The date was January 6th 1941. President Franklin D. Roosevelt gave his “Four Freedoms speech” urging Congress to change course on global matters by helping America’s allies in WWII. He saw U.S. involvement as a must for protecting national security and world democracies.

Within a year, Japan attacked Pearl Harbor and the U.S. declared war. America’s main threat today is domestic, and we can choose to take action or be pushed. Roosevelt’s Four Freedoms—freedom of speech, freedom of worship, freedom from want, freedom from fear—were a call to action to secure the future.

In the spirit of Roosevelt’s Four Freedoms, we offer Four Care Facts:

1. We’ll all need or give care eventually.
2. Long-term care is especially broken.
3. Broken care puts our prosperity & security at risk.
4. Connection is the key to prosperity & quality care.

1. WE’LL ALL NEED OR GIVE CARE EVENTUALLY.

To paraphrase Rosalynn Carter, there are four kinds of people in the world:
Current, past and future caregivers, and those who will need them.

Caregiving affects us ALL, and care demands are only growing. In the U.S., loneliness, chronic disease and other illnesses are on the rise at a time when our nation is trending older. By 2030, all baby boomers—now estimated at about 73 million people—will be 65 or older.¹

According to the U.S. Census Bureau, …

People 85 and over are the fastest-growing age group in America. And by 2035, older people (65+) will outnumber children for the first time in U.S. history.

Truly, we’re not ready.

2. LONG-TERM CARE IS ESPECIALLY BROKEN.

It’s widely held that America’s health care is broken. We hold that long-term care is especially so.

Long-term care is for people, like many older adults and people with disabilities, needing help with activities of daily living, like bathing and toileting. It includes medical and non-medical services and supports that can be provided in homes, community settings, nursing homes and assisted living facilities. But it’s costly.

Median long-term care costs per year (all states):⁵

Medicare—national health insurance for Americans 65+—doesn’t cover long-term care.

Neither do most insurance plans.

The high costs of long-term care translate into family caregivers—de facto health care workers—providing it most, and the number of family caregivers has grown by 20 million in the last decade to 63 million in 2025. That’s 1 in 4 U.S. adults 18+ at high risk of harming their careers and future earning potential.

There are also an estimated 5.4 million kid caregivers, and their health and school performance suffer for it.

(This section was recently updated and missing citations will be added soon.)

3. BROKEN CARE PUTS OUR PROSPERITY & SECURITY AT RISK.

Our families, care systems and economy only do as well as caregivers who keep them going, and our future prosperity is looking bleak because family caregivers—essential workers in all sectors—aren’t doing well.

Caregiving robs jobs & compensation, drains vitality and shortens lives:

• Caregiving is the single most common reason people aged 25-54 give for not working.
• Valued at over $835 billion, if caregiving were a business it would be the largest revenue-generating company in the world.
• Caregivers spend an average of about $7200 a year on caregiving needs like food, gas and medication.
• 70% of caregivers show signs of clinical depression.
• 40% of caregivers of someone with Alzheimer’s die before their caree.
• Caregiving spouses have a 63% higher mortality risk compared to non-caregivers.

Caregiving costs employers billions:

• Lost productivity due to caregiving costs U.S. businesses between about $17 – $34 billion a year.
• In addition to lost productivity resulting from employees being absent or distracted, hidden costs of caregiving include turnover costs, such as replacing employees forced to resign and lost knowledge.

Caregiving drives up healthcare costs:

• Caregiving health declines add an estimated $28 billion to healthcare costs a year.
• There’s a 73% increase in ER visits for people with dementia whose caregivers have depression.

In addition to all this, …

Care professionals are quitting or taking their own lives:

In the broader environment, …

A lack of access to healthcare aids the spread of misinformation, which is linked to despair.¹⁵

Despair is itself considered a health crisis as well as national security issue:¹⁶

In the last decade, “Deaths of Despair”—premature deaths from drugs, alcohol and suicide—have claimed over a million lives, precipitating a decline in our national life expectancy. ¹⁷

In addition, people in despair are more prone to manipulation by players with nefarious intent.¹⁸

(This section was recently updated and missing citations will be here soon.)

4. CONNECTION IS THE KEY TO PROSPERITY & QUALITY CARE.

Now for some good news:

“As a force in shaping our health, medical care pales in comparison with the circumstances of the communities in which we live. Few aspects of community are more powerful than is the degree of connectedness and support for individuals.”¹⁹

Translation:

Caring communities—villages—are more vital for our basic health than health professionals.

#NeighborsFirstDoctorsNext

“Neighbors first, doctors next” isn’t to downplay the role of doctors, but to say that prevention is better than cure. And together, we can prevent the further spread of loneliness, social isolation and more.

