Eckenwiler Publishes Book on Long-term Care, Globalization, and Justice

Thanks in part to a century of progress in public health and medicine, many people are enjoying longer lives. These changing demographics are generating a greater need for long-term care.  In the US alone, the number of people using nursing facilities, alternative residential care, or home care services is expected to increase from roughly 15 million to 27 million in 2050.  Yet by all accounts, long-term care is no longer sustainable.                                                                               

The longstanding absence of coherent long-term care public policy raises urgent concerns for the burgeoning population of dependent elderly. It generates pressing problems for family caregivers, who navigate perilous terrain as they strive to support their loved ones and often suffer ill health themselves. It threatens long-term care workers who are born and trained in the US, working and living in low-resource conditions. And at the same time, it holds profound implications for the health care workforce and those in need of care in the global South. As governments in affluent countries confront growing demands and expectations for affordable, quality long-term care services, health workers, including nurses and direct care workers like home care aides, are emigrating from the Philippines, countries in Africa and the Caribbean, India, China, and South Korea at unprecedented rates to take up positions in long-term care. Many so-called “source countries”, however, have more rapidly growing long-term care needs, higher burdens of disease, and at the same time suffer from lower care worker-to-population ratios than destination countries like the US.                                                    

Long-term Care, Globalization and Justice, which begins with a personal narrative of family caregiving and develops into an ethical argument for health policy, explores the landscape of long-term care in the context of globalization and its implications for justice and health equity for the elderly, their caregivers – family members and health workers alike – and people in need of care in poor parts of the world.