In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. One is a shortage of caregivers and direct support professionals, which is likely to get worse.
It is estimated that more direct care workers will be needed in the next decade and beyond. The Bureau of Labor Statistics projects 3% employment growth in the average occupation 2023-2032, but 22% for home health and personal care aides, with about 700,000 openings projected annually. One 2017 estimate from MIT researcher Paul Osterman predicted a shortfall of 151,000 paid direct care workers by 2030 and 355,000 workers by 2040. Chronic shortages have been exacerbated by the pandemic. More than half of nursing homes surveyed in 2022 reported that they limited new patient admissions due to nursing shortages. Even if U.S.-born participation in this occupation can be stabilized, there will still be a severe need for direct care workers as the population ages.
Economic research supports the critical importance of immigrants in the care workforce. Immigrants are important to nursing home staffing and quality of care. They also reduce flows into nursing homes by facilitating aging in place of U.S.-born older adults through their employment as home health aides. (Immigrants are also disproportionately represented among doctors, and could continue to help address chronic shortages in nursing.)
