Distribution of Care
Measuring the transmission of care between those who provide it and those who need it.
Care Capacity and Inequality
Two measures describe the distribution of formal care resources across the U.S.: the GINI Coefficient of Formal Care measures inequality in the geographic distribution of care jobs, and the bCare Resource Equity Score (CaRES) combines the Gini with a location quotient to account for regional resource availability.
GINI Coefficient of Formal Care
Overall

2023 |
0.65 Inequality in the distribution of care jobs
0.65
low
high
Source: ACS 5-Year Estimates; CPS ASEC; 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.
CaRES
Overall

2023 |
0.41 Capacity-adjusted inequality measure.
0.41
favorable
unfavorable
Source: ACS 5-Year Estimates; CPS ASEC; Longitudinal Employer Household Dynamics; Workforce Area Characteristics, US Census Bureau.
The Care Resource Equity Score (CaRES) creates a single metric combining the Gini with Location Quotient scores to adjust for regional specialization. A highly unequal state might have a lot of resources, while a highly equal state might be resource-poor. This metric captures both considerations. This metric has a linear scale applied to be on the range of 0-1. A lower score represents a more favorable distribution of resources in both total number of resources and equality of their distribution. For more info, see: Ahn, Yoonjung, and Joseph Bommarito. "Beyond “care deserts”: a new metric for mapping formal care employment equity in the United States." Humanities and Social Sciences Communications (2026).
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

2025 |
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 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

2025 |
46M total hours per day
8.8 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.
Household Bargaining
Within each household, individuals negotiate on a variety of topics ranging from who does the cooking to who tucks the child into bed. We provide two key metrics to help us understand how bargaining power has shifted, and how bargaining power can result in people being care privileged.
Maternal Financial Bargaining Power
Overall

2025 |
0.33 Mother's share of parents' combined wage and salary income
0.33
low
high
Source: Yearly CPS ASEC, US Census Bureau via IPUMS
Among married parents living with at least one child under 18, this measure shows the average share of the two parents' combined wage and salary income earned by the mother.
Care Privileged: Population
Overall

2025 |
98M 18+ adults who have care needs met by other sources
46%of all adults
Source: Yearly 5-year pooled ATUS (excluding 2020), US Census Bureau via IPUMS
The Care Privileged Population represents the number and share of adults (18+) who have the majority of their care needs handled by someone else, either through paid care or an unpaid family member. The status of care privilege allows individuals to pursue increased economic and leisure activities but comes at the cost of whoever is doing the caregiving for them.