Skip to main content

Advertisement

SpringerLink
Log in

The Quality of Life of Female Informal Caregivers: From Scandinavia to the Mediterranean Sea

  • Published:
European Journal of Population Aims and scope Submit manuscript

Abstract

We analyse the impact of the provision of care on the health and quality of life (QoL) of adult female informal caregivers using a representative sample drawn from the survey of health, ageing and retirement in Europe (SHARE). We match each informal caregiver with a non-carer using propensity score matching and test whether matched individuals differ on self-assessed health and a functional indicator of QoL and whether this relationship differs across European regions. We find a North–South gradient both for self-assessed health and QoL, and our results show that the provision of caregiving to close relatives in Europe impacts on the caregivers’ QoL and health in a way that depends on their geographical location, the degree of formal care and specific cultural and social factors of the area. We find that informal caregiving is a complex phenomenon which may bring both psychological rewards and distress to providers of care and this complexity, along with the geographical gradient highlight the importance of ensuring that policies match the needs of individual carers in their own geographical areas and cultural contexts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Abel, E. K. (1986). Adult daughters and care for the elderly. Feminist Studies, 12(3), 479–497.

    Article  Google Scholar 

  • Amirkhanyan, A. A., & Wolf, D. A. (2006). Parent care and the stress process: Findings from panel data. Journals of Gerontology: Series B, 61(5), S248–S255.

    Article  Google Scholar 

  • Andreoni, J., & Vesterlund, L. (2001). Which is the fair sex? Gender differences in preferences. The Quarterly Journal of Economics, 116(1), 292–312.

    Article  Google Scholar 

  • Andrén, S., & Elmståhl, S. (2005). Family caregivers’ subjective experiences of satisfaction in dementia care: Aspects of burden, subjective health and sense of coherence. Scandinavian Journal of Caring Sciences, 19(2), 157–168.

    Article  Google Scholar 

  • Balia, S., & Jones, A. M. (2008). Mortality, lifestyle and socio-economic status. Journal of Health Economics, 27(1), 1–26.

    Article  Google Scholar 

  • Bass, D. M., Noelker, L. S., & Rechlin, L. R. (1996). The moderating influence of service use on negative caregiving consequences. Journal of Gerontology, 51(3), S121–S131.

    Article  Google Scholar 

  • Bettio, F., & Plantenga, J. (2004). Comparing care regimes in Europe. Feminist Economics, 10(1), 85–113.

    Article  Google Scholar 

  • Binder, M., & Freytag, A. (2013). Volunteering, subjective well-being and public policy. Journal of Economic Psychology, 34(1), 97–119.

    Article  Google Scholar 

  • Bolin, K., Lindgren, B., & Lundborg, N. P. (2008). Your next of kin or your own career? Caring and working among the 50+ of Europe. Journal of Health Economics, 27(3), 718–738.

    Article  Google Scholar 

  • Bonsang, E. (2009). Does informal care from children to their elderly parents substitute for formal care in Europe. Journal of Health Economics, 28(1), 143–154.

    Article  Google Scholar 

  • Börsch-Supan, A., Brugiavini, A., Jürges, H., Kapteyn, A., Mackenbach, J., Siegrist, J. & Weber, G. (2008). First results from the survey of health, ageing and retirement in Europe (2004–2007): Starting the longitudinal dimension, Mannheim Research Institute for the Economics of Aging (MEA), Mannheim. Retrieved from http://www.share-project.org/uploads/tx_sharepublications/BuchSHAREganz250808.pdf.

  • Brandt, M., Haberken, K., & Szydlik, M. (2009). Intergenerational help and care in Europe. European Sociological Review, 25(5), 585–601.

    Article  Google Scholar 

  • Browne, M. J., & Doerpinghaus, H. I. (1993). Information asymmetries and adverse selection in the market for individual medical expense insurance. The Journal of Risk and Insurance, 60(2), 300–312.

