The material well-being of veterans and their families is an important, policy-relevant topic. I research this topic through two crucial measures. In Chapters 1 and 2, I focus on wages, and in Chapter 3, I focus on poverty. In Chapter 1, I estimate the effect of veteran status on unconditional quantiles of wages for males across the period 1979-2017. I show there are important changes to the veteran wage differential over time across the entire wage distribution. In earlier periods, veterans enjoyed wage premiums across the entire wage distribution. Beginning in the early 1990s, wage premiums systematically declined across the wage distribution and largely became slight wage penalties across the wage distribution.

Although it is widely acknowledged that high-skilled teachers are integral to service quality and young children’s well-being in child care settings, little is known about the qualifications and skills of the child care workforce. This paper combines data from multiple sources to provide a comprehensive assessment of the quality of individuals employed in the child care sector. I find that today’s workforce is relatively low-skilled: child care workers have less schooling than those in other occupations, they score substantially lower on tests of cognitive ability, and they are among the lowest-paid individuals in the economy. I also show that the relative quality of the child care workforce is declining, in part because higher-skilled individuals increasingly find the child care sector less attractive than other occupations. Furthermore, I provide evidence that at least three other factors may be associated with the decline in worker quality. First, the recent proliferation of community college programs offering child care-related certificates and degrees may divert students away from attending four-year schools. Second, those majoring in child care-related fields are negatively selected for their cognitive skills, thereby decreasing the quality of the child care labor pool. Third, I show that the increased availability of outside employment options for high-skilled women had a detrimental effect on the quality of the child care workforce.

Ways of leaving the labor force has been an understudied aspect of labor market outcomes. Labor market institutions such as occupational licensing may influence how individuals transition to retirement. When and how workers transition from career jobs to full retirement may contribute to pre-and post-retirement well-being. Previous investigations of retirement pathways focused on the patterns and outcomes of retirement transitions, yet the influence of occupational licensing on retirement transition has not been analyzed. In this study, we use the Current Population Survey and Survey of Income and Program Participation to investigate how occupational licensing influences American later-career workers' choice of retirement pathways. Our results show that licensed workers are less likely to choose to change careers but more likely to reduce work hours in transitioning out of the workforce. These results are consistent with the findings that licensed workers receive more benefits in the form of preferable retirement options, suggesting that these workers tend to have higher wages, benefits, and flexibility even toward the end of their careers.

BACKGROUND Eliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based on socio-economic and demographic factors. METHODS We used data from five National Family Health Surveys (NFHS) conducted between 1993 to 2021 for the 36 states/Union Territories (UTs) of India. The study population included women of ages 15-49 years who were married or in a union at the time of the survey. The outcome was unmet need for family planning which captures the prevalence of fecund and sexually active women not using contraception, who want to delay or limit childbearing. We calculated the standardized absolute change to estimate the change in prevalence on an annual basis across all states/UTs. We examined the patterning of prevalence of across demographic and socioeconomic characteristics and estimated the headcount of women with unmet need in 2021. RESULTS The prevalence of unmet need in India decreased from 20·6% (95% CI: 20·1- 21·2%) in 1993, to 9·4% (95% CI: 9·3-9·6%) in 2021. Median unmet need prevalence across states/UTs decreased from 17·80% in 1993 to 8·95% in 2021. The north-eastern states of Meghalaya (26·9%, 95% CI: 25·3-28·6%) and Mizoram (18·9%, 95% CI: 17·2-20·6%), followed by the northern states of Bihar (13·6%, 95% CI: 13·1-14·1%) and Uttar Pradesh (12·9%, 95% CI: 12·5-13·2%), had the highest unmet need prevalence in 2021. As of 2021, the estimated number of women with an unmet need for family planning was 24,194,428. Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for half of this headcount. Women of ages 15-19 and those belonging the poorest wealth quintile had a relatively high prevalence of unmet need in 2021. CONCLUSIONS The existing initiatives under the National Family Planning Programme should be strengthened, and new policies should be developed with a focus on states/UTs with high prevalence, to ensure unmet need for family planning is eliminated by 2030. This study looked at the trends in unmet need for family planning in India, which is defined as the percentage of women of reproductive age who want to delay or limit childbearing but are not using any contraceptive method. A public dataset was used to analyze national and sub-national trends from 1993 to 2021. It was determined that although the percentage prevalence of unmet need decreased in the last 30 years, there were still a substantial number of women with unmet need in 2021. More than half of these women were in Uttar Pradesh, Bihar, Maharashtra, and West Bengal. Furthermore, it was found that percentage prevalence of unmet need was relatively higher amongst younger women and those belonging to poorer households in 2021. Initiatives and policies aimed at reducing unmet need for family planning should be implemented while considering geographic, socioeconomic, and demographic differences.

