Is the grass greener on the other side? The health impact of providing informal care in the UK and the Netherlands.

Judith Bom,Jannis Stöckel

doi:10.1016/j.socscimed.2020.113562

Judith Bom, Jannis Stöckel

Open Access

https://doi.org/10.1016/j.socscimed.2020.113562

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Abstract

Facing rapidly ageing populations, many Western countries aim to stimulate informal care provision as a way to meet the growing long-term care (LTC) demand. While various studies report the impact of providing informal care on the health of caregivers, it is less clear whether and to what extent this impact differs across countries. Using propensity score matching we match caregivers to similar non-caregiving individuals using four waves of the Dutch Study on Transitions in Employment, Ability and Motivation and the UK Household Longitudinal Study. The samples consist of 8129 Dutch and 7186 UK respondents, among which respectively 1711 and 1713 individuals are identified as caregivers. We explore whether the health impact of providing informal care differs by country once similar caregivers, in terms of the intensity of provided care, are compared. In both countries we find negative mental health effects of providing informal care. While these effects slightly differ by country, the main differences arise between subgroups of caregivers. Individuals that provide more than 20 hours of informal care per week, and those who face a double burden of care and full-time employment experience the most severe negative mental health effects. These results indicate that health effects of providing informal care are mediated by the specific caregiving context, allowing policymakers to use information on this context to provide targeted aid. In addition, it suggests that previously reported differences of caregiving effects across countries could be driven by differences in the population of informal caregivers which are shaped by countries' LTC policies.

Highlights

Facing rapidly ageing populations, many Western countries search for ways to meet the growing long-term care (LTC) demand
While several studies have reported negative health effects of informal care provision on the caregivers’ health, there remains uncer tainty with regards to their causal nature and the differences of these effects across countries and caregiver subgroups
We investigated whether observed average health differences between informal caregivers and non-caregivers within and across countries are attributable to the composition of the caregiver populations in each country

Summary

Introduction

Many Western countries search for ways to meet the growing long-term care (LTC) demand. To its potential impact on caregivers’ labor market participation, various studies indicate that the provision of informal care negatively affects informal caregivers’ health (see Bom et al, 2019a for a review) These health effects are not the same for all caregivers. Both countries are relatively similar in terms of the share of (dependent) elderly within the population, with slightly more elderly in the Netherlands. The system is largely publicly funded, copayments contribute only a small fraction (Maarse and Jeurissen, 2016) These copayments depend on type and duration of care, age, household composition, income, and (as of 2013) wealth. The payments are capped and cannot exceed the household income (Bakx et al, 2020a)

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