Aging America: The Coming Shortage of Care Workers and Builders
Nadègeand Jeffrey discuss declining U.S. labor force participation, falling birth rates and immigration, and the resulting shortages in nursing, long-term care, construction, and other labor‑intensive industries - plus why AI won't solve hands‑on care gaps and what policymakers should prioritize (retraining, protecting vulnerable sectors, preserving institutional knowledge).
Jeffrey Snyder, Broadcast Retirement Network
Nadège, it's so great to see you, thanks for joining us this morning.
Nadège Ngomsi, IMPLAN
Thank you so much, Jeffrey, it's a pleasure to be here today.
Jeffrey Snyder, Broadcast Retirement Network
It's great. And I really wanted to tap into your research for ImPlan. Let's talk about a declining U.S. population. I know you looked at a lot of the census data. How significant is this decline in the U.S. population?
Nadège Ngomsi, IMPLAN
Yes, well, mainly what we're talking about this decline in the U.S. population, we're mainly speaking on, you know, the decrease in labor force participation rate, particularly in ages 55 to 64. It's not as significant in the sense that we still have enough in order to continue to, you know, reproduce our current circumstances. But we're mainly talking about the future here and what it's going to look like further down the road when we will have that labor shortage.
It's going to affect many different industries, especially the top industry is things like nursing, construction, amusement and leisure and activities. So when we're thinking about significance, we're mainly focusing on what's going to happen in the future.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. And, you know, my understanding, and you can confirm this for me, is that the birth rate here in the States, and I think it is globally as well, has really gone down. So we're not producing as many babies or as many people as we had with other generations.
Nadège Ngomsi, IMPLAN
Correct. We're not. And also another driver that's affecting this is that there is also a decrease in immigration.
So we don't have that replacement rate. We have a decline in labor force participation, you know, replacement rate, but we also have this decline in, you know, vital industries that are not being able to be replaced by younger workers or an influx of younger workers that are coming into the country and filling those vital roles.
Jeffrey Snyder, Broadcast Retirement Network
And you mentioned nursing. One of the things that I've read about is this peak 65, which is a term for people that maybe not my generation, but they will, you know, I think you alluded to this, that in the future we will have many, many people who are age 65. So nursing, long-term care, these are some of the industries, I think you mentioned, that are going to be impacted by not having, you know, we're going to need people to care for us.
I can't put this all on my wife.
Nadège Ngomsi, IMPLAN
Yes, exactly. Exactly. And, you know, your wife shouldn't have to have, and again, everyone else's and whatsoever, they shouldn't have to bear that extra burden.
And you're absolutely right. You're going to see an increase in demand for those care services. So for nursing, like I mentioned, but other community care services as well, you're going to see an increase.
And I don't know if you haven't already noticed, I'm seeing in my area, an increase in retirement homes that are being built almost like this overnight. So those are the main sectors that you're going to see an increase in demand, but a shortage in the replacement of that labor force.
Jeffrey Snyder, Broadcast Retirement Network
Are there certain parts geographically of the country, of the United States, that maybe are going to be hit harder than others? I know the report mentioned California. That's obviously our largest state.
But are there states geographically that are going to be more impacted than others because their populations have declined or maybe their birth rates are down significantly and they need to get to work on that?
Nadège Ngomsi, IMPLAN
Yeah, that's a good question. My analysis mainly focuses on the U.S. total overall. You will see a form of shortage in those high concentration cities such as New York, cities in California.
But also I want to focus on the rural communities as well in the U.S. Because of the decrease in services already in the rural communities, those hospital services, the care services, you're going to see, and excuse me if I don't say if this is too harsh of a phrase, but a drought in those types of services for rural communities, which means they're going to have to drive further, expend more gas, expend more resources just to get that care that they need.
So I feel like they're actually a bit more vulnerable to those high concentration areas such as New York, California, Texas, and Florida, and also like larger cities in the Midwest like Chicago.
Jeffrey Snyder, Broadcast Retirement Network
Good old Chicago, the second city. I'm a big fan of Chicago, big streets. Me too.
I'm not a Cubs fan or a White Sox fan, but I know they love their sports. You brought up migration and people coming into the country. Let me ask you about, I don't know if you got into this detail, but there are people, even since the pandemic and now that people can work remotely, although businesses want people to come back to work in an office, but people have moved around this country and seem to really be moving around.
I live in North Carolina. I grew up in Baltimore. I spent some time in New York.
My wife grew up here in Greensboro in North Carolina, went to New York, and now we're back here. There are a lot of people like us. That migration also is going to have an impact.