Objectives Sleep plays an essential role in well-being. Although U.S. immigrants are considerably growing, few studies have examined sleep in this diverse population, particularly those from Asian backgrounds. It is also unclear how sleep differs by the length of residence across immigrant groups. In this study, we examined the relationships among race/ethnicity, length of residence, and sleep using a nationally representative cohort of U.S. immigrants. Methods We analyzed data from the 2013-2018 National Health Interview Survey. The sample (N = 27,761; 14% ≥65 years old) included foreign-born adults from the following racial/ethnic backgrounds: non-Hispanic White, non-Hispanic Black, Asian (Chinese, Filipino, Asian Indian), and Hispanic/Latino. Length of residence was categorized as <5, 5-9, 10-14, and ≥15 years. Sleep was assessed with self-reported sleep duration (normal, short, and long) and poor sleep quality (trouble falling asleep, trouble staying asleep, and waking up unrested). Results Filipino and Hispanic/Latino immigrants reported the highest prevalence of short (41.8%) and long (7.0%) sleep, respectively. Non-Hispanic White immigrants had the highest prevalence rate across all three poor sleep quality measures (range 17.7-41.5%). Length of residence ≥15 years was significantly associated with worse sleep, and it moderated White-Asian differences in sleep quality. Immigrants from different racial/ethnic groups showed variations in sleep patterns as they resided longer in the US. Conclusions Immigrants exhibited substantial heterogeneities in sleep. Future research should investigate the contributing factors to the variations in their sleep patterns, both between groups and within the same group of immigrants, in order to inform tailored interventions.

Medical debt, or medical costs owed for health care services, is a pressing issue across the U.S., with implications for health and well-being for those facing debt burden. While recognition of medical debt as a social problem is growing, details about who is most at risk of holding this debt remain less clear. We address this gap by examining the differences in the proportion of people with medical debt in collections and median amount of medical debt by rural-urban location. We also focus on additional differences within rural and urban communities of color. The high cost of health care and associated medical debt in the U.S. persist as pressing social issues with an estimated over 100 million people having some medical debt.1,2 The consequences of medical debt are wide-reaching. Beyond the financial and household budget strain, individuals also report being denied, delaying, or not seeking health care because of cost and debt with repercussions for health, mental health, and well-being

Since the 1990s, immigrants have been increasingly moving to rural areas of the U.S., yet we know little about the economic well-being of these immigrants as compared to their more urban peers. To fill this knowledge gap, we draw on both segmented assimilation and industrial restructuring approaches and use microdata data from the American Community Survey (ACS) 2019 5-year estimates (n = 10,536,645) to examine the household income of U.S.-born and foreign-born heads of households by metropolitan status, as well as the roles of race/ethnicity and regional location in conditioning the impact of nativity status on household income. Similar to Census reports on the urban–rural wealth gap (Shrider et al. in Income and poverty in the United States: 2020. United States Census Bureau. Washington, DC. https://www.census.gov/library/publications/2021/demo/p60-273.html , 2021), OLS regression results indicate that rural respondents tend to report significantly less income than their nonrural peers, however, there is significant variation by nativity status, racial/ethnic background, and regional location. On average, foreign-born respondents, racial/ethnic minorities, and respondents located in the South report lower household incomes than their peers. Racial/ethnic background has a greater influence on household income than does nativity status, however, especially in rural areas. Race/ethnicity also moderates the effects of nativity status, although somewhat differently depending on metropolitan location and region. Predicted estimates of household income by nativity and race/ethnicity show that, regardless of race/ethnicity, foreign-born individuals in urban areas tend to have household incomes that are slightly lower than or similar to those of their same-race U.S.-born peers, with the exception of Black immigrants, those who report having two or more races, and respondents who belong to the Other Race category who tend to have higher incomes. In rural areas, however, substantively meaningful nativity differentials in income are only apparent for Black respondents.

