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Review of Economics of the Household

, Volume 14, Issue 4, pp 745–778 | Cite as

Is caring for older parents detrimental to women’s mental health? The role of the European North–South gradient

  • Elenka Brenna
  • Cinzia Di Novi
Article

Abstract

In the last decades, both the lengthening of life expectancy and an accentuated decline in birth rates have reduced the consistency of the younger generational cohorts. Due to an ageing population, the burden of caregiving is expected to intensify in the next quarter of the century in Europe, especially for mature women. This paper investigates the impact of the provision of constant care for older parents on the mental health of adult daughters, between the ages of 50 and 75, living in different European countries. Data is drawn from the Survey of Health, Ageing and Retirement in Europe. Information on mental health status is provided by Euro-D depression scale, a measure of depression standardized across European countries. We focus on differences in the effects according to the North–South gradient: we test whether the relationship between informal caregiving and mental health differs across European macro-regions. Our results, robust under different specifications of the propensity score model, reveal a clear North–South gradient: the provision of informal care has a negative and significant impact on daughters’ mental health in the Mediterranean countries only, where the amount of resources allocated to the Long Term Care is minimal and the local system of health and social services for the elderly lacks the necessary structures to meet the increasing demand for eldercare.

Keywords

Caregiver burden Depression Parent care LTC systems Mature women 

JEL Classification

I10 I12 D10 

Notes

Acknowledgments

An earlier draft of this paper was presented at the annual meeting of the Italian Health Economics Association (AIES), Trento, Italy, at the International Health Economics Association (iHEA) annual conference, Milan, Italy, at the European Federation of Retired and Older Persons (FERPA) Annual Conference, Bruxelles, Belgium, at XII Workshop of Public Economics at Regional and Local Level (PEARL), Alessandria, Italy, and at seminars at the University of Lugano, Marche Polytechnic University, Ca’ Foscari University of Venice. The authors thank the conference and seminar participants for their detailed and helpful comments. The authors also thank Andrea Albarea, Silvia Balia, Vincenzo Carrieri, Alberto Cassone, Claudio Lucifora, Fabrizio Mazzonna, Giacomo Pasini, Elisabetta Trevisan, Francesca Zantomio for useful suggestions. Financial support provided by Fondazione FarmaFactoring (Milan) for this research project is gratefully acknowledged. The authors also wish to thank the editors and two anonymous referees for helpful comments. The usual disclaimer applies.

Supplementary material

11150_2015_9296_MOESM1_ESM.doc (86 kb)
Supplementary material 1 (DOC 85 kb)