Nadège Ngomsi, IMPLAN
Yeah, and I wanted to be specific when we talk about the migration is, and I don't want to just focus on immigration policies. There's just not as many people that are just coming into the country like they used to. As a result of that, we're going to see some workers in the U.S. that are going to have to shift their thinking in particular types of jobs that they need to take or that they would like to take. We're going to also see more retraining. Right now, there's already a critical, again, a critical drought in the nursing and these heavy, human-intensive industries. So although people are moving around in the country, they're moving around in the country, but they're moving around when they're taking these remote-type jobs or IT-related jobs.
The jobs that I'm focusing about are jobs that are more human-intensive, labor-intensive, jobs that require you to carry heavy items, jobs that require you to care for others. Those types of jobs are in critical condition right now because the infrastructure, we're experiencing these structural shifts that the infrastructure is not able to handle as quickly.
Jeffrey Snyder, Broadcast Retirement Network
Sorry, I didn't mean to interrupt you. I was going to ask you, you brought up a good point, and these are things that AI, because everyone talks about it. I mean, I can't have a conversation with somebody without bringing up artificial intelligence.
AI is not going to be able to lift me up when I'm 80 years old to go to the bathroom. AI, I guess a robot could, but in its current state, AI is not the answer here. AI is going to help lead to greater efficiencies, but it's not going to do the heavy lift as you're describing it.
Nadège Ngomsi, IMPLAN
Exactly. And you just hit the nail on the head. So right now, we are kind of seeing two opposing forces in the economy.
We're seeing an increase in productivity due to AI, but we're also seeing a decrease in labor force participation. And so AI, there is going to be a gap that AI will not be able to fill. And so when I look at AI, we're seeing these IT professionals, and we're also seeing all these other professionals in different industries that are seeing the significant rise in AI, and they're exiting the workforce because they don't want to retrain or they don't have the capacity to retrain.
And so they decided that, hey, look, I can live on my retirement savings, number one. I have some equity in my home, and I'm at the highest point that I'm earning right now, which is this is around the age that they've already hit their highest average employee compensation. And so they've decided to just exit their workforce and live off of those pensions, live off of those 401ks, live off of those home equities.
And so some of them are moving around the country for that. But AI cannot solve all of our problems. You have an AI agent that can help you do more work in IT-related services.
But like you said, AI is not going to be able to help you down the stairs. But we're also seeing an increase in this technology in which a lot of older workers can use AI for certain activities. You're seeing a lot of Amazon Alexa, and now they're able to remind you of your medication, things like that.
But it won't replace an actual worker, an actual touching industries where you can actually provide that senior care. So that strain is very layered.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, I think this is a, without sounding overly dramatic, I think this is a big challenge that we, and we're not the only ones. I know you looked at the US, but I have to think this is going on in other countries across the globe. I want to finish off with some lessons for our public policymakers, both at the state, federal, and local level.
Are there lessons? What do they need to be focused on? If you were sitting testifying before Congress at the aging committee, subcommittee, what would you tell them they need to focus on?
Nadège Ngomsi, IMPLAN
Yeah, that's really good. I think the number one lesson that is to be learned from this is that when we are introducing new technology, we don't want to displace workers. We don't want to feel like these workers have to choose between, you know, should I eat or do I need to retrain?
There should be enough experience for everyone to still particularly have, you know, a job if they want a job, and also to be able to replace those older workers. The second lesson is that we should constantly be retraining. Retraining is a very, very big factor right now is that we don't have enough training programs.
And so we're losing a lot of intellectual capacity. These older workers have a lot of knowledge. They have a lot of institutional knowledge.
And when they're exiting the workforce, and they're leaving and moving around, we lose that institutional knowledge. We're also losing, you know, supervision, trade judgment, safety knowledge, you know, a lot of these hazards and complex tasks that a lot of these older workers were participating and they were conducting. You know, AI does not have that institutional knowledge.
It cannot, it doesn't have the ability or the heuristical knowledge to know, okay, when this occurs, we should do this. And when that occurs, we should do that. Another thing I wanted to mention is that a third lesson, and this is a real issue, is that we do have a replaceability problem.
So we need to be careful on these vulnerable workers in vulnerable sectors. We need to keep an eye on those vulnerable sectors and ensure that we have enough, not just training, but also workers that are able to shift between different roles, but that don't require so much retraining as well. So those workers that are on, you know, the line, the precipice, shall I say, of one job versus another, they should be able to move within industries without having to lose that institutional knowledge.
Jeffrey Snyder, Broadcast Retirement Network
Well, obviously this is not going away. This is a challenge that I think we're going to have to work collectively to overcome. Nadège, it was great to meet you.
Great research. And look, this needs to be continued. We look forward to having you back on the program again very soon.
Nadège Ngomsi, IMPLAN
Thank you so much, Jeffrey. And I would totally love to come back on the program.
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This story was originally published May 16, 2026 at 7:30 AM.