    Article  Google Scholar 

  • Caliendo, M., & Kopeinig, S. (2008). Some practical guidance for the implementation of propensity score matching. Journal of Economic Surveys, 22(1), 31–72.

    Article  Google Scholar 

  • Cantor, M. H. (1975). Life space and the social support system of the inner city elderly of New York. Gerontologist, 15(1), 23–27.

    Article  Google Scholar 

  • Castillo, M. E., & Cross, P. J. (2008). Of mice and men: Within gender variation in strategic behavior. Games and Economic Behavior, 64(2), 421–432.

    Article  Google Scholar 

  • Chiang, E. P., & Assane, D. (2007). Determinants of music copyright violations on the university campus. Journal of Cultural Economics, 31(3), 187–204.

    Article  Google Scholar 

  • Chiang, E. P., & Assane, D. (2008). Music piracy among students on the university campus: Do males and females react differently? Journal of Socio-Economics, 37(4), 1371–1380.

    Article  Google Scholar 

  • Coe, N. B., & van Houtven, C. H. (2009). Caring for mom and neglecting yourself? The health effects of caring for an elderly parent. Health Economics, 18(9), 991–1010.

    Article  Google Scholar 

  • Contoyannis, P., & Jones, A. M. (2004). Socio-economic status, health and lifestyle. Journal of Health Economics, 23(5), 965–995.

    Article  Google Scholar 

  • Crespo, L., & Mira, P. (2010). Caregiving to elderly parents and employment status of European mature women. Madrid: CEMFI.

    Google Scholar 

  • Croson, R., & Gneezy, U. (2009). Gender differences in preferences. Journal of Economic Literature, 47(2), 448–474.

    Article  Google Scholar 

  • Deeken, J. F., Taylor, K. L., Mangan, P., Yabroff, K. R., & Ingham, J. M. (2003). Care for the caregivers: A review of self-reported instruments developed to measure the burden, needs, and quality of life of informal caregivers. Journal of Pain and Symptom Management, 26(4), 922–953.

    Article  Google Scholar 

  • De Luca, G. (2009). Determinants of the attrition process in the first two waves of SHARE. ISFOL. London: The Royal Society.

    Google Scholar 

  • Dentinger, E., & Clarkberg, M. (2002). Informal caregiving and retirement timing among men and women gender and caregiving relationships in late midlife. Journal of Family Issues, 23(7), 857–879.

    Article  Google Scholar 

  • Donelan, K., Hill, C. A., Hoffman, C., Scoles, K., Feldman, P. H., Levine, C., & Gould, D. (2002). Challenger to care: Informal caregivers in a changing health system. Health Affairs, 21(4), 222–231.

    Article  Google Scholar 

  • Eikemo, T. A., Bambra, C., Joyce, K., & Dahl, E. (2008). Welfare state regimes and income-related health inequalities: A comparison of 23 European countries. European Journal of Public Health, 18(6), 593–599.

    Article  Google Scholar 

  • Elster, J. (1989). Social norms and economic theory. Journal of Economic Perspectives, 3(4), 99–117.

    Article  Google Scholar 

  • Gallicchio, L., Siddiqi, N., Lagenberg, P., & Baumgarten, M. (2002). Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17(2), 154–163.

    Article  Google Scholar 

  • Gjerberg, E. (2002). Gender similarities in doctors’ preferences—and gender differences in final specializations. Social Science and Medicine, 54(4), 591–605.

    Article  Google Scholar 

  • Gneezy, U., Leonard, K. L., & List, J. A. (2009). Gender differences in competition: Evidence from a matrilineal and patriarchal society. Econometrica, 77(5), 1637–1664.

    Article  Google Scholar 

  • Gräsel, E. (2002). When home care ends: Changes in the physical health of informal caregivers caring for dementia patients: A longitudinal survey. Journal of the American Geriatrics Society, 50(5), 843–849.

    Article  Google Scholar 

  • Grundy, E., & Henretta, J. C. (2006). Between elderly parents and adult children: A new look at the intergenerational care provided by the ‘Sandwich Generation’. Ageing and Society, 26(5), 707–722.

