Work-Related Travel Among Home Care Workers

• In Event: The Direct Care Workforce: Recruitment, Retention, and Labor Market Dynamics

Abstract

A worker’s employability in home-based long-term services and supports (LTSS) may depend on their ability to travel, including possession of a valid driver’s license. It is not clear how travel requirements affect the estimated 34% of home care workers (HCWs) who are foreign born. Depending on visa and citizenship status, immigrants have limited, if any, pathways for legally obtaining a driver’s license. Research on work-related travel for HCWs is limited, with no existing evidence on the prevalence or duration of work-related travel for workers by immigration status.We describe the nature of work-related travel for HCWs by immigration status, including modes of travel, household car ownership, and time spent traveling throughout the workday.We used 2021-2023 American Community Surveys (ACS) to identify individuals aged 18 and above that commuted to work as an HCW. HCWs included home health aides, personal care aides, and nursing assistants that reported employment within home health care, individual and family services, or private homes. We identified workers as US-born or foreign-born and, following previous work, we categorized foreign-born Hispanic individuals without a high school degree as likely undocumented (LUD) and the remaining foreign-born population as likely documented (LD). We estimated probability of driving, taking public transit, and walking/biking to work as a function of immigration status, year, state, and metropolitan status. We explored probability of carpooling among drivers, car availability, and commute time by mode of transportation. Additional ACS analyses will incorporate hours worked per week, wages, demographic factors, and locality. To contextualize our findings, we will also draw comparisons to nursing home-based direct care workers.In a sample of 34,626 HCWs, representing 3.9 million individuals from 2021–2023, 4% were LUD, 30% were LD, and 66% were US-born. Most (80%) HCWs drove to work while the remaining took public transportation (12%), walked/biked (5%), or other modes (2%). Relative to US-born workers, LUD and LD workers were 9.6 (95% CI: -12.8, -7.0) and 6.2 (95% CI: -7.4, -5.0) percentage points less likely to drive to work, respectively, when controlling for year, state, and metropolitan status. LUD and LD workers were 7.3 (95% CI: 4.9, 9.7) and 5.2 (95% CI: 4.2, 6.3) percentage points more likely to take public transportation than US-born workers. Among drivers, LUD workers had a higher likelihood of carpooling than US-born workers (ME: 2.4, 95% CI: -0.5, 5.4) and reported shorter commutes by 4.6 minutes on average (95% CI: -6.9, -2.4). LUD workers were also 5.8 percentage points less likely to have a car available (95% CI: -8.2, -3.3) than US-born workers. Observed differences by immigration status were consistent across alternative definitions of likely undocumented.As the demand for home care continues to outstrip supply, it is important to understand factors that impede workforce participation of immigrants. Our findings suggest that immigrant HCWs approach work-related travel differently than US-born workers, with differences most pronounced among likely undocumented immigrants.

Author

• Emmaline C Keesee, Vanderbilt University
  Presenting Author