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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
 APHA 2005
 
4019.0: Tuesday, December 13, 2005 - 9:24 AM

Abstract #114412

Personal Assistance Services: Trends in supply and demand

H. Stephen Kaye, PhD, Disability Statistics Center, Institute for Health & Aging, University of California, San Francisco, 3333 California Street, Room 340, San Francisco, CA 94118, 415 502-7266, skaye@itsa.ucsf.edu, SA Chapman, PhD, Center for the Health Professions, University of California, San Francisco, 3333 California Street, Suite 410, San Francisco, CA 94118, Robert Newcomer, PhD, PAS Center, University of California, 3333 California Street, Suite 455, San Francisco, CA 94118, and Charlene Harrington, PhD, Department of Social & Behavioral Sciences, University of California San Francisco, 3333 California St, Suite 455, San Francisco, CA 94143-0612.

People with disabilities often need formal Personal Assistance Services (PAS) to enable them to live independently in the community. Prior research has shown that lack of availability of such services can lead to adverse health consequences, physical or social isolation, or institutionalization. This research assesses trends both in the need for assistance in activities of daily living (ADLs) and in the size of the PAS workforce, to evaluate whether the supply has kept pace with the demand for such services. Data come from three nationally representative Federal surveys: the Current Population Survey for 1994-2004, the National Health Interview Survey for 1994-2003, and the American Community Survey for 2000-2003. We find a rapid expansion in the PAS workforce during the past decade, from 0.5 million workers in 1994 to more than 0.9 million in 2004. Particularly rapid growth occurred during the mid-1990s and between 2001 and 2004. The growth rate exceeds that of the community-resident population needing help in ADLs, which also grew substantially during the period. These trend data suggest that formal, community-based personal assistance services have become increasingly available to those who need them. Findings on the employment conditions of PAS workers are less positive, however: Wage levels are low, with no indication of improvement, and health insurance benefits remain rare. Job tenure data indicate high rates of turnover for these workers. Quality of services may be an issue as a result, and continued growth of this workforce to meet future needs is by no means assured.

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