The socioeconomic disadvantage experienced by disabled people is too often perceived as the natural, logical, or inevitable consequence of disability rather than resulting from policies and social structures that produce inequality. This dissertation aims to challenge this individualistic understanding of disability by examining how ableism and other systems of oppression are jointly embedded in institutions, policies, structures, and culture in ways that create and maintain disability-based inequalities in socioeconomic well-being, disproportionately harming multiply marginalized disabled communities. Using a variety of analytic techniques and drawing primarily on over a decade of data from the American Community Survey, this dissertation cuts across topics related to disability, inequality, and health policy, ultimately providing new insights into how structural ableism shapes disparities in Supplemental Poverty and unemployment between disabled and nondisabled people and at the intersection of disability and other axes of stratification. The first chapter provides rich, descriptive evidence of disparities in poverty and unemployment at the intersection of disability, gender, race-ethnicity, and age, highlighting intersectional injustices in which disabled Black, Indigenous, and Latine women across age iv groups experience heightened socioeconomic disadvantage. The second chapter documents the vast interstate variation in socioeconomic disparities between disabled and nondisabled people across U.S. states, suggesting that structural ableism operates through state contexts to shape geographic patterns in disability-based socioeconomic inequities. Linking the American Community Survey data with a variety of state-level policy and administrative data sources, the third chapter investigates whether and to what extent state-level policy contexts and specific policies related to Medicaid and Long-Term Services and Supports shape interstate variation in socioeconomic inequalities between disabled and nondisabled people. Taken together, the findings from the three chapters challenge the assumption that socioeconomic disadvantage among disabled people is natural or inevitable; rather, such disadvantage results from policies and structural contexts that create and maintain inequality. This work uncovers patterns of relational inequalities at national and state levels, providing essential context for the development of social and health policies and structural changes that promote disability and economic justice.

Objectives: To descriptively document birth cohort differences in sleeping patterns, self-reported age-specific sleep duration, and insomnia symptoms among adults aged 50+ from the National Health Interview Survey (NHIS) and the Health and Retirement Study (HRS). Methods: We analyzed respondents aged 50+ (born 1920–1969) from the 2006–2018 NHIS (n = 162,400) and HRS (n = 28,918). We fit multinomial models among the NHIS sample predicting age-specific optimal sleep duration (optimal for age vs short for age, and optimal for age vs long for age). For the HRS sample, we fit growth curve models predicting age-based insomnia symptom trajectories. The models for both samples adjusted for age, gender, race/ethnicity, and educational attainment. Results: Results regarding sleep duration in the NHIS, suggested that cohorts born in the 1950s and 1960s had significantly higher odds of reporting short sleep duration than cohorts before them. Results from the HRS similarly illustrated that cohorts born in the 1950s and 1960s had significantly higher levels of insomnia symptoms than those born before them. The worsening sleep among cohorts entering midlife was consistent regardless of alternative cohort specification, when age groups or periods were analyzed, and when more extensive covariates were modeled. Discussion: We observe a pronounced decline in healthy sleeping patterns among American cohorts in midlife, with consistent and striking results across data sets, methods, and measures. These findings have important implications for the well-being and longevity of Americans who have entered midlife in the 21st century.

This study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019–2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.

Mounting evidence signals that cohabitation operates as an alternative to remarriage inlater life. However, others have maintained that cohabitation is an incomplete institution marked byless favorable outcomes than remarriage. We appraise these two frameworks by examining thewell-being of remarried and previously married cohabiting older adults. Drawing on the 2010–2020 Health and Retirement Study, we assessed whether remarriedand previously married cohabiting older adults differed in their depressive symptoms and loneliness.We also tested whether the association between relationship quality and well-being varied by uniontype. Among women, cohabitors reported higher levels of depressive symptoms than their remar-ried counterparts. In contrast, union type was not appreciably associated with men’s depressive symp-toms. Meanwhile, among men, cohabitors reported less loneliness, on average, than did those inremarriages. No corresponding union-type differential emerged among women. Additionally, the association between relationship quality and psychological well-being did not differ by union type for both men and women.

