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Committee Task and Approach

In December 2019, the National Academies of Sciences, Engineering, and Medicine’s standing Committee on Women in Science, Engineering, and Medicine held a public workshop to scope the current state of knowledge on the impact of caregiving responsibilities on gender equity in science, engineering, and medicine and the policy landscape available to support caregivers. The public workshop revealed a range of serious issues—widespread bias and discrimination against caregivers; a lack of comprehensive policies and resources at local, national, and organizational levels; poor implementation; and underutilization of existing policies at institutions. At that time, the committee could not foresee the global pandemic that would come a year later and further exacerbate the longstanding challenges facing family caregivers in science, technology, engineering, mathematics, and medicine (STEMM) fields. The many challenges facing caregivers that were made more visible during the COVID-19 pandemic, coupled with the information shared at the workshop, reinforced for the committee the critical need for a major National Academies consensus study to detail the current challenges caregivers face and provide clear recommendations to better support family caregivers in academic STEMM.

Thus, in September 2022, with support from a coalition of private and public sponsors, including the National Institutes of Health, the National Science Foundation, the National Aeronautics and Space Administration, the National Institute of Standards and Technology, the Henry Luce Foundation, and the Doris Duke Foundation, the National Academies assembled

an ad hoc committee to examine policies and practices to support family caregivers in STEMM. This expert committee was interdisciplinary and diverse in nature and included a range of individuals who have been nationally and locally recognized for their roles in leading and evaluating effective policies, practices, and programs for supporting family caregivers as well as work-life management in science, engineering, and medicine. The committee included leading scholars and researchers in industrial and organizational psychology, basic science, medicine, human resource management, labor law, economics, sociology, and expertise in federal and state policy.

The committee was charged with detailing current knowledge about the state of family and unpaid caregivers in STEMM careers as well as efforts to support them; to document innovative and promising practices to build

further support for caregivers in STEMM and identify barriers to effective policy implementation; and to develop a set of consensus recommendations for academic institutions, federal agencies, and other important interested parties to provide sustainable and comprehensive support for scientists, engineers, and medical and health professionals with caregiving responsibilities. The full Statement of Task for the committee is provided in Box 1-1.

In interpreting this Statement of Task, the committee determined its focus would be on academic STEMM and sought to capture the variety of experiences of family caregivers in academic STEMM as well as the wide range of academic STEMM careers. The committee sought to ensure broad coverage of the various groups that make up the academic STEMM ecosystem, including students, postdocs, residents, and other trainees; staff;

and tenure-track and non-tenure-track faculty in science, engineering, and medicine and nursing fields in universities, academic research centers and institutions, and government national laboratories. Box 1-2 presents an index of the various titles and positions within the STEMM ecosystem.

Many STEMM professionals with family caregiving responsibilities are employed in industry and government and face some of the same challenges outlined above and in the chapters that follow. There is a need to examine the policies, practices, and norms related to caregiving that affect these groups, yet the committee determined that the context for these sectors was substantially different from that of academic STEMM professionals and was beyond the scope of this single report. The committee urges a separate study to address the unique needs and environments of industry and government STEMM sectors. Innovative solutions from each of these workplaces have the potential to stimulate creative approaches to be applied elsewhere. Additionally, caregivers in a wide variety of workplaces encounter challenges and barriers. Though beyond the scope of this report, much can be learned from workplaces outside of STEMM fields. The committee draws on outside examples to generate ideas for creative solutions to support caregivers in Chapter 7.

In recognizing that caregiving takes on many forms, can vary across people, and can change in pace and intensity over time, the committee also chose to adopt an expansive definition to include care for both immediate family and other close individuals; to include individuals of all genders who provide caregiving labor; and to consider both intense, episodic moments of care as well as less intense ongoing caregiving tasks. More detail on the expansive definition of family caregiving employed by the committee can be found in Chapter 2.