Loneliness is the feeling of being alone, despite social connections. Social isolation, which can lead to loneliness, is a lack of social connections. By preventing both, we can prevent…

And potentially prevent some of these significantly: Loneliness and social isolation increase the risk of dementia by 50%, stroke by 32% and heart disease by 29%.²³ On the flip side, cancer patients who feel satisfied with their level of social support have a greater chance of survival.²⁴

To repeat:

“Few aspects of community are more powerful than is the degree of connectedness and support for individuals.” And the beauty is that there are countless ways to connect with and support others. What’s more, each of us—babies to centenarians—can play a part.

People feel lonely for different reasons:

One study found that adults 66-75 were likely to mention limited shopping opportunities as a source of loneliness, whereas those 44-55 were likely to mention divorce.²⁵

About half of lonely young adults in another study said that no one had taken more than a few minutes in the prior weeks to ask about them in a way that communicated genuine care.²⁶

That all means that we can help to mitigate loneliness by spending more time to say hello, taking someone to the thrift store or even going on a date! And helping with “small” things—walking a dog, folding laundry, taking out trash etc.—are big deals for someone grappling with illness or exhaustion.

And here’s something even better to consider:

While prevention is better than cure, we can surpass prevention by making prosperity on purpose.

Making prosperity on purpose means working together—connecting and creating—to unlock widespread VITALITY, which necessarily includes laying the groundwork for quality care.

WE CAN PREVENT HUNGER WITH JUNK FOOD THAT CAUSES DIABETES.

Or, hunger prevention isn’t the same as feeding people well. Similarly, preventing loneliness and social isolation isn’t the same producing systems and supports to help people prosper, or to feel alive.

“In the future days, which we seek to make secure, we [The People of Village Company 360] look forward to a world [in which groups of all ages live, work and play together in pursuit of widespread prosperity] founded upon four essential [design] freedoms”:

Freedom of imagination.

Imagination is our creative power. To restrict it is to restrict our lives.

Freedom of experimentation.

“Take a method and try it. If it fails, admit it and try another. But by all means try something.”

Freedom from perfection.

Failing to make progress by trying to improve all things for all people.

Freedom from exclusion.

How can we design for anyone’s prosperity if they’re not part the process?

“That is no vision of a distant millennium.

It is a definite basis for a kind of world attainable [as soon as we decide].”

(The quoted text is Roosevelt.)

If ageism is discrimination against our future selves, improving quality of life (and death) for older adults is the highest form of self-love. Next, we propose a way of loving not only ourselves but caregivers and us all.

THANKS FOR READING.

CONTINUE TO OUR VISION OF VILLAGE CARE FOR ALL >>>

References:

1. 2020 Census Will Help Policymakers Prepare for the Incoming Wave of Aging Boomers; Census.gov
2. As above.
3. How Much Care Will You Need?; Administration for Community Living at LongTermCare.gov
4. As above.
5. Genworth Cost of Care Survey; Genworth.com
6. Caregiving in The U.S. 2020; National Alliance for Caregiving and AARP; Caregiving.org
7. Caregiving in The U.S. 2015; National Alliance for Caregiving and AARP; Caregiving.org
8. The MetLife Study of Working Caregivers and Employer Health Costs: Double Jeopardy for Baby Boomers Caring for their Parents.
9. Caregiving in The U.S. 2020; National Alliance for Caregiving and AARP; Caregiving.org
10. Caregiver Depression: A Silent Health Crisis; Family Caregiver Alliance at Caregiver.org
11. As above.
12. Low-wage workers prop up the nursing home industry. They’re quitting in droves.; The Washington Post
13. Mercer’s US Healthcare External Labor Market Analysis; Mercer.us
14. Doctors’ Suicide Rate Highest of Any Profession; WebMd.com
15. Despair Undermines our Misinformation Crisis; John Templeton Foundation “Grantee Voices” at Templeton.org
16. As above.
17. As above.
18. Addressing America’s crisis of despair and economic recovery; The Brookings Institute at Brookings.edu
19. The Loneliness Epidemic; Health Resources and Services Administration; Archived webpage at HRSA.gov
20. Loneliness and Social Isolation Linked to Serious Health Conditions; Centers for Disease Control and Prevention at CDC.gov
21. Loneliness in America: How the Pandemic Has Deepened an Epidemic of Loneliness and What We Can Do About It; Harvard Graduate School of Education at mcc.gse.harvard.edu
22. As above.
23. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System; National Academies of Sciences, Engineering, and Medicine at nap.NationalAcademies.org
24. Social Relationships, Inflammation, and Cancer Survival; Collaborative study accessed via National Library of Medicine at ncbi.nlm.nih.gov
25. 2021 Consumer Wellness Survey: Loneliness; Consumer Affairs at ConsumerAffairs.com
26. Loneliness in America: How the Pandemic Has Deepened an Epidemic of Loneliness and What We Can Do About It; Harvard Graduate School of Education at mcc.gse.harvard.edu