Disability in Older People and Socio-Economic Deprivation in Italy: Effects on the Care Burden and System Resources

Georgia Casanova,Roberto Lillini

doi:10.3390/su14010205

Abstract

The sustainability of European Long-Term Care systems faces the demographic and socio-economic circumstances, mainly the increasing ageing of the population, with its chronic disease conditions, and the simultaneous economic general crises, exacerbated by the recent COVID-19 pandemic. Beyond the increase in general rate of relative poverty, there is a higher risk of poverty among elderly and families in a high demand of care, especially if situations of Activities Daily Living (ADL) disability are present. Italian welfare, which is based on family care regimes and regional strategies, and is oriented to private or public care, is a relevant case study with which to analyze such a relationship. This paper aims to study the relationship between ADL disability and the socio-economic deprivation of families, that is, household poverty. Variables came from the ISTAT Health for All Italian Database and the INAIL Disability Allowance Database. A pool of statistical methods, based on bivariate and multivariate analyses, from bivariate correlation, through multiple linear regression to principal component factor analysis, were used to reduce the number of the variables and compute the indicators. The multivariate analysis underlines how ADL disability impacts on a household’s poverty, confirming the existence of statistical correlation between them. Moreover, the study identifies and measures two answer capability models to cope with household poverty. The answer capability of the formal system is the main tool for reducing poverty due to one family member’s ADL disability. Integration and collaboration between the formal system and family capabilities remains the main solution.

Highlights

Activities of Daily Living (ADL) disability, ageing, and poverty are central themes in the social and health policy debate
This study aims to define the correlation between ADL disability and the increasing poverty of families in Italy and to evaluate the effects on families, describing the main accountable factors
Low education level, and unemployment, along with the presence of ADL disability, elderly people to be cared for at home, and regional out-of-pocket contribution, each stimulated an increase in HP

Summary

Introduction

Activities of Daily Living (ADL) disability, ageing, and poverty are central themes in the social and health policy debate. In 2017, Mosca and colleagues underlined how the sustainability of European LTC systems seemed to be fragile due to the demographic and fiscal circumstances and the complexities of LTC systems [7]. These authors emphasised the usefulness of learning from the policy design and implementation of LTC policy in other countries, within and outside of the EU. Low income and poverty risk issues have been relevant causes of social exclusion for older people [10,11]. Janković-Milić et al [10] underlined that most European countries use the baseline of relative income poverty.

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