Socioeconomic status and the likelihood of informal care provision in Japan: An analysis considering survival probability of care recipients.
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ABSTRACT:
SUBMITTER: Ibuka Y
PROVIDER: S-EPMC8362941 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundProviding informal care has a negative effect on the caregiver's health and well-being, but little is known about how individuals respond to receiving informal care. Care recipients may improve their health behaviours to minimise the onerousness of caregiving and the stress faced by their carer from seeing a loved one in ill-health.ObjectiveWe aimed to examine whether informal care recipients internalise the potential for carer spillovers through changes in health behaviours.MethodsWe used data from 3250 older adults with care needs who took part in the UK Household Longitudinal Study between 2017 and 2019. We examined the response to informal care receipt in terms of the probability of engaging in four health behaviours: healthy diet, physical activity, smoking and alcohol consumption. We estimated average treatment effects using regression adjustment with inverse probability treatment weights, comparing individuals that received informal care to those receiving either formal or no care.ResultsWe found that informal care receipt increased the probability of refraining from negative health behaviours (smoking and alcohol consumption) but reduced the probability of engaging in positive health behaviours (eating fruits and/or vegetables and physical activity).ConclusionsThe asymmetric effects detected suggest that the underlying mechanisms are different, and care recipients may be engaging in risk and effort compensation between negative and positive health behaviours. Failure to account for the behavioural responses from informal care recipients may lead to under-estimation or over-estimation of the extent of caregiving burden and the effectiveness of interventions impacting informal carers.
| S-EPMC10864417 | biostudies-literature
Project description:ObjectiveTo estimate how labor force participation is affected when adult children provide informal care to their parents.Data sourceSurvey of Health, Ageing and Retirement in Europe from 2004 to 2013.Study designTo offset the problem of endogeneity, we exploit the availability of other potential caregivers within the family as predictors of the probability to provide care for a dependent parent. Contrary to most previous studies, the dataset covers the whole working-age population in the majority of European countries. Individuals explicitly had to opt for or against the provision of care to their care-dependent parents, which allows us to more precisely estimate the effect of caregiving on labor force participation.Principal findingsResults reveal a negative causal effect that indicates that informal care provision reduces labor force participation by 14.0 percentage points (95 percent CI: -0.307, 0.026). Point estimates suggest that the effect is larger for men; however, this gender difference is not significantly different from zero at conventional levels.ConclusionsResults apply to individuals whose consideration in long-term care policy is highly relevant, that is, children whose willingness to provide informal care to their parents is altered by available alternatives of family caregivers.
| S-EPMC6051969 | biostudies-literature
Project description:OBJECTIVES: To test hypotheses concerning the relationship between formal and informal care and to estimate the impact of hours of formal care authorized for Medicaid Personal Care Services (PCS) on the utilization of informal care. DATA SOURCES/STUDY SETTING: Data included home care use and adult Medicaid beneficiary characteristics from assessments of PCS need in four Medicaid administrative areas in Texas. STUDY DESIGN: Cross-sectional design using ordinary least-squares (OLS) and instrumental variable (IV) methods. DATA COLLECTION/EXTRACTION METHODS: The study database consisted of assessment data on 471 adults receiving Medicaid PCS from 2004 to 2006. PRINCIPAL FINDINGS: Both OLS and IV estimates of the impact of formal care on informal care indicated no statistically significant relationship. The impact of formal care authorized on informal care utilization was less important than the influence of beneficiary need and caregiver availability. Living with a potential informal caregiver dramatically increased the hours of informal care utilized by Medicaid PCS beneficiaries. CONCLUSIONS: More formal home care hours were not associated with fewer informal home care hours. These results imply that policies that decrease the availability of formal home care for Medicaid PCS beneficiaries will not be offset by an increase in the provision of informal care and may result in unmet care needs.
| S-EPMC3401403 | biostudies-literature
Project description:Background: Previous studies in the UK and Denmark found no significant association between low socioeconomic status (SES) and weight faltering. However, to our knowledge, there are no studies from other developed countries. We examined the association between parental SES and weight faltering in infants up to 1.5 years of age, and investigated whether the inequalities changed between 2001 and 2010 in Japan. Methods: We used data from two Japanese population-based birth cohorts started in 2001 (n = 34,594) and 2010 (n = 21,189). Parental SES was assessed as household income and parental education when the infant was 6 months old. Weight faltering was defined as the slowest weight gaining in 5% of all children in each cohort. Logistic regression analyses were conducted with adjustment for covariates. The relative index of inequality was used to assess relative impact of parental SES on weight faltering. Results: Infants in the lowest quartile of household income were 1.29 (95% confidence interval [CI]: 1.10, 1.52) and 1.27 (95% CI: 1.03, 1.56) times more likely to experience weight faltering than those in the highest income quartile both in the 2001 and 2010 cohorts, respectively. The relative index of inequality for household income was 1.66 (95% CI: 1.36, 1.96) in 2001 and 1.86 (95% CI: 1.42, 2.31) in 2010. Conclusions: Infants from lower income families have a greater risk of weight faltering in Japan. Additionally, the income-related inequalities in weight faltering did not change between the two cohorts. Social policies to address maldistribution of weight faltering due to household income are needed.