In recognition of the many ways that intersecting identities of gender, race/ethnicity, socioeconomic status, and other key demographics shape experiences of both caregiving and academic STEMM and the lack of literature on this topic, the committee adopted an intersectional framework.¹ In doing this, the committee acknowledges that the current literature is underdeveloped in its discussion of the unique challenges that women of color caregivers face in academic STEMM. The committee drew on those

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¹ Intersectionality refers to the interplay of different demographic categories such as race/ethnicity, gender, sexuality, socioeconomic status, and so forth, and how this interplay affects people in unique and nonadditive ways such that the experience of being a Black woman is not simply equal to the experience of being Black and the experience of being a woman. The committee sought to engage an intersectional framework that considers the ways in which caregiving experiences differ among people based on multiple intersecting characteristics, such as highlighting the ways that Black women caregivers, for example, experience certain policies differently than White women caregivers as well as men caregivers.

studies that exist, but more work is needed to provide a more complete and fully intersectional picture. To build its knowledge base for this report, the committee also sought out additional data on the experiences of women of color caregivers in STEMM as part of qualitative interviews conducted for this study, which are discussed later. More specifically, the committee sought to ensure the experiences of individuals with intersecting marginalized identities were not only detailed to describe how experiences of caregiving may vary by identity but were central to considering the ways in which policies and practices should be implemented or approached to be effective for everyone.

ACTIVITIES TO INFORM THE REPORT

To inform its deliberations and findings, the committee engaged in a range of information gathering and research activities. The committee held two national symposia in February and March of 2023. These symposia brought in experts from academia, government, and policy advocacy to discuss key issues related to the challenges family caregivers face in academic STEMM careers. Current federal, state, and institutional policy landscapes supporting family caregivers in academic STEMM careers were presented as well as ideas for possible future landscapes. A proceedings from these events was published in July 2023 detailing each of the talks and panels.² The two symposia provided important background for the committee as it began its early discussions and deliberations on the report.

In addition to these symposia, the committee commissioned three papers. Each paper focused on a specific aspect of the Statement of Task. The three papers covered (1) the economic impact of caregiving,³ (2) current and promising practices to support caregivers in academic STEMM,⁴ and (3) challenges faced by caregivers in STEMM and barriers to successful

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² The proceedings of the two symposia, Barriers, Challenges, and Supports for Family Caregivers in Science, Engineering, and Medicine, are available at https://nap.nationalacademies.org/catalog/27181.

³ “The Economic Impacts of Family Caregiving for Women in Academic STEMM: Driving an Evidence-Based Policy Response,” by Courtney Harold Van Houtven and Ngoc Dao, is available at https://nap.nationalacademies.org/resource/27416.

⁴ “Comprehensive Literature Review of Current and Promising Practices to Support Unpaid Caregivers in Science, Technology, Engineering, and Medical STEMM,” by Jessica Lee, Erin Frawley, and Sarah Stoller, is available at https://nap.nationalacademies.org/resource/27416.

policy implementation.⁵ These papers provided valuable insights for the committee and formed the backbone to multiple sections and chapters of this report. Instances where the committee drew directly and substantially on these reports are noted at the start of the chapter and in relevant tables.

The committee also sought outside input in the form of a Dear Colleague letter with a call for information on promising practices to support caregivers. This letter sought information from the public on existing efforts to support caregivers at their institutions, particularly novel or unique practices, along with any evaluative evidence published or unpublished on the efficacy of these practices. Responses to this call for information were reviewed by committee members to inform their discussion of report recommendations.

Along with seeking input from the broader scientific community, this report also draws on the results of interviews conducted with caregivers who currently or recently held positions within the academic STEMM ecosystem.⁶ The interviews addressed two research questions: (1) How do caregivers’ understanding and conceptualizing of factors at the macro level (including structural disadvantage and culture), the meso level (including everyday interactions and social support networks), and the micro level (including personal identities and priorities) shape the ways they engage in and make meaning of caregiving and navigate work-life balance and access policies; and (2) What alternative structures, standards, norms, and supports might better promote work-life balance for caregivers in academic STEMM? Interviewees were asked questions regarding their experiences managing their career and caregiving; cultural, interpersonal, and institutional factors affecting their career and caregiving; ways they might reimagine what success and productivity look like in STEMM; and satisfaction and joy within their career and caregiving. The full interview guide can be found in Appendix B.

