Half of states face growing demands on unpaid family caregiving
A study warns the problem is greatest in Florida, California and Texas
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Key Insights
- Florida, categorized as “critical” on the scorecard, has a caregiver valuation of $60.6 billion — surpassing the economic impact of Walt Disney World Resort.
- California, categorized as “high-risk” on the scorecard, leads the nation with a state caregiving valuation of $122.3 billion, more than double the state’s $59 billion agriculture industry.
- Texas, categorized as “high-risk” on the scorecard, has a caregiver valuation of $62.4 billion — more than four times the size of the state’s $15.5 billion cattle industry.
Seniors who plan to “age in place” in their own homes may need home care at some point. A new report suggests that’s a problem that could become a crisis.
The study by Columbia University Mailman School of Public Health and sponsored by Otsuka America Pharmaceutical found a growing national labor shortage that is reaching emergency levels, with nearly half of U.S. states at “critical” or “high risk” for strain on unpaid family caregivers.
“America’s Unseen Workforce: The State of Family Caregiving,” reveals a sobering portrait of the hidden labor sustaining the nation’s healthcare system: unpaid family caregivers. In 24 states, researchers found, the caregiving landscape is on the brink of collapse due to healthcare worker shortages, rising dementia rates, and insufficient policy support.
Value of unpaid labor
The economic value of unpaid caregiving is staggering. In states like California, Texas, and Florida, unpaid family caregivers are now generating more value than some of their largest industries:
- California: With a valuation of $122.3 billion, unpaid caregiving exceeds the state’s agriculture sector ($59 billion).
- Texas: Family caregivers contribute an estimated $62.4 billion, eclipsing its $15.5 billion cattle industry fourfold.
- Florida: Categorized as “critical,” the state’s caregiver economy is valued at $60.6 billion, surpassing even the Walt Disney World Resort’s economic impact.
“These numbers challenge us to rethink who we consider essential,” said Dr. John McHugh, the study’s lead researcher. “Unpaid caregivers are functioning as the backbone of our healthcare system without recognition or compensation.”
A major driver of this invisible labor force is the sharp rise in dementia-related caregiving, which accounts for over $340 billion of unpaid work nationally. The study estimates that even a modest 10% increase in dementia care hours would add another $62 billion to this figure, underscoring the need for urgent intervention.
The trend is particularly concerning in states with aging populations and limited healthcare infrastructure,” the researchers said. The report warns that without state-level policy action, the demands on unpaid caregivers will continue to grow unchecked.