| S-EPMC5938368 | biostudies-literature
Project description:A comprehensive methodology for semiparametric probability density estimation is introduced and explored. The probability density is modelled by sequences of mostly regular or steep exponential families generated by flexible sets of basis functions, possibly including boundary terms. Parameters are estimated by global maximum likelihood without any roughness penalty. A statistically orthogonal formulation of the inference problem and a numerically stable and fast convex optimization algorithm for its solution are presented. Automatic model selection over the type and number of basis functions is performed with the Bayesian information criterion. The methodology can naturally be applied to densities supported on bounded, infinite or semi-infinite domains without boundary bias. Relationships to the truncated moment problem and the moment-constrained maximum entropy principle are discussed and a new theorem on the existence of solutions is contributed. The new technique compares very favourably to kernel density estimation, the diffusion estimator, finite mixture models and local likelihood density estimation across a diverse range of simulation and observation data sets. The semiparametric estimator combines a very small mean integrated squared error with a high degree of smoothness which allows for a robust and reliable detection of the modality of the probability density in terms of the number of modes and bumps.
| S-EPMC8577774 | biostudies-literature
Project description:IntroductionInformal carers in paid employment-working carers (WKCs)-have complex support needs. However, little is known about WKCs' pattern of informal care provision, the support they receive, the impact providing care has on their employment, and how these vary between male and female WKCs. This study describes the pattern of informal care provision and received support among Swedish WKCs.Research method/designThe study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire addressed the type and extent of informal care provided, support received and the impact of care provision on employment. Of the 30,009 people who received the questionnaire, 11,168 (37.3%) responded, providing an analytic sample of 818 (7.32% of respondents) employed or self-employed informal carers.FindingsA typical Swedish WKC was a middle-aged female, providing weekly or daily care to a non-cohabitant parent, who experiences care as sometimes demanding and receives no formal support as a carer. Female WKCs were more likely than males to care alone and with higher intensity, to report a need for help in meeting their care-recipient's needs, and to experience care as demanding. Approximately 17% of WKCs reported their employment had been affected due to caring, 40% their ability to work, and 31% their career development opportunities. Female WKCs' ability to work was affected more than males', and they were more commonly prevented from applying for work.ConclusionSwedish female WKCs compared to males provide more hours of informal care, across more care domains, more often alone. This places them in a challenging situation when combining paid work and care. Greater recognition of the challenges faced by WKCs is required in Sweden and other countries, as are policies to reduce gender inequalities in informal care provision in this group.
| S-EPMC8901065 | biostudies-literature
Project description:BACKGROUND: Considerable evidence suggests that communication inequality is one potential mechanism linking social determinants, particularly socioeconomic status, and health inequalities. This study aimed to examine how dimensions of health communication outcomes (health information seeking, self-efficacy, exposure, and trust) are patterned by socioeconomic status in Japan. METHODS: Data of a nationally representative cross-sectional survey of 2,455 people aged 15-75 years in Japan were used for secondary analysis. Measures included socio-demographic characteristics, subjective health, recent health information seeking, self-efficacy in seeking health information, and exposure to and trust in health information from different media. RESULTS: A total of 1,311 participants completed the questionnaire, giving a response rate of 53.6%. Multivariate logistic regression revealed that education and household income, but not employment, were significantly associated with health information seeking and self-efficacy. Socioeconomic status was not associated with exposure to and trust in health information from mass media, but was significantly associated with health information from healthcare providers and the Internet. CONCLUSION: Health communication outcomes were patterned by socioeconomic status in Japan thus demonstrating the prevalence of health communication inequalities. Providing customized exposure to and enhancing the quality of health information by considering social determinants may contribute to addressing social disparities in health in Japan.
