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

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12 Scopus citations


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.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalJournal of Rural Health
Issue number1
StatePublished - Jan 2019

Bibliographical note

Funding Information:
Funding: This study was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), US Department of Health and Human Services (HHS) under PHS Grant No. 5U1CRH03717. The information, conclusions and opinions expressed in this manuscript are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.

Funding Information:
Data for this study come from the Caregiving in the US 2015 data, which was a nationally representative survey of unpaid caregivers of adults (18 and older). The sample was drawn from the GfK’s KnowledgePanel (GfK SE, Nuremberg, Germany), a panel of respondents from across the United States, which is designed to be completely nationally representative. Potential respondents were invited to participate via telephone or mail and the survey itself was conducted online. For anyone without access to a computer, a laptop and internet connection was provided for the duration of the survey at no charge to the respondent. The survey was sponsored by AARP and the National Alliance for Caregiving. More information about the survey design is published elsewhere.1

Publisher Copyright:
© 2018 National Rural Health Association


  • caregiving
  • employment
  • long-term care
  • policy
  • article
  • caregiver burden
  • cross-sectional study
  • employer
  • human
  • long term care
  • major clinical study
  • personnel management
  • responsibility
  • rural area
  • telecommuting
  • workplace

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, P.H.S.


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