    Article  Google Scholar 

  • Ham, J.C., & Li, X. (2011). Assessing the ability of matching to address attrition bias in a randomized experiment using data from the rand health insurance experiment, IZA Working Papers.

  • Hammer, L. B., & Neal, M. (2008). Working sandwiched-generation caregivers: Prevalence, characteristics, and outcomes. The Psychologist-Manager Journal, 11(1), 93–112.

    Article  Google Scholar 

  • Hank, K. (2007). Proximity and contacts between older parents and their children: A European comparison. Journal of Marriage and Family, 69(1), 157–173.

    Article  Google Scholar 

  • Henz, U. (2006). Informal caregiving at working age: Effects of job characteristics and family configuration. Journal of Marriage and Family, 68(2), 411–429.

    Article  Google Scholar 

  • Hirst, M. (2003). Caring-related inequalities in psychological distress in Britain during the 1990s. Journal of Public Health Management, 25(4), 336–343.

    Article  Google Scholar 

  • Hirst, M. (2005). Carer distress: A prospective, population-based study. Social Science and Medicine, 61(3), 697–708.

    Article  Google Scholar 

  • Hyde, M., Wiggins, R. D., Blane, D., & Higgs, P. (2003). A measure of quality of life in early old age: The theory, development and properties of a needs satisfaction model. Aging and Mental Health, 7(1), 86–94.

    Google Scholar 

  • Ichino, A., Mealli, F., & Nannicini, T. (2008). From temporary help jobs to permanent employment: What can we learn from matching estimators and their sensitivity? Journal of Applied Econometrics, 23(3), 305–327.

    Article  Google Scholar 

  • Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 21–37.

    Article  Google Scholar 

  • Idler, E. L., & Kasl, S. V. (1995). Self-ratings of health: Do they also predict change in functional ability? Journal of Gerontology, 50(6), 344–353.

    Article  Google Scholar 

  • Imbens, G. W., & Wooldridge, J. M. (2009). Recent developments in the econometrics of program evaluation. Journal of Economic Literature, 47(1), 5–86.

    Article  Google Scholar 

  • Ingersoll-Dayton, B., Neal, M. B., & Hammer, L. B. (2001). Ageing parents helping adult children: The experience of the Sandwiched Generation. Family Relations, 50(3), 262–271.

    Article  Google Scholar 

  • Joy, L. (2006). Occupational differences between recent male and female college graduates. Economics of Education Review, 25(2), 221–231.

    Article  Google Scholar 

  • Kemper, P. (1992). The use of formal and informal home care by disabled elderly. Health Services Research, 27(4), 421–451.

    Google Scholar 

  • Kenkel, D. S. (1994). The demand for preventive medical care. Applied Economics, 26(4), 313–325.

    Article  Google Scholar 

  • Kennedy, B. P., Kawachi, I., Glass, R., & Prothrow-Stith, D. (1998). Income distribution, socio-economic status, and self rated health in the United States: Multilevel analysis. British Medical Journal, 317(7163), 917–921.

    Article  Google Scholar 

  • Klevmarken, N. A., Swensson, B., & Hesselius, P. (2005). The share sampling procedures and calibrated design weights. In A. Bo¨rsch-Supan & H. Ju¨rges (Eds.), The survey of health, aging, and retirement in Europe. Mannheim: Mannheim Research Institute for the Economics of Aging.

    Google Scholar 

  • Kunst, A. E., Bos, V., Lahelma, E., Bartley, M., Lissau, I., Regidor, E., et al. (2005). Trends in socioeconomic inequalities in self-assessed health in 10 European countries. The International Journal of Epidemiology, 34(2), 295–305.

    Article  Google Scholar 

  • Le Bihan, B., & Martin, C. (2006). A comparative case study of care systems for frail elderly people: Germany, Spain, France, Italy, United Kingdom and Sweden. Social Policy & Administration, 40(1), 26–46.