| S-EPMC3395686 | biostudies-other
Project description:Due to an increased prevalence of chronic diseases, older individuals may experience a deterioration of their health condition in older ages, limiting their capacity for social engagement and in turn their well-being in later life. Focusing on care provision to grandchildren and (older) relatives ('informal care') as forms of engagement, this paper aims to identify which individual characteristics may compensate for health deficits and enable individuals with multimorbidity to provide informal care. We use data from the SHARE survey (2004-2012) for individuals aged 60 years and above in 10 European countries. Logistic regression estimates for the impact of different sets of characteristics on the decision to provide care are presented separately for people with and without multimorbidity. Adapting Arber and Ginn's resource theory, we expected that older caregivers' resources (e.g., income or having a spouse) would facilitate informal care provision to a greater extent for people with multimorbidity compared to those without multimorbidity, but this result was not confirmed. While care provision rates are lower among individuals suffering from chronic conditions, the factors associated with caregiving for the most part do not differ significantly between the two groups. Results, however, hint at reciprocal intergenerational support patterns within families, as the very old with multimorbidity are more likely to provide care than those without multimorbidity. Also, traditional gender roles for women are likely to be weakened in the presence of health problems, as highlighted by a lack of gender differences in care provision among people with multimorbidity.
| S-EPMC5550603 | biostudies-literature
Project description:BackgroundThe population aging, together with the shrinking caring potential of families, is a major challenge for social policy in the coming years. The aim of the study is to identify the factors that determine not only the use of long-term care (LTC) but also the selection of individual types of such care in Poland.MethodsUsing unique data collected from inpatient LTC facilities in Poland and the Survey on Health, Ageing and Retirement in Europe (SHARE) database, we estimate logistic regressions explaining the choice of LTC solution.ResultsOur results suggest that social inequalities play a role in choosing the type of LTC. Better educated people choose private institutions, while people without support network use more often social residential homes. The impact of multimorbidity on choosing different types of inpatient facilities is limited, thus the number of ADL limitations remains a better indicator of long term care utilization.ConclusionsThe study confirms that social inequalities influence decisions about the choice of LTC. However, multi-morbidity is a predictor of using LTC to a limited extent. The differences in LTC selection determinants between women and men are noticeable.
| S-EPMC10463875 | biostudies-literature
Project description:Background: The number of people living with dementia worldwide is increasing, particularly in low- and middle-income countries (LMICs) where little is known about existing post-diagnostic care and support. This study aimed to better understand healthcare provision for people living with dementia in Malaysia, and to identify priorities for providing timely, quality, and accessible care and support to all. Methods: This is a qualitative interview study on care providers and facilitators (health and community care professionals, paid carers, traditional medicine practitioners, faith healers, community leaders, non-governmental organisations). A topic guide, piloted in Malaysia and peer reviewed by all LMIC partners, elicited the understanding of dementia and dementia care and barriers and facilitators to care for people living with dementia and carers, and perceptions of key priorities for developing efficient, feasible, and sustainable dementia care pathways. Verbatim transcription of audio-recorded interviews was followed by iterative, thematic data analysis. Results: Twenty interviews were conducted (11 healthcare professionals, 4 traditional medicine practitioners, and 5 social support providers). The findings indicate that dementia care and support services exist in Malaysia, but that they are not fully utilised because of variations in infrastructure and facilities across the country. Despite a locally recognised pathway of care being available in an urban area, people with dementia still present to the healthcare system with advanced disease. The interviewees linked this to a public perception that symptoms of dementia, in particular, are normal sequelae of ageing. Earlier detection of dementia is commonly opportunistic when patients present to GPs, government clinic staff, and general physicians with other ailments. Dementia may only be identified by practitioners who have some specialist interest or expertise in it. Workforce factors that hindered early identification and management of dementia included lack of specialists, overburdened clinics, and limited knowledge of dementia and training in guideline use. Post-diagnostic social care was reported to be largely the domain of families, but additional community-based support was reported to be available in some areas. Raising awareness for both the public and medical professionals, prevention, and more support from the government are seen as key priorities to improve dementia management. Conclusions: This qualitative study provides novel insight into the availability, delivery, and use of post-diagnostic care and support in Malaysia from the perspective of care providers. The respondents in this study perceived that while there was a provision for dementia care in the hospital and community settings, the different care sectors are largely unaware of the services each provides. Future work should explore how care provision across different service sectors and providers can be supported to better facilitate patient access and referral between primary, secondary, and social care. The importance of supporting families to understand dementia and its progression, and strategies to help them care for relatives was emphasised. There is also a need for broad workforce training and development, at both the postgraduate and undergraduate levels, as well as improved general awareness in the community to encourage earlier help-seeking for symptoms of dementia. This will enable the use of preventive strategies and access to specialist services to optimise care and quality of life for people living with dementia in Malaysia.
| S-EPMC8333996 | biostudies-literature