With no policy at the federal level, U.S. employers, counties, cities, and states have established a patchwork of paid sick leave (hereafter, PSL) policies that regularly force many workers in the United States to choose between their health and wages. Employees without PSL benefits are often penalized—for example, they may be forced to take unpaid days off from work or may even be fired—when they miss work to seek medical care or look after an ill loved one (National Partnership for Women and Families and National Association for the Advancement of Colored People [NAACP], 2017). These penalties can heighten workers’ feelings of job insecurity and negatively impact workers’ mental health and stress levels. Prior research demonstrates mental health's integral role in shaping our overall well-being. Poor mental health is associated with a host of adverse outcomes, including increased physical illness, lower probability of full-time employment, and reduced quality of life (Doherty and Gaughran, 2014; Doran and Kinchin, 2017). Although many researchers have considered the relationship between access to PSL benefits, physical health outcomes (Collins et al., 2020; DeRigne et al., 2016), and access to health services (DeRigne et al., 2017), fewer studies have examined PSL's relationship to mental health (Asfaw, 2023, DeRigne et al., 2019; Stoddard-Dare et al., 2018). Even fewer studies have used an intersectional racial capitalism lens to examine whether this relationship is conditional on race and gender (Alang et al., 2023). Existing evidence highlights racialized and gendered disparities in access to PSL (Harknett and Schneider, 2022; Williamson, 2023a) and mental well-being (Astbury, 2001; Williams and Mohammed, 2013). Understanding the roles that race, gender, and PSL play in mental health may provide critical insights into strategies for addressing disparities in the American workforce. Our research addresses the following questions: Is there a relationship between access to PSL benefits and psychological distress? If so, does this relationship vary by race and gender? Our study uses racial capitalism and intersectionality as conceptual lenses for examining these issues. Investigating how access to PSL benefits may be differentially related to mental health across genders, races, and ethnicities is paramount to understanding PSL’s impact on our diverse workforce.

This article draws upon 89 in-person surveys with Rwandan women (ages 26–75) whose partners were incarcerated for genocide and examines how these women explain participation in the violence. We first engage in exploratory factor analysis of reasons cited for perpetrating genocide, which reveals (1) a factor comprised of internal reasons for participation, including greed and hatred; (2) a factor of external reasons, such as peer pressure or coercion, and (3) a factor driven by alcohol use. Next, we analyze how these factors are associated with the women’s psychosocial wellbeing as measured by the World Health Organization’s Self-Reporting Questionnaire. This quantitative analysis finds that, net of relevant control variables, accounts of participation in genocide that emphasize external reasons for participation are associated with better psychosocial wellbeing, while accounts of participation that emphasize internal reasons are associated with worse psychosocial wellbeing. We conclude by addressing the link between explanations for actions and wellbeing.

Decarbonizing our building stock is a critical step in reducing emissions and slowing the effects of climate change. Residential decarbonization involves replacing all gas appliances, including stoves, dryers, water heaters, and HVAC systems with electric systems and increasing the energy efficiency of homes by upgrading windows, doors, air sealing, and insulation. The federal government and the state of California have made historic large-scale investments to encourage homeowners to retrofit their homes. Creating labor standards to mandate wage floors and benefits levels in the industry can ensure that residential decarbonization investments improve job quality rather than reinforcing labor practices that undermine workers’ well-being. Climate advocates want building decarbonization investments to go as far and fast as possible toward reaching climate goals. Some have expressed concerns that attaching labor standards could raise the costs of residential decarbonization work significantly, reducing the number of projects that can be completed with available funds and slowing down the timeframe for reducing emissions. This paper explores the potential economic impacts of adopting labor standards for the residential decarbonization industry in the 9-county Bay Area. Our study compares the status quo in the industry to two different labor standards that could be adopted: (1) prevailing wages and benefits and (2) setting a wage floor of 180 to 250 percent of the state minimum wage, depending on a worker’s trade, and requiring that employers provide health insurance and retirement plans. For each of these potential labor standards, we estimate the potential impact on worker earnings, operating costs for employers, project prices for consumers and public agencies, the size of the local economy, and local government revenues and expenditures.

