In general, research has shown that rural communities face serious shortages in health care workforce. This is especially concerning, as rural areas are aging at a faster rate than the rest of the country, and therefore have particular needs for a robust long-term care workforce. Women make up the vast majority of the health care workforce, including more than 90 percent of all nurses and health care paraprofessionals, such as home health care aides — which make up the backbone of the long-term care workforce. Efforts to recruit and retain health care workforce in rural areas tend to focus on individual-level initiatives, such as loan forgiveness and provider training, rather than on broader family and community issues like access to child care.
In a new study in the Journal of Community Health, researchers in the School of Public Health at the University of Minnesota found fewer than one-third of all children under the age of five living in rural Wisconsin counties had access to an available slot in a licensed child care facility (either center or family-based), compared to nearly half of children under the age of five living in urban and suburban Wisconsin counties.
“Our findings are concerning not only because of the effects they have on rural area children but also because this could act as a deterrent for health care professionals who have families or intend to start a family, to relocate to rural areas,” said Carrie Henning-Smith, Ph.D., M.P.H., M.S.W., lead author and research associate at the University of Minnesota Rural Health Research Center. “In order to address health care workforce shortages in rural areas, it is essential that policies focus on broader community and family contextual issues, including the availability of child care.”
Henning-Smith says that if rural areas have fewer licensed child care slots, it also has the possibility to limit the success of “home-grown” rural health care workforce initiatives which attempt to recruit and train individuals already living in rural communities.
The study found no association between women’s labor force participation and child care availability. In contrast, the study found the availability of child care was significantly associated with men’s labor force participation, and not in the way one might expect. The study found the more hours men worked, the more limited the child care availability. Henning-Smith says that it should be concerning that child care availability does not seem responsive to women’s labor force participation.
“Prior research has shown the availability of child care is positively associated with women entering the workforce. Given that women make up the majority of the health care workforce, increasing the availability of child care could make a difference in enticing women already living in rural areas to enter the health care workforce,” she said.
“Child care shortages are important everywhere, but the burden of these shortages falls disproportionately on rural families and rural communities,” said Katy Kozhimannil, Ph.D., co-author and associate professor in the School of Public Health. “Rural towns have many benefits and strengths for raising a family, but it’s hard to recruit professionals with young children without high quality child care options available. This evidence is part of the broader conversation on work and family for American women and men.”
Like the rest of the country, Minnesota faces shortages in health care workforce. Increasing the availability, affordability and quality of child care may provide an avenue for helping to address this shortage. Unfortunately, data was not available on the number of licensed child care slots for Minnesota children. In order to address child care issues and workforce shortages on a national scale, it may be necessary to collect and report uniform measures of child care availability, affordability and quality across the country.
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