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 Formal Care
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 Formal Care measures how formal care jobs are geographically distributed across the U.S. among those individuals at risk of needing care. A Gini Coefficient of 0 would indicate perfect equality, meaning formal care jobs are evenly located in areas where at-risk individuals reside. A higher Gini Coefficient signals a greater mismatch in the availability of care by location. A Gini Coefficient usually measures income inequality, but here we use it to measure spatial inequality of care services to the population most at-risk of needing those services.
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, & elderly adults—to the number of available able-bodied adult caregivers in both the formal and informal economy. A Care Ratio of one means there is one caregiver for every person in need. A ratio below one indicates a higher number of people in need of care for each available provider. A ratio above one is a higher number of people available to provide care than those 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

2024 |
5.3M 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 the number of adults balancing the responsibilities of caring for both a child under 10 and an elderly adult.
Sandwich Generation: Daily Caregiving Hours
Overall

2024 |
48M total hours per day
8.7 hrsmedian time per day per caregiver
Source: Yearly 5-year pooled ATUS (excluding 2020), US Census Bureau via IPUMS
Daily Caregiving Hours estimates the number of hours per day that Sandwich Caregivers spend providing care.