Summary

Care is one of the most universal human experiences. We all need care as babies and young children, at times in our lives when we are ill, or as we age. Most of us provide family care, largely unpaid, throughout our lives, whether this takes the form of parenting, caring for older adults, or caring for relatives or loved ones who are ill or have a disability. Caregiving is necessary and important labor that helps society to function and thrive, and proper support for caregivers is crucial for national economic growth, economic and social outcomes for families, and gender equality. However, stigma and barriers exist within the U.S. workforce for family caregivers,¹ including those pursuing a career in science, technology, engineering, mathematics, and medicine (STEMM). These stigma and barriers disproportionately affect women and contribute to the national trend of fewer women advancing and succeeding in academic STEMM careers. The U.S. STEMM workforce faces a lack of governmental and organizational support

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¹ The term family caregivers is used throughout this report to refer to those who provide largely unpaid care to family members, friends, and loved ones. Other terms used in the literature included unpaid caregivers or informal caregivers. This definition includes those caring for children as well as for adults with illnesses or disabilities. The committee acknowledges that the current literature on caregiving varies in the types of labor that are included and thus can produce disparate estimates of both the magnitude and the intensity of care. The committee adopted a broad definition to capture the full expanse of what caregiving includes (see Chapter 2), but also provides details on how caregiving is defined when providing estimates of the caregiving population and time spent on caregiving.

for caregiving that needs to be addressed to ensure inclusion and continued innovation and competitiveness.

This report aims to capture the ways in which the labor and contributions of caregivers are often invisible and undervalued, with a specific focus on the academic STEMM ecosystem, including undergraduate and graduate students, postdoctoral scholars, resident physicians and other trainees, tenure-track and non-tenure-track faculty, staff, and researchers. The report describes how caregiving responsibilities clash with ingrained norms in academic STEMM environments, which demand that STEMM students and workers demonstrate immense devotion to their fields and are always available and visibly working. The report reviews policies and practices that support caregivers, locally and nationally, and describes best practices in policy implementation and design. It also highlights innovative practices and offers actionable recommendations to higher education institutions, public and private funders, and the federal government.

The goal of this report and its recommendations is to facilitate and accelerate greater participation of caregivers in STEMM education and work and thereby advance scientific innovation and support a stronger and more inclusive academic STEMM workforce. The academic STEMM workforce needs caregivers, and, particularly at a time when many STEMM fields face challenges with workforce shortages and a lack of diversity, support for this diverse population is even more important. Family caregiving is not simply an outside obligation that has no bearing on the workings of academic STEMM as it affects the lives of so many people working and studying in colleges and universities around the country. The committee seeks with this report to showcase the immense value caregivers bring to academic STEMM, the current limitations of the system to adequately support them, and the kinds of solutions that will create a more welcoming and inclusive STEMM environment.

CAREGIVING AND STEMM

Family caregivers make up an important and significant portion of the U.S. workforce and the STEMM workforce. Though in the past, most caregivers were women who stayed at home, today that has shifted and millions of people who provide care are also employed either part-time or full-time (Lerner, 2022). Estimates from 2019 find that, among the nearly 53 million adults in the United States providing care for someone aged 18 or older, more than 60 percent were employed (AARP & National Alliance

for Caregiving, 2020). Further, examinations of workers with graduate or postgraduate degrees find that around 15 percent of these workers are caregivers (Cynkar & Mendes, 2011). Caregivers are the faculty, researchers, postdocs, students, and staff that make up academic STEMM. As such, a lack of support for caregiving has consequences not just for individual caregivers but for the STEMM enterprise as a whole.

