expectancy, the elderly population is growing at a rate significantly faster than the population as a whole. Though the most dramatic shifts in the percentage of persons who are 65 or older will not take place for another 30 or 40 years, when the baby boom generation begins to retire, there has been a consistent and significant increase in the percentage of the American population in this age category. In 1930, only about 5.4 percent of the population was 65 or older; by 1960, that population accounted for 9.2 percent; by 1990, it is projected to be about 12.7 percent. This year-1980-marks the first time that the number of Americans over 60 is larger than the number of children who are 10 or younger. The tipping of the age structure which that shift implies is highly significant: Just as the nation's attention was focused on the young in the 1950s when their numbers were increasing so rapidly, now it is shifting to the elderly as their numbers increase.

With regard to the dependency patterns of the 1980s, there are two main implications. The first is the sizeable increases in the 75-and-older category. Compared to their younger counterparts in the 65-74 age category, this group is far more likely to be dependent and to require a variety of services, including full-time institutional care.

The second implication has an immediate relevance in the 1980s. Because women typically marry men who are several years older, because their life expectancy is roughly 7 years longer than that of men, and because they are less likely to remarry after the death of their spouse than men are, the problems of the very old are increasingly the problems of women. There is an additional factor that complicates the lives of many elderly widows now in their seventies: Many find they have no relatives to take care of them because their low fertility rate in the 1920s and 1930s left them with few surviving children.

The third and fourth of those trends that have transformed the structure of so many American families-the rise of the single-parent family and the entry of increasing numbers of married women into the labor force-are closely related.

Largely as a consequence of higher divorce rates, the single-parent family-which in 9 out of 10 cases means a female-headed family-has become far more common than it was in the 1950s. As of March 1979, one in every seven families, a total of 8.5 million families, was headed by a woman. There are about 3 million more such families now than there were in 1970. While female-headed households have become more common among all groups in American society, their numbers have increased most rapidly among Hispanics and blacks. Today, nearly half of the nation's black children under 18 live with only one parent."

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There is no conclusive evidence that the absence of a father, in itself, is critical in affecting the behavior or adjustment of the children. However, single-parent families often have two problems that are beyond dispute: The first is that the children are deprived of the attention of the remaining parent because he or she is overburdened by having to carry both the childrearing and the wage-earning responsibilities. The second problem is poverty. (See Figure 3.) As a group, single-parent women earn low wages and have difficulty supporting themselves and their families. One-parent families are six times more likely to live in poverty than two-parent families.' Many of the mothers who head such households confront a painful dilemma: In order to earn the wages that their families depend upon, they are often forced to resort to less-than-satisfactory child care arrangements.

The last of these four trends-the rising number of married women in the labor force-also has pervasive consequences for the care of the nation's dependent population, both young and old. Prodded by inflation as well as their own educational experience and aided by a boom in white-collar jobs, married women have been entering the labor force in increasing numbers over the past generation. In March 1979, three out of five husband-wife families reported that at least two family members had been in the labor force in the previous year. Today, for the first time in our history, a majority of American women work outside the home. The school-age child whose mother works is now the rule, not the exception. Compared to her counterpart in the 1950s, she is less likely to work in a job—such as teaching-where her work hours are compatible with the task of caring for school-age children. She is also more likely to return to the labor force soon after the birth of a child. Indeed, the most striking increase in labor force participation has been among mothers with children younger than 6. In 1950, only about 11 percent of the mothers with such young children worked outside the home; today, over 45 percent are in the labor force. Of all the children between the ages of 3 and 5, more than half have mothers in the labor force.' (See Figure 4.)

Why have so many wives and mothers entered the labor force? While other influences play a part, the overriding reason for that trend is one that is beyond the control of individuals: Most of the working women in this country are in the labor force because the earning power of the wife makes an important contribution to the family's well-being. In some families, the wife's income allows the family to enjoy a few more amenities or to send their children to college. But in an increasing number of families, the wife has to work in order to maintain the family's standard of living in the face of strong inflationary pressures

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Figure 3

Median Family Income, by Presence of Children and
Type of Family: 1978

Figure 4

Mothers in the Labor Force, in Families with Husband
Present (by Presence and Age of Own Children,

pressures that were not a factor a generation earlier.

Together, these four trends have transformed American families and households. They create new patterns of dependency and affect our patterns of caring for young and old alike. Because of factors such as the increase in the number of elderly dependents, the need for care is greater than ever. But, due to their increasing participation in the labor force, women have less time and energy to carry out their traditional roles as primary caretakers of children and the elderly. Although the entry of women into the labor force has clearly improved the quality of life for millions of American families, it has also raised new concerns about where, how well, and by whom the children of working mothers are cared for.

It should also raise concern about how well dependent older people are being cared for. To an extent not widely recognized, it is still the family-not nursing homes or other facilities-that provides most of the personal care that the dependent elderly require. Contrary to the persistent misconception that ours is a society in which most of the dependent elderly are institutionalized, institutionalization is, in fact, regarded by most families as the alternative of last resort. As Elaine Brody, director of human services at the Philadelphia Geriatric Center, writes:

Professionals and personnel of service organiza-
tions who constitute the formal support system
easily fall under the illusion that they are the prin-
cipal providers of services to older people. In focus-
ing on our own activities, we fail to credit the
families of the elderly, whose services dwarf those
of the formal system in providing the vast majority
of health and social services. . . . Most impaired
older people who receive care at home receive it
from a household member, and most receive it for
long periods of time. Family members give 80 per-
cent of the medically related and personal care to
the chronically limited elderly. Family members
are also the ones who, when needed, are depended
upon to negotiate with the health system, to main-
tain the households of impaired old people, shop
and cook and provide emotional support.1o

The family member upon whom that responsibility typically
falls is the adult daughter or daughter-in-law. Research
shows that impaired older persons depend most on their
spouses and the females in the next generation." Those
women-the principal caregivers to the elderly as well as
the young-are subjected to the competing demands of
their roles as parents, spouses, and filial caregivers. As
they enter the labor force in increasing numbers, they face
stresses created by that additional role.

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