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Globalization, Women's Migration, and the Long-Term-Care Workforce

Correspondence: Address correspondence to Dr. Colette Browne, School of Social Work, University of Hawai'i, 1800 East West Road, Honolulu, HI 96822. E-mail: cbrowne{at}hawaii.edu

With the aging of the world's population comes the rising need for qualified direct long-term-care (DLTC) workers (i.e., those who provide personal care to frail and disabled older adults). Developed nations are increasingly turning to immigrant women to fill these needs. In this article, we examine the impact of three global trends—population aging, globalization, and women's migration—on the supply and demand for DLTC workers in the United States. Following an overview of these trends, we identify three areas with embedded social justice issues that are shaping the DLTC workforce in the United States, with a specific focus on immigrant workers in these settings. These include world poverty and economic inequalities, the feminization and colorization of labor (especially in long-term care), and empowerment and women's rights. We conclude with a discussion of the contradictory effects that both population aging and globalization have on immigrant women, source countries, and the long-term-care workforce in the United States. We raise a number of policy, practice, and research implications and questions. For policy makers and long-term-care administrators in receiver nations such as the United States, the meeting of DLTC worker needs with immigrants may result in greater access to needed employees but also in the continued devaluation of eldercare as a profession. Source (supply) nations must balance the real and potential economic benefits of remittances from women who migrate for labor with the negative consequences of disrupting family care traditions and draining the long-term-care workforce of those countries.

Key Words: Aging • Elder custodial care • Filipino Americans • Geriatrics • Globalization • Health services for the aged • Immigration • Long-term care • Poverty • Social justice • Women • Workforce