Research has shown the significant effect of a lack of support for family caregiving on the careers of STEMM professionals. For example, a 2019 study using nationally representative data on full-time professionals in science, technology, engineering, and mathematics found that a startling 43 percent of new mothers and 23 percent of new fathers left full-time employment in these fields after the birth of their first child, and most of the mothers and a substantial portion of fathers noted they left for “family-related” reasons (Cech & Blair-Loy, 2019). Other work has found that scientists may feel the need to have fewer children than they would otherwise desire given the demands of STEMM, and having fewer children than desired is related to lower satisfaction and greater plans to exit STEMM (Ecklund & Lincoln, 2011). The impacts of a lack of caregiving support on attrition are problematic especially in fields already facing challenges with diversity and hiring shortages (American Association of Colleges of Nursing, 2023; Jean, Payne, & Thompson, 2014).

LACK OF SUPPORT AND THE IMPACT ON CAREGIVERS

Caregiving of all forms can be rewarding and individually fulfilling for the caregiver and care recipient, producing strengthened ties with loved ones, a sense of purpose, and other positive emotions (AP-NORC Center for Public Affairs Research, 2014; Hoefman et al., 2013; Mackenzie & Greenwood, 2012; Quinn et al., 2010). However, there are also economic and physical challenges and emotional burdens associated with caregiving and the lack of institutional and societal support for caregivers. Individual caregivers can incur heavy financial costs and reduced earnings and advancement at work (Wakabayashi & Donato, 2005). Family caregivers who take reduced hours or leave the workforce incur foregone wages and reduced retirement savings (Weller & Tolson, 2019) as well as the potential for career disruptions and loss of seniority (Bainbridge & Broady, 2017; Stoner & Stoner, 2016). Those who do not or cannot leave the workforce and lack sufficient support at work face potential constraints on productivity (Morgan et al., 2021), disruptions to work schedules (AARP & National

Alliance for Caregiving, 2020; Witters, 2011), and discrimination, which has increased over the past few decades (Morris et al., 2021). Family caregiving can also take a physical and emotional toll on the individual providing care, with caregivers reporting greater levels of anxiety and depression; insufficient sleep; worse self-reported health; and limited time for exercise, rest, and personal care of their own physical and mental health needs (Centers for Disease Control and Prevention, 2019; Conley et al., 2004; Park, 2020; Tay et al., 2022).

The barriers that family caregivers face in academic STEMM fields are further exacerbated by expectations of devotional allegiance to work (Blair-Loy & Cech, 2022). Many academic STEMM environments uphold “ideal worker” norms, norms that suggest that to be an ideal worker² requires full dedication to work such that a person’s life centers on their work without outside influences affecting them (Acker, 1990; Williams, 1989). In these settings, strong stigma develops around any apparent violations of these norms. In particular, flexibility stigma³ is one such censure of those who go against ideal worker norms by utilizing or appearing to utilize accommodations and alternative work arrangements that allow them to attend to responsibilities outside of work (Williams et al., 2000). The entrenched nature of ideal worker norms also posed additional challenges during the COVID-19 pandemic, as many caregivers, particularly of young children, struggled to navigate the high expectations and demands of paid work alongside increased caregiving demands at home while working (Zanhour & Sumpter, 2022).

CAREGIVING AND EQUITY

Family caregiving cuts across gender, race/ethnicity, and other characteristics, and a lack of support for caregiving poses challenges for employees with caregiving responsibilities from all backgrounds. At the same time, women continue to bear disproportionate caregiving responsibilities in

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² Ideal worker norms grew from the separation of work and home into distinct spheres coupled with the development of new technologies through which employers could track worker productivity with the onset of the industrial revolution. These norms were adapted in white-collar work in the early 20th century as these settings took on productivity standards seen prior in factories. Media portrayals in the following decades further entrenched these norms (Davies & Frink, 2014).