    Article  Google Scholar 

  • Lee, H. S., Brennan, P. F., & Daly, B. J. (2001). Relationship of empathy to appraisal, depression, life satisfaction and physical health in informal caregivers of older adults. Research in Nursing & Health, 24(1), 44–56.

    Article  Google Scholar 

  • Leuven, E. & Sianesi, B. (2003). PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching, common support graphing, and covariate imbalance testing. Statistical Software Components S432001: Boston College Department of Economics, Retrieved July 19, 2012.

  • Litwak, E. (1985). Helping the elderly: The complementary roles of informal networks and formal systems. New York: Guilford Press.

    Google Scholar 

  • Lyons, K. S., & Zarit, S. H. (1999). Formal and informal support: The great divide. International Journal of Geriatric Psychiatry, 14, 183–196.

    Article  Google Scholar 

  • Malach-Pines, A., Hammer, L., & Neal, M. (2009). Le Couple de la ‘Génération pivot’: Ètude Interculturelle et Intergenres. Pratiques Psychologiques, 15(2), 225–237.

    Article  Google Scholar 

  • Marks, N. F., Lambert, J. D., & Choi, H. (2002). Transitions to caregiving, gender, and psychological well-Being: A prospective U.S. national study. Journal of Marriage and Family, 64(3), 657–667.

    Article  Google Scholar 

  • Mazzonna, F., & Peracchi, F. (2012). Ageing, cognitive abilities and retirement. European Economic Review, 56(4), 691–710.

    Article  Google Scholar 

  • McCullagh, P. (1980). Regression models for ordinal data (with discussion). Journal of the Royal Statistical Society: Series B, 42(2), 109–142.

    Google Scholar 

  • Nowak, M. A., & Sigmund, K. (2005). Evolution of indirect reciprocity. Nature, 437, 1291–1298.

    Article  Google Scholar 

  • O’Donnell, O., van Doorslaer, E., Wagstaff, A., & Lindelow, M. (2008). Analyzing health equity using household survey data: A guide to techniques and their implementation. Washington, D.C.: The World Bank.

    Google Scholar 

  • Oudijk, D., Woittiez, I., & de Boer, A. (2011). More family responsibility, more informal care? The effect of motivation on the giving of informal care by people aged over 50 in The Netherlands compared to other European countries. Health Policy, 101(3), 228–235.

    Article  Google Scholar 

  • Pagani, L., & Marenzi, A. (2008). The labor market participation of Sandwich Generation Italian women. Journal of Family and Economic Issues, 29(3), 427–444.

    Article  Google Scholar 

  • Pezzin, L. E., & Steinberg, S. B. (1999). Intergenerational household formation, female labor supply and informal caregiving. Journal of Human Resources, 34(3), 475–803.

    Article  Google Scholar 

  • Piko, B., & Keresztes, N. (2007). Self-perceived health among early adolescents: Role of psychosocial factors. Pediatrics International, 49(5), 577–583.

    Article  Google Scholar 

  • Pinquart, M., & Sörensen, S. (2007). Correlates of physical health of informal caregivers: A meta-analysis. Journal of Gerontology, 62B, P126–P137.

    Article  Google Scholar 

  • Pocock, B. (2005). Work/care regimes: Institutions, culture and behaviour and the Australian Case. Gender, Work & Organization, 12(1), 32–49.

    Article  Google Scholar 

  • Rangone, M., Solari, S. (2010) Southern Europe’s social model of economic growth in an age of financialisation and crisis, institutional change and trajectories of socio-economic models, Working Paper no. 2010.

  • Reher, D. S. (1998). Family ties in Western Europe: Persistent contrasts. Population and Development Review, 24(2), 203–234.

    Article  Google Scholar 

  • Robin, J. M., Michel, J. P., & Herrmann, F. R. (2007). Who will care for the oldest people in our ageing society? British Medical Journal, 334, 570–571.

    Article  Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41–55.