Importance Since 1999, over 1 million people have died of a drug overdose in the US. However, little is known about the bereaved, meaning their family, friends, and acquaintances, and their views on the importance of addiction as a policy priority. Objectives To quantify the scope of the drug overdose crisis in terms of personal overdose loss (ie, knowing someone who died of a drug overdose) and to assess the policy implications of this loss. Design, Setting, and Participants This cross-sectional study used data from a nationally representative survey of US adults (age ≥18 years), the fourth wave of the COVID-19 and Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March to April 2023. Main Outcomes and Measures Respondents reported whether they knew someone who died of a drug overdose and the nature of their relationship with the decedent(s). They also reported their political party affiliation and rated the importance of addiction as a policy issue. Logistic regression models estimated the associations between sociodemographic characteristics and political party affiliation and the probability of experiencing a personal overdose loss and between the experience of overdose loss and the perceived salience of addiction as a policy issue. Survey weights adjusted for sampling design and nonresponse. Results Of the 7802 panelists invited to participate, 2479 completed the survey (31.8% response rate); 153 were excluded because they did not know whether they knew someone who died of a drug overdose, resulting in a final analytic sample of 2326 (51.4% female; mean [SD] age, 48.12 [0.48] years). Of these respondents, 32.0% (95% CI, 28.8%-34.3%) reported any personal overdose loss, translating to 82.7 million US adults. A total of 18.9% (95% CI, 17.1%-20.8%) of all respondents, translating to 48.9 million US adults, reported having a family member or close friend die of drug overdose. Personal overdose loss was more prevalent among groups with lower income (<$30 000: 39.9%; ≥$100 000: 26.0%). The experience of overdose loss did not differ across political party groups (Democrat: 29.0%; Republican: 33.0%; independent or none: 34.2%). Experiencing overdose loss was associated with a greater odds of viewing addiction as an extremely or very important policy issue (adjusted odds ratio, 1.37; 95% CI, 1.09-1.72) after adjustment for sociodemographic and geographic characteristics and political party affiliation. Conclusions and Relevance This cross-sectional study found that 32% of US adults reported knowing someone who died of a drug overdose and that personal overdose loss was associated with greater odds of endorsing addiction as an important policy issue. The findings suggest that mobilization of this group may be an avenue to facilitate greater policy change.

African Economic Development Solutions (AEDS) works throughout the Twin Cities metropolitan area to create wealth, lift immigrant communities out of poverty, and contribute to and benefit from the region’s vibrant economy. Over the past several decades, the proportion of African-born residents living in the Twin Cities has increased by 72% (Ruggles et al., 2007-2011; 2017-2021). The majority of African-born adults are working (78%) and more than half (56%) have attended at least some college. As Minnesota welcomes more immigrant communities, organizations like AEDS can play an important role in supporting and building the economic success of those who arrive. Business ownership is an important part of the United States economy and has multiple advantages for business owners in the form of independence, flexible lifestyle, learning opportunities, creative freedom and personal satisfaction, and financial rewards (Exploring Business, 2016). In addition, the ability to earn income, own a house, and build and sustain wealth is critical to the health and well-being of all Twin Cities residents, as well as the overall economy.

Health insurance coverage for both children and their parents can facilitate access to affordable health care, protect families' economic security, enhance families' overall well-being, and promote children's healthy development During the COVID-19 public health emergency (PHE), numerous federal and state policies were enacted to protect access to affordable health insurance coverage, including a continuous coverage requirement in Medicaid that maintained enrollment for all enrollees between March 2020 and March 2024 and enhanced Marketplace subsidies beginning in 2021. 1 Prior research has shown that uninsurance fell during this period for both children and nonelderly adults (Lee et al. 2022; Haley et al. 2022; McMorrow et al. 2022). 2 Access to affordable health care is particularly critical in the perinatal period and during early childhood, given high and inequitable risks of infant mortality and maternal morbidity and mortality and the important physical, cognitive, and socio-development occurring in children under age 3 (Center on the Developing Child 2010; Declercq and Zephyrin 2021; Ely and Driscoll 2023; Gunja, Gumas, and Williams 2023; Lipkin and Macias 2020). We focus on coverage among children under age 3 and their custodial parents, hereafter referred to as young children and their parents.

