Abstract

Studies show that the burden of caregiving tends to fall on individuals of low socioeconomic status (SES); however, the association between SES and the likelihood of caregiving has not yet been established. We studied the relationship between SES and the likelihood of adults providing long-term care for their parents in Japan, where compulsory public long-term insurance has been implemented. We used the following six comprehensive measures of SES for the analysis: income, financial assets, expenditure, living conditions, housing conditions, and education. We found that for some SES measures the probability of care provision for parents was greater in higher SES categories than in the lowest category, although the results were not systematically related to the order of SES categories or consistent across SES measures. The results did not change even after the difference in the probability of parents' survival according to SES was considered. Overall, we did not find evidence that individuals with lower SES were more likely to provide care to parents than higher-SES individuals. Although a negative association between SES and care burden has been repeatedly reported in terms of care intensity, the caregiving decision could be different in relation to SES. Further research is necessary to generalize the results.

Highlights

  • Health policy researchers have taken considerable interest in the influence that socioeconomic status (SES) has on individual health

  • This study aims to analyze the association between SES and the likelihood of individuals providing care for parents and the underlying mechanism, using the Japanese Study of Aging and Retirement (JSTAR) datasets

  • When we study the relationship between SES and the decision to participate in informal care provision, one important aspect that needs to be considered is the relationship between SES and the survival probability of care recipients

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Summary

Introduction

Health policy researchers have taken considerable interest in the influence that socioeconomic status (SES) has on individual health. Recent studies have extended the analysis to long-term care, as the SES gradient in long-term care, including both care receipt and care provision, is an important consideration when designing a public long-term care system, in which equality is valued. As in many European countries, several policy reforms have recently been implemented in Japan’s public long-term care system, mainly due to the state’s limited fiscal capacity. These policy reforms include adjustments in eligibility rules and an increase in the coinsurance rate for long-term care services.

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