Distribution of Care
Measuring the transmission of care between those who provide it and those who need it.
Care Capacity and Inequality
To understand how care needs are met across the U.S., we begin by measuring the balance between those who need care and those who can provide it. Two key metrics help us assess this:
Gini Coefficient of Care Jobs
Overall

2022 |
0.74 Inequality in the distribution of care jobs
0.74
low
high
Source: ACS 5-Year Estimates; CPS ASEC & 5-year pooled ATUS (excluding 2020), US Census Bureau via IPUMS; Longitudinal Employer Household Dynamics; Workforce Area Characteristics, US Census Bureau.
The Gini Coefficient of Care Jobs measures how paid care jobs are geographically distributed across the U.S. among those individuals at risk of needing care. A Gini Coefficient is a measure of resource distribution across a population. It is often used to measure income inequality, but here we use it to measure spatial inequality of paid care services to the population(s) most at-risk of needing those services. A Gini Coefficient of 0 indicates perfect equality, meaning paid care jobs are evenly distributed in areas where the at-risk individuals reside. A higher Gini Coefficient signals a greater mismatch in the availability of care by location.
The Care Ratio
Overall

2021 |
0.59 Weighted working-age individuals to dependents
0.59
undersupply
oversupply
Source: ACS 5-Year Estimates; CPS ASEC & 5-year pooled ATUS (excluding 2020), US Census Bureau via IPUMS; Longitudinal Employer Household Dynamics; Workforce Area Characteristics, US Census Bureau.
The Care Ratio compares the number of individuals needing care—children, disabled, and elderly adults—to the number of available able-bodied adult caregivers in both the paid and unpaid economy. A Care Ratio of one means there is one potential caregiver for every person at risk of needing care. A ratio below one indicates more people at risk of needing care than available potential providers. A ratio above one implies more people potentially available to provide care compared to those at risk for needing care.
The Sandwich Generation
The sandwich generation refers to those caring for an elderly individual, usually a family member, while also supporting their own children under age 10. These individuals shoulder unique responsibilities and complexities that set them apart from other caregivers. This dual care load can lead to increased pressures impacting caregiver well-being.
Sandwich Generation: Population
Overall

2023 |
5.5M Working-age adults caring for a child and an elderly adult.
2%of all adults
Source: Yearly 5-year pooled ATUS (excluding 2020), US Census Bureau via IPUMS
The Sandwich Generation Population tracks individuals who live with their own child under age 10 and spend at least one minute providing unpaid care for an elderly person needing support because of a condition related to aging. We present this both as a count and as a percentage of the total adult population.
Sandwich Generation: Daily Caregiving Hours
Overall

2023 |
49M total hours per day
9 hrsmedian time per day per caregiver
Source: Yearly 5-year pooled ATUS (excluding 2020), US Census Bureau via IPUMS
Daily Caregiving Hours estimates the median hours per day spent in care activities for sandwich caregivers, computed using only responses from sandwich caregivers (as defined above) from the IPUMS ATUS.