Rural‐Urban Difference in Workplace Supports and Impacts for Employed Caregivers

• Published in: The Journal of rural health Vol. 35; no. 1; pp. 49 - 57
• Main Authors: Henning‐Smith, Carrie, Lahr, Megan
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 2019
• Subjects: Adult; Benefits; Bivariate analysis; Caregiver burden; Caregivers; caregiving; Cross-Sectional Studies; Employee assistance programs; Employers; employment; Female; Health Personnel - economics; Health Personnel - psychology; Health Personnel - trends; Humans; long‐term care; Male; Middle Aged; Occupational health; Odds Ratio; policy; Psychosocial Support Systems; Regression analysis; Regression models; Rural areas; Rural communities; Rural Health Services - classification; Rural Health Services - standards; Rural Health Services - statistics & numerical data; Rural urban differences; Salaries and Fringe Benefits - trends; Surveys and Questionnaires; Telecommuting; United States; Urban areas; Urban Health Services - classification; Urban Health Services - standards; Urban Health Services - statistics & numerical data; Work; Workplace - psychology; Workplace - standards; Workplace - statistics & numerical data; Workplaces; United States; employment; caregiving; long-term care; policy
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12309

Purpose This study examines rural‐urban differences in employed caregivers’ access to workplace supports, negative impacts of caregiving on work, and the association between work and caregiver strain, which can have negative impacts on health. Methods We used a cross‐sectional analysis of employed caregivers (n = 635) from the 2015 Caregiving in the US survey, including bivariate comparisons of caregiver characteristics, access to workplace benefits, and workplace impacts by rural‐urban location, as well as ordered logistic regression models to assess the relationship between workplace benefits and impacts and caregiver strain, stratified by rural‐urban location. Findings Employed rural caregivers had significantly fewer workplace benefits available to them (1.3 out of 5 vs 1.9, P < .001), compared with urban caregivers. In particular, employed rural caregivers were less likely to have access to telecommuting, employee assistance programs, and paid leave. For the full sample, having more negative workplace impacts was associated with greater caregiver strain (adjusted odds ratio [AOR]: 1.65, P < .001); for employed rural caregivers, using paid help for caregiving was associated with more strain (AOR: 4.39, P < .05). Conclusions More should be done to support all employed caregivers, especially those in rural locations who have more limited access to workplace supports and who may be more negatively impacted by the financial toll of caregiving and of missing work because of caregiving responsibilities. Interventions could range from employer‐initiated programs to local, state, or national policies to improve supports provided to employed caregivers in urban and rural areas.