³ Flexibility stigma refers to negative evaluations and/or treatment of individuals who make use of policies designed to allow greater flexibility in work schedule, location, or intensity.

the United States (U.S. Bureau of Labor Statistics, 2023a). This societal distribution of care has substantial implications for gender equity generally and is of growing concern in academic STEMM roles. The burden of these family caregiving responsibilities placed on women contributes to unequal advancement opportunities and influences career choices (Fox & Gaughan, 2021; Wakabayashi & Donato, 2005). Additionally, research has shown that even for women who may not have caregiving responsibility, the “specter of motherhood,” or the belief that all women want to and will become mothers, looms and leads to presumptions about their long-term engagement and commitment to STEMM (Thébaud & Taylor, 2021).

The challenges faced by mothers and women caregivers may also be particularly acute for women of color given intersecting biases of gender and race/ethnicity (Kachchaf et al., 2015; Williams, 2014). Additionally, policies to support caregivers are also shaped by assumptions that more often align with the experiences of White, middle- to upper-class Americans but less so with other groups. For example, while many existing caregiving policies assume the care provider is a direct relative of the care recipient, Black, Hispanic, and Asian caregivers are more likely to take care of nonrelatives or extended family members (McCann et al., 2000; Sodders et al., 2020).

CURRENT CAREGIVING SUPPORTS AND BARRIERS

Supports for caregivers in academic STEMM are generally piecemeal and incomplete, creating challenges for family caregivers. A patchwork of federal and state legal requirements exists by which universities and other organizations must abide. There is no federal law establishing a right to paid leave, and because there are so many laws operating, the legal landscape is quite complex, making it challenging to navigate and understand available protections. The complexity may also contribute to the high degree of noncompliance seen across universities (Calvert, 2016; Gulati et al., 2022; Lee et al., 2017; Mensah et al., 2022; Williams et al., 2022). Current laws are also incomplete, often focusing on caregivers of young children and not as frequently considering protections and supports for caregivers of adults.

Caregivers in STEMM are also influenced by the policies of funders and accrediting institutions. Federal agencies and private funders, for example, may provide flexibility in timelines as well as use of grant monies to support family caregiving responsibilities. Federal agencies and private funders may also provide guidance to the institutions they fund to better

support the STEMM workforce. Accrediting bodies also set standards for university family caregiving support.

Finally, colleges and universities have a myriad of local policies. Common policies include caregiving leave, accommodations and adjustments, direct care support, and protections against discrimination. Though support for family caregiving can exist in these many forms, there is still limited knowledge on exactly how many institutions provide each of these policies and programs and immense variation in how much support is offered. Ultimately, many caregivers in academic STEMM find current support lacking to meet their needs. This report aims to reduce this variation that leads some family caregivers to encounter less support than others and to outline policies and practices that are greatly needed to produce a more inclusive academic STEMM ecosystem. It calls for concerted action to support family caregivers so that they can have fulfilling careers and thrive in academic STEMM.

CONCLUSIONS

To this end, the committee reached five major conclusions based on a comprehensive review of the literature detailed across the chapters that follow.

1. Supporting family caregivers is an issue of equity and a strategic labor force investment.

   Because family caregiving demands are unevenly distributed, women have borne the brunt of the financial, mental, and physical burdens of caregiving. Though current data on caregiving and race/ethnicity as well as the intersection of race/ethnicity and gender is much more limited, existing evidence suggests that women of color may face a particularly strong burden. Lack of support for family caregivers and stigma against caregiving can push women further out of academic STEMM, an environment where women are already underrepresented. The loss of a STEMM academic due to insufficient caregiving support results in turnover, inefficiencies due to hiring replacements, increased organizational stress due to understaffing and workforce churn, the loss of training, experience, and hundreds of thousands of dollars, often from federally funded grants. It also perpetuates less STEMM workforce diversity, and it

1. risks ongoing labor shortages, impoverishing growth, innovation, creativity, solutions, and success.

2. Family caregivers provide care in many forms and for a wide range of relationships, but family caregiving is often viewed in a very limited way.