References

  1. Alessie, R., Angelini, V., & Pasini, G. (2014). Is it true love? Altruism versus exchange in time and money transfers. De Economist, 162, 193–213.CrossRefGoogle Scholar
  2. Amirkhanyan, A. A., & Wolf, D. A. (2006). Parent care and the stress process: Findings from panel data. The Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 61, 248–255.CrossRefGoogle Scholar
  3. Averett, S. L., Argys, L. M., & Sorkin, J. (2013). In sickness and in health: An examination of relationship status and health using data from the Canadian National Public Health Survey. Review Economics of the Household, 11, 599–633.CrossRefGoogle Scholar
  4. Barnett, R. C., Marshall, N. L., & Singer, J. D. (1992). Job experiences over time, multiple roles, and women’s mental health: A longitudinal study. Journal of Personality and Social Psychology, 62, 634–644.CrossRefGoogle Scholar
  5. Bettio, F., & Plantenga, J. (2004). Comparing care regimes in Europe. Feminist Economics, 10(1), 85–113.CrossRefGoogle Scholar
  6. Billari, F. C. (2004). Becoming an adult in Europe. Demographic Research, 15–44 (special collection 3, article 2 published 17 April 2004).Google Scholar
  7. Billari, F. C., & Kholer, H. P. (2006). Patterns of low and lowest fertility in Europe. Population Studies, 58(2), 161–176.CrossRefGoogle Scholar
  8. Bolin, K., Lindgren, B., & Lundborg, P. (2008a). Your next of kin or your own career?: Caring and working among the 50 + of Europe. Journal of Health Economics, 27, 718–738.CrossRefGoogle Scholar
  9. Bolin, K., Lindgren, B., & Lundborg, P. (2008b). Informal and formal care among single-living elder in Europe. Health Economics, 17, 393–409.CrossRefGoogle Scholar
  10. Bonsang, E. (2009). Does informal care from children to their older parents substitute for formal care in Europe? Journal of Health Economics, 28, 143–154.CrossRefGoogle Scholar
  11. Bookwala, J. (2009). The impact of parent care on marital quality and well-being in adult daughters and sons. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64B(3), 339–347.CrossRefGoogle Scholar
  12. Booth, A. L., Francesconi, M., & Frank, J. (2002). Temporary jobs: Stepping stones or dead ends? Economic Journal, 112(480), 189–213.CrossRefGoogle Scholar
  13. Börsch-Supan, A., & Jürges, H. (Eds.). (2005). The survey of health, ageing and retirement in Europe—Methodology. Mannheim: MEA.Google Scholar
  14. Brown, M. (2006). Informal care and the division of end-of-life transfers. Journal of Human Resources, 41, 191–219.CrossRefGoogle Scholar
  15. Caliendo, M., & Kopeinig, S. (2008). Some practical guidance for the implementation of propensity score matching. Journal of Economic Surveys, 22, 31–72.CrossRefGoogle Scholar
  16. Callegaro, L., & Pasini, G. (2008). Social interaction effects in an inter-generational model of informal care giving. Netspar discussion paper 023.Google Scholar
  17. Cannuscio, C. C., Colditz, G. A., Rimm, E. B., Berkman, L. F., Jones, C. P., & Kawachi, I. (2004). Employment status, social ties, and caregivers’ mental health. Social Science and Medicine, 58, 1247–1256.CrossRefGoogle Scholar
  18. Carrieri, V., Di Novi, C., Jacobs, R., & Robone, S. (2014). Insecure, sick and unhappy? Well-being consequences of temporary employment contracts. In S. W. Polachek, K. Tatsiramos (Eds.), Factors affecting worker well being. Research in labor economics (Vol. 40, ch. 4).Google Scholar
  19. Coe, N., & Van Houtven, C. H. (2009). Caring for mom and neglecting yourself? The health effects of caring for an older parent. Health Economics, 18, 991–1010.CrossRefGoogle Scholar
  20. Crespo, L., & Mira, P. (2010). Caregiving to elderly parents and employment status of European mature women. Madrid: WP CEMFI.Google Scholar
  21. Davey, A., & Patsios, D. (1999). Formal and informal community care to older adults: Comparative analysis of the United States and Great Britain. Journal of Family and Economic Issues, 20, 271–299.CrossRefGoogle Scholar
  22. Dewey, M. E., & Prince, M. J. (2005). Mental Health. In Axel Börsch-Supan & Hendrik Jürges (Eds.), Health, ageing and retirement in Europe—First results from the survey of health, ageing and retirement in Europe (pp. 108–117). Mannheim: MEA Eigenverlag.Google Scholar
  23. Di Novi, C., Jacobs, R., & Migheli, M. (2015). The quality of life of female informal caregivers: From Scandinavia to the Mediterranean Sea. European Journal of Population, 31, 1–27. doi: 10.1007/s10680-014-9336-7.
  24. El Habhoubi, E. (2012). The effect of caregiving on employment and mental health examined for midlife European citizens. Netspar thesis. http://arno.uvt.nl/show.cgi?fid=129941.
  25. EOP (European Overview Paper). (2010). Informal care in the long-term care system.Google Scholar
  26. Esping-Andersen G. 1990. The three worlds of welfare capitalism. London: Polity.Google Scholar
  27. Ganzeboom, H. B. G., & Treiman, D. G. (1996). Internationally comparable measures of occupational status for the 1988 International Standard Classification of Occupations. Social Science Research, 25, 201–239.CrossRefGoogle Scholar
  28. Grammenos, S. (2005). Implications of demographic ageing in the enlarged EU in the domains of quality of life, health promotion and health care. Studies on the policy implications of demographic changes in national and community policies, Lot 5 Contract VC/2004/0076 no S12.396079, Brussels.Google Scholar
  29. 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, 707–723.CrossRefGoogle Scholar