Farmers face unique challenges and opportunities in saving for and maintaining income during retirement relative to other Americans. Farm households have higher income than the average American household but may decide to invest in their farm rather than save for retirement. We use information from the Agricultural Resource Management Survey, the Survey of Consumer Finances, and the Current Population Survey to answer three questions pertaining to the retirement preparedness of farm households. First, what is the composition of income and assets for farm households? Second, how do retirement income and assets for farm households compare to those of all U.S. households and nonfarm self-employed households? Third, do retirement income and assets vary across subpopulations of retirement-age farmers? Our results suggest that, on average, older farm households received smaller shares of their income from retirement sources and had smaller retirement assets than older U.S. households. However, farm households had higher levels of total income and assets with most assets being concentrated in the farm operation. Farm assets may be relatively illiquid compared to retirement assets making it more difficult to rely on them for income during retirement. Among older farm households, those with low-sales farm businesses and Hispanic and non-White operators may be particularly unprepared for retirement relative to other farm households. Our results have implications for farm household well-being as operators’ average age rises. They highlight the similar and distinct challenges farmers face in saving for and maintaining income in retirement relative to other workers.

Introduction: 22q11.2 deletion syndrome (22q11DS) and 22q duplication syndrome present a wide range of medical challenges. The health and well-being of pediatric patients with 22q11DS may be influenced by socioeconomic factors, which can significantly shape their healthcare experiences, access to services, and overall quality of life. The objective of this study is to identify what factors are correlated with no-show clinic visits for children with 22q11DS. Methods: A retrospective chart review was performed on pediatric patients in a 22q patient registry of a tertiary care facility that includes patients with 22q11DS and 22q duplication syndrome. Demographic data, sex assigned at birth, appointment attendance, comorbid conditions, and patient specific outcomes were collected for analysis. The patient’s home address was cross-referenced with the GeoMarker database to define corresponding specific socioeconomic contextual variables. Results: 236 patients were included in the study including 198 patients (83.9%) with 22q11DS and 38 patients (16.1%) with 22q duplication syndrome. Collectively, these patients were scheduled for a total of 9,734 clinic visits and 2,347 visits with the 22q multidisciplinary clinic (22q MDC). The overall mean rate of no-show clinic visits for the 22q MDC was 7.7% ± 10.9 and the median was 0% (IQR = 8.4%). Factors associated with clinic no-show included lower median household income (OR (95% CI) 1.43 (1.25-1.64), p < .001), lower fraction of population with high school diploma (OR (95% CI) 2.33 (2.04-2.67), p < .001) higher fraction of population below the poverty line (OR (95% CI) 1.52 (1.32- 1.73), p < .001) and higher fraction of population that required assisted income (OR (95% CI) 1.38 (1.21-1.58), p < .001). Interestingly, farther distance from the tertiary care facility was associated with lower no-show rate (OR (95% CI) 0.71 (0.60-0.85), p < .001). Conclusion: These findings highlight the potential influence of socioeconomic factors on no-show clinic appointments in pediatric patients with 22q11DS. These factors can be used to help identify patients at risk of no-show clinic appointments and be used to develop targeted interventions aimed at improving clinic attendance and ultimately elevating patient outcomes.

This qualitative study builds on previous work by Portland State University’s Institute on Aging (IOA/PSU) during fall 2022 that focused on direct care staff experiences in Oregon assisted living and residential care facilities (AL/RC).1 During individual and focus group interviews, direct care workers, state policy analysts, and AL/RC administrators and executives discussed diversity and inclusion. IOA/PSU learned about the ways that AL/RC providers promote acceptance, respect, and belonging among their care staff. For example, staff talked about feeling welcome and hosting potlucks with international foods, and some providers hired interpreters to assist with training and respected holidays important to staff from diverse cultures. However, some direct care workers experience racism, sexism, and other forms of interpersonal discrimination at work, as well as structural inequities that can affect well-being, job performance, and job tenure.