   Family caregiving includes individuals of all ages with a variety of relationships to their care provider—children, adult dependent children, parents, spouses, nonrelative loved ones, and neighbors. It entails a wide range of tasks, including caring for physical or mental health needs, providing transportation and organizational support, and assisting with finances. Family caregiving also can vary both across individuals and over time as to whether the tasks are ongoing or short-term and whether they involve more or less intense effort from the caregiver. This range is not often considered in conversations about caregiving or the policies and programs that are offered. Most often, family caregiving is implicitly or explicitly viewed as largely parents caring for children or children caring for aging parents, which can limit the sufficiency of policies. A broad understanding of caregiving is a key component to ensuring policies fully support the wide variety of needs of family caregivers.

3. Cultural barriers present a particular challenge for increasing support for family caregivers in academic STEMM.

   The culture of academic STEMM sets expectations for ideal workers who are expected to be able to devote immense time, energy, and attention to work without being affected by outside demands. This presents challenges for family caregivers and results in flexibility stigma, a form of bias and discrimination that penalizes those who need to seek out resources and supports that allow them to meet needs outside of paid work. These cultural stigmas affect people of all backgrounds but can be particularly detrimental to women given both the disproportionate family caregiving burden they bear as well as assumptions made about caregiving and gender. Efforts to challenge these assumptions are needed to shift cultural norms and set a more level playing field.

4. Policy options and best practices exist for colleges and universities to support caregivers, but many institutions still fail to meet their needs.

   Exemplar policies and practices have been implemented at colleges and universities to support caregivers covering many different

4. needs, including leave, accommodations and adjustments, direct care support such as on-site centers, and protection from discrimination and bias. These are not consistently employed across academic institutions, and issues of availability and affordability produce barriers. When implemented, existing policies are often not well communicated, leaving people unaware of what they can access. Additionally, many policies are written without attention to the wide variety of caregiving experiences as well as differences across caregivers along lines of race/ethnicity, gender, and other characteristics that influence what caregiving looks like. Moreover, even when direct care supports are provided such as on- or near-site child or older adult care, they are often underresourced with limited availability and long waiting lists. Even with these challenges, best practices can and should be implemented with attention to evaluation to understand their effect and potential unintended consequences.

5. Federal and state regulations cover many sets of needs, but they remain incomplete and piecemeal and are not always followed.

   Unlike other industrialized nations, the United States still does not provide federal protections for paid family and sick leave. It is in fact the only country in the Organisation for Economic Co-operation and Development that does not have a national, paid caregiving leave policy. Some federal and state laws governing caregiving already exist and more are emerging across the country, encompassing the right to caregiving leave, protections against discrimination, and access to other supports such as maternity care and lactation support. The legal landscape, however, is composed of a disconnected set of mandates that is quite complex to follow and understand. This in part may contribute to why institutions often fail to meet their legal obligations to caregivers. All parts of the STEMM workforce are affected: students and faculty, as well as postdocs, medical residents and interns, and staff in soft-money research positions, emphasizing the need for centralized government action.

6. Innovation in caregiving support is desperately needed.

   Given continued challenges and gaps as well as persistent barriers to policies, innovation is needed to support family caregivers. The policies supporting caregiving that already exist do not sufficiently address common situations that undermine the vitality

1. and effectiveness of the STEMM workforce. These challenges have been underappreciated and include the needs of those caring for adults or nonrelative loved ones. There are innovative solutions that need greater implementation and evaluation to see how they could strengthen, augment, and expand upon existing support. Unfortunately, senior leaders in STEMM, policymakers, and the public still seem unaware of the urgent need or uncertain how to prioritize organizational innovation and flexibility to enhance support of family caregivers as a critical issue for the future of the STEMM workforce and the nation’s capacity to remain a STEMM leader in the world. This cannot, however, stand in the way of creative and new ideas to produce more effective policies, practices, and interventions to support family caregivers.