    Article  Google Scholar 

  • Rubin, R. M., & White-Means, S. I. (2009). Informal caregiving: Dilemmas of sandwiched caregivers. Journal of Family and Economic Issues, 30(3), 252–267.

    Article  Google Scholar 

  • Saraceno, C. (1997) Family change, family policies and the restructuring of welfare. In Family, market and community: equity and efficiency in social policy. OECD Social Policy Series 21. Paris: OECD.

  • Schröder, C. (2008) Economic insecurity and cohabitation strategies in Italy. MPIDR, Working Paper 2008 004. Retrieved http://www.demogr.mpg.de/papers/working/wp-2008-004.pdf.

  • Tawney, R. H. (1926). Religion and the rise of capitalism: A historical study. New York: Harcourt¸ Brace & Co.

    Google Scholar 

  • Torgler, B., & Valev, N.T. (2006). Women and illegal activities: Gender differences and women’s willingness to comply over time. Center for Research in Economics, Management and the Arts: CREMA Working Paper no. 2006-15. Retrieved http://www.crema-research.ch/papers/2006-15.pdf.

  • Torgler, B., & Valev, N. T. (2010). Gender and public attitudes towards corruption and tax evasion. Contemporary Economic Policy, 28(4), 554–568.

    Article  Google Scholar 

  • Undén, A. L., & Elofsson, S. (2006). Do different factors explain self-rated health in men and women? Gender Medicine, 3(4), 295–308.

    Article  Google Scholar 

  • Van Houtven, C. H., & Norton, E. C. (2009). Informal care and health care use of older adults. Journal of Health Economics, 23(6), 1159–1180.

    Article  Google Scholar 

  • Wagstaff, A., & Van Doorslaer, E. (1994). Measuring inequalities in health in the presence of multiple-category morbidity indicators. Health Economics, 3(4), 281–289.

    Article  Google Scholar 

  • Weber, M. (1905, 1930). The protestant ethics and the spirit of capitalism. Sydney: Allen & Urwin.

  • Wilson, M. R., van Houtven, C. H., Stearns, S. C., & Clipp, E. C. (2007). Depression and missed work among informal caregivers of older individuals with dementia. Journal of Family and Economic Issues, 28(4), 684–698.

    Article  Google Scholar 

Download references

Acknowledgments

An earlier draft of this paper was presented at the annual meeting of the Italian Health Economics Association, Rome, Italy; at the annual meeting of the International Institute of Public Finance, Taormina, Italy; at the annual international conference on Health Economics, Management & Policy, Athens, Greece. The authors wish to thank the participants for useful comments received. We also thank Vincenzo Carrieri, Giacomo Pasini, Mario Padula, Paola Profeta, Chiara D. Pronzato and Francesca Zantomio for useful suggestions. The authors also wish to thank the editors and two anonymous referees for helpful comments. Financial support provided by Fondazione FarmaFactoring (Milan) for this research project is gratefully acknowledged. This research collaboration emerged as a result of Cinzia Di Novi being awarded an Alan Williams Fellowship to visit the Centre for Health Economics at the University of York. The usual disclaimer applies.

Author information

Authors and Affiliations

  1. Department of Economics, Ca’ Foscari University of Venice, Venezia, Italy

    Cinzia Di Novi

  2. Centre for Health Economics, University of York, York, UK

    Rowena Jacobs

  3. Department of Economics and Statistics “Cognetti de Martiis”, University of Torino and CeRP - Collegio “Carlo Alberto”, Lungodora Siena, 100, 10153, Torino, TO, Italy

    Matteo Migheli

Authors
  1. Cinzia Di Novi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rowena Jacobs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Matteo Migheli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matteo Migheli.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Di Novi, C., Jacobs, R. & Migheli, M. The Quality of Life of Female Informal Caregivers: From Scandinavia to the Mediterranean Sea. Eur J Population 31, 309–333 (2015). https://doi.org/10.1007/s10680-014-9336-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10680-014-9336-7

Keywords

JEL Classification Code

Search

Navigation