These interviews included 40 individuals who within the past 3 years were studying or working at a U.S. university in the sciences, engineering, or medicine and had regular, unpaid caregiving responsibilities of 12 hours or more per week. Interviews lasted approximately 1 hour and followed

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⁵ “A Comprehensive Literature Review of Caregiving Challenges to STEMM Faculty and Institutional Approaches Supporting Caregivers,” by Joya Misra, Jennifer Lundquist, and Joanna Riccitelli, is available at https://nap.nationalacademies.org/resource/27416.

⁶ “Supporting Caregivers Working in STEMM: Qualitative Study Report,” by Tasseli McKay, Monica Sheppard, and Ashley Lowe, is available at https://nap.nationalacademies.org/resource/27416.

a semistructured guide that covered four main topics: (1) experiences of managing career and caregiving responsibilities simultaneously; (2) the macro-, meso-, and microlevel contexts in which caregivers managed those demands; (3) ideas for reimagining success and productivity; and (4) experiences of joy and satisfaction in career and caregiving. Interview recordings were professionally transcribed for analysis. A deductive codebook was developed based on the study research questions and early study committee guidance. Inductive codes were developed jointly by the research team to reflect themes that emerged during the interviews.

In recognition of the many ways that intersecting identities of gender, race/ethnicity, socioeconomic status, and other key demographics shape experiences of both caregiving and academic STEMM and the lack of literature on this topic, the committee specifically sought the experiences of women of color, LGBTQ+ women, immigrant women, and women with disabilities in STEMM as part of the additional interviews conducted for this study. Interview consultants and study staff focused on identifying and connecting with member listservs and similar communication tools that centered these identities. Roughly one-quarter of the sample identified as Black, Hispanic, or Asian; half identified as White; and smaller numbers identified as American Indian or Alaska Native or Native Hawaiian or Pacific Islander. Sixty percent of the sample were from immigrant families, and first-generation college students also represented a majority of the sample. These groups were deliberately oversampled to learn more about their experiences. Interviewees were drawn from across all career stages, from students to senior faculty and academic leadership, with heaviest representation from graduate students, medical residents, and other early-career scholars. More information on the interview sample and analysis can be found in Appendix B.

ORGANIZATION OF THE REPORT

The report responds to the committee’s Statement of Task, beginning with an overview of caregiving in Chapter 2. This chapter defines who family caregivers are, details the wide range of tasks and experiences that encompass family caregiving, and outlines trends in family caregiving over the past several decades. Chapter 3 explores the challenges faced by family caregivers in the United States and within academic STEMM with a particular focus on issues of equity and how these challenges are disproportionately borne by certain individuals based on gender and race/ethnicity.

Chapters 4 through 6 engage with the policy landscape of family caregiving. In Chapter 4, the committee outlines existing policies and practices established in federal and state laws, implemented by federal agencies, and developed within individual institutions to support family caregivers. Chapter 5 then examines the barriers to effective policy implementation, highlighting financial, cultural, and practical barriers to policy success. Chapter 6 builds from these two knowledge bases to outline best practices for supporting family caregivers, drawing on existing evaluative research. Chapter 7 considers innovative approaches to flexibility for academic STEMM faculty to push beyond the boundaries of established methods and encourage creative solutions.

The report concludes in Chapter 8 with the committee’s recommendations for the ecosystem supporting academic STEMM and the actions that are necessary to support family caregivers and, in doing so, support STEMM innovation and inclusion. This includes recommendations for colleges and universities, federal and private funders, and the federal government. Together, this report represents the committee’s expert view on the state of family caregiving in academic STEMM and its hopes for a more inclusive and supportive future for all family caregivers.

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