Rural and Urban Differences in the Trends in Supply of Home Care Workers From 2015 to 2024

Background Given the rapidly aging population in the United States and preferences to age-in-place, demand for direct care workers in the home will increase. Yet, it is unclear whether labor supply will meet demand, particularly in rural areas. Objective To describe differences in home care worker supply and demand by rurality and temporal trends between 2015 and 2024. Methods Repeated cross-sectional description of the supply of care workers serving adults 65 and older with functional impairments in the United States using 2015-2024 American Community Survey data. Results From 2015 to 2024, the national supply of home care workers increased by 6.0% (95% CI: [2.6%, 9.4%]). Relative supply in metropolitan areas increased 7.3% (95% CI: [3.6%, 11.0%]) and decreased in rural areas by −10.3% (95% CI: [-19.7%, −1.0%]). While potential demand for care increased in both rural and metropolitan areas over this period, the number of care workers increased only in urban areas.