplace satisfaction, and less turnover from employees. Strategies employers can use to increase the level of support in their work environment could include flexible work hours, telecommuting/working from home, supportive programs, paid leave, and paid sick leave.

Policy-makers can also help ease the strain on caregivers by mandating workplace protections, such as expanding access to family leave. Additionally, they can address systemic issues, such as increasing access to broadband Internet in rural areas, so it would be easier for employers to give caregivers flexibility in how, when and where they work. Health care providers can play a role as well by being aware of a caregivers’ multiple roles and ensuring that they have the support they need to provide high-quality care while taking care of their own health.

Henning-Smith is continuing her researching by looking at rural-urban differences in support programs caregivers prefer and use.

This study was funded by the Health Resources and Services Administration’s Federal Office of Rural Health Policy.