This seminar will highlight some of the work from a UK Economic and Social Science Research Council (ESRC) funded project investigating how varying care systems are associated with inequalities in care and well-being in later life. This is part of a larger Open Research Area (ORA) funded project led by the Vrije Universiteit Amsterdam, in the Netherlands, and with Radboud Universiteit Nijmegen also in the Netherlands, the Technical University of Dortmund, in Germany, and Keio University in Japan.
The project examines if and how long-term care (LTC) reforms exacerbate existing social disparities in care and in caregiver and care recipient well-being. It investigates (a) how different long-term care systems and recent long-term care reforms are associated with socioeconomic inequalities in care among older adults, and (b) the consequences of these inequalities for the wellbeing of older care recipients and their caregivers. A better understanding of the consequences of different care policies for inequalities in care, and caregiver and care recipient wellbeing, will inform debate on the potential impact of future policy decisions.
This seminar focuses on findings from two strands of work. The first involves a description of and challenges encountered in the creation of a theory-based database of national (and where possible regional) indicators of key LTC features in European countries between 2004 and 2018. The database draws on available data on social care and family benefits from OECD databases and reports, Eurostat, and other macro-level databases together with cross-national individual-level survey data. In developing the database, we focused on indicators of specific LTC features reflecting ‘supported familialism’ (e.g., cash provided to relatives), ‘supported defamilialisation through the market’ (e.g., tax deductions) and ‘defamilialisation through public provision’ (e.g., number of beds in residential care, home care services) as they may impact care differently (as developed by Saraceno).
The second strand of work examines how wealth and income gradients in the use of informal, formal, and mixed home care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care (“de-familisation”). We use SHARE data on disabled older adults from 136 administrative regions in 12 European countries and linked them to a regional indicator of de-familisation in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models to study home-care use as a function of individual and regional-level LTC characteristics. We find that poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. This suggests that de-familisation in LTC favours the combination of formal and informal home-care among the more socio-economically disadvantaged, potentially mitigating health inequalities in later life.
Speaker Professor Karen Glaser,Institute of Gerontology, Department of Global Health and Social Medicine, King’s College London, link bio
Meeting ID: 943 0947 9118