RECOMMENDATIONS

The committee’s recommendations focus on tangible actions that need to be taken by universities, federal and private funders, and Congress and the federal government to ensure adequate support for family caregivers in academic STEMM. These recommendations address needs not only for leave, flexibility, and direct care support, but also for a greater understanding of the efficacy of current efforts and support for innovations to better assist family caregivers. Greater detail and specific guidance on implementing these recommendations can be found in Chapter 8.

University Recommendations

Universities must and can do a great deal to support family caregivers. The overarching goal of these recommendations is to help universities create an environment that allows for continued and sustainable productivity in a way that is more inclusive of family caregivers. Such an environment shows a continued commitment to the long-term health and well-being of the academic STEMM workforce and challenges ideals of overwork as well as barriers to needed leave and flexibility. This overarching goal is reflected throughout these recommendations, which provide individual, concrete steps that can be taken. Together, they can serve to shift broader cultural norms in more inclusive ways. To assist in goal setting to achieve a more caregiver-friendly workplace, the committee organized its recommendations to universities into three categories: legal compliance, best practices, and innovative practices.

Legal Compliance

RECOMMENDATION 1: To ensure accountability and compliance, college and university leadership need to appoint a senior leader, ombuds, or team who is responsible for protecting, publicizing, and monitoring compliance with the legal mandates under Title IX, Title VII, the Family Medical and Leave Act, the Pregnant Workers Fairness Act, and any state- and local-level policies that protect caregiving faculty, postdocs and other trainees, students, and staff.

Best Practices

RECOMMENDATION 2: Caregiving Leave. Colleges and universities should comply with FMLA’s requirement for 12 weeks of unpaid leave per year and provide paid family and medical leave to faculty, staff, postdocs and other trainees, and graduate students receiving pay, even if this leave is not mandated by state or federal law. Additionally, colleges and universities should provide leave for caregiving students, which allows them to maintain their student status so that they can continue to receive any aid or health insurance to which they are entitled.

RECOMMENDATION 3: Accommodations and adjustments. Colleges and universities should institutionalize opportunities for individually customized work and educational flexibility across a variety of needs, including location, time, workload, and intensity.

RECOMMENDATION 4: Direct care support. Centralized resources to support basic caregiving needs for staff, faculty, postdocs and other trainees, and students need to be easily available and searchable.

RECOMMENDATION 5: Data Collection and Analysis. To ensure that colleges and universities understand the needs of the caregiving populations within their ranks, understand the impact of their policies, existing and new, and address potential unintended consequences, colleges and universities should collect and analyze data on family caregivers.

Innovative Practices

RECOMMENDATION 6: Colleges and universities should pilot and evaluate innovative policies and practices intended to increase support

for caregivers and influence lasting cultural change. Less research-intensive colleges and universities should partner with research-intensive institutions and participate in projects and efforts to test new policy ideas.

Federal Agencies and Private Funders

RECOMMENDATION 7: Federal and private funders should allow and support flexibility in the timing of grant eligibility as well as grant application and delivery deadlines for those with caregiving responsibilities and provide support for coverage while a grantee is on caregiving leave.

RECOMMENDATION 8: Federal and private funders should facilitate the leave and reentry processes for those who take a caregiving leave.

RECOMMENDATION 9: Federal and private funders should fund innovative research on family caregiving in academic STEMM by providing competitive grants to institutions to support pilot projects and develop policy innovations. Funders should collaboratively develop and offer caregiver policy guidance to the institutions they fund based on the findings of this research as well as existing evidence.

Congress and the Federal Government

RECOMMENDATION 10: Congress should enact legislation to mandate a minimum of 12 weeks of paid, comprehensive caregiving leave. This leave should cover the various forms of caregiving, including childcare, older adult care, spousal care, dependent adult care, extended family care, end-of-life care, and bereavement care.

RECOMMENDATION 11: Following the model of the recent CHIPS and Science Act, which required the provision of on-site childcare for those seeking access to funds supporting semiconductor development, the agency or department tasked with implementation of future STEMM funding bills should include support for childcare in application requirements.

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