  30. Hirst, M. (2002). Transitions to informal care in Great Britain during the 1990s. Journal of Epidemiology and Community Health, 56, 579–587.CrossRefGoogle Scholar
  31. Hu, Y., & Wolfe, B. (2002). Health inequality between black and white women. Discussion paper no. 1251-02. Institute for Research on Poverty.Google Scholar
  32. 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, 305–327.CrossRefGoogle Scholar
  33. Imbens, G. W., & Wooldridge, J. M. (2009). Recent developments in the econometrics of program evaluation. Journal of Economic Literature, 47, 5–86.CrossRefGoogle Scholar
  34. Kalwij, A., Pasini, G., & Wu, M. (2014). Homecare for the Elderly: Family, friends and the state. Review of Economics of the Household, 12, 379–404.CrossRefGoogle Scholar
  35. Kim, M., Kim, C., Park, J., & Kawachi, I. (2008). Is precarious employment damaging to self-rated health? Results of propensity score matching methods, using longitudinal data in South Korea. Social Science and Medicine, 67, 1982–1994.CrossRefGoogle Scholar
  36. Kotsadam, A. (2011). Does informal care impede employment? The case of European welfare states. Gothenburg: WP Department of Economics, University of Gothenburg.Google Scholar
  37. 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, Revised 19 July 2012.Google Scholar
  38. Lin, W. F., Chen, L. H., & Li, T. (2012). Adult children’s caregiver burden and depression: The moderating roles of parent–child relationship satisfaction and feedback from others. Journal of Happiness Studies. Google Scholar
  39. Mortensen, J., Spiess, C. K., Katharin, C., Schneider, T., Costa-Font, J., & Concepcio, P. (2004). Health care and female employment: A potential conflict. European Network of Economic Policy Research Institutes, Occasional paper 6/April.Google Scholar
  40. O’Donnell, O., Van Doorslaer, E., Wagstaff, A., & Lindelow, M. (2008). Analysing health equity using household survey data. Washington DC: The World Bank.Google Scholar
  41. OECD. (2011). Help wanted? Providing and paying for long term care. http://www.oecd.org/els/healthpoliciesanddata/47884865.pdf.
  42. Pavalco, E. K., & Artis, J. (1997). Women’s caregiving and paid work: Causal relationships in late midlife. The Journals of Gerontology Series B: Psychological Sciences and Social Science, 52, 170–179.CrossRefGoogle Scholar
  43. Pezzin, L., & Steinberg-Schone, B. (1999). Intergenerational household formation, female labor supply and informal caregiving: A bargaining approach. The Journal of Human Resources, 34, 475–503.CrossRefGoogle Scholar
  44. Prince, M. J., Beekman, A. T., Deeg, D. J., Fuhrer, R., Kivela, S. L., Lawlor, B. A., et al. (1999). Depression symptoms in late life assessed using the EURO-D scale: Effect of age, gender and marital status in 14 European centres. British Journal of Psychiatry, 174, 339–345.CrossRefGoogle Scholar
  45. Reher, D. S. (1998). Family ties in Western Europe: persistent contrasts. Population and Development Review, 24, 203–234.CrossRefGoogle Scholar
  46. Reinhard, S. C., et al. (2008). Safety and quality: An evidence-based handbook for nurses: Vol. 1. In Hughes R. F. (Ed.), AHRQ publication no. 08-0043. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  47. Riedel, M., & Kraus, M. (2011). The organization of formal long-term care for the elderly: Results from the 21 European country studies in the ANCIEN project. Report: Enepri Research. 95.Google Scholar
  48. Riley, L. D., & Bowen, C. (2005). The Sandwich Generation: Challenges and coping strategies of multigenerational families. Family Journal, 13, 52–58.CrossRefGoogle Scholar
  49. Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70, 41–55.CrossRefGoogle Scholar
  50. Rubin, R. M., & White-Mean, S. I. (2009). Informal caregiving: Dilemmas of sandwiched caregivers. J Fam Econ Issue, 30, 252–267.CrossRefGoogle Scholar
  51. Sarasa, S., Mestres, J. (2005). Women’s employment and the adult caring burden. DemoSoc working paper 2005–07.Google Scholar
  52. Shulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality: the caregiver health effect study. Journal of the American Medical Association, 282, 2215–2219.CrossRefGoogle Scholar
  53. Shulz, R., & Sherwood, P. R. (2008). Physical and mental effects of family caregiving. American Journal of Nursing, 108, 23–27.CrossRefGoogle Scholar
  54. Silverstein, M., Gans, D., & Yang, F. M. (2006). Intergenerational support to ageing parents. Journal of Family Issues, 27, 1068–1084.CrossRefGoogle Scholar
  55. Sloan, F. A., Picone, G., & Hoerger, T. J. (1997). The supply of children’s time to disabled older parents. Economic Inquiry, 35, 295–308.CrossRefGoogle Scholar
  56. Sloan, F. A., Zhang, H. H., & Wang, J. (2002). Upstream intergenerational transfers. Southern Economic Journal, 69, 363–380.CrossRefGoogle Scholar
  57. SPRU (Social Policy Research Unit) University of York. (2009). Care Provision within families and its socio-economic impact on care providers. Working paper no. EU 2342, Report for the European Commission DG EMPL Negotiated Procedure VT/2007/114.Google Scholar
  58. Vitaliano, P. P., Zhang, J., & Scanlan, J. M. (2003). Is caregiving hazardous to one’s physical health? A meta-analysis. Psychological Bullettin, 129, 946–973.CrossRefGoogle Scholar
  59. Walker, A. T., Pratt, C. C., & Eddy, L. (1995). Informal caregiving to aging family members: A critical review. Family Relations, 44, 402–411.CrossRefGoogle Scholar
  60. Wooldridge, J. M. (2000). The initial conditions problem in dynamic, nonlinear panel data models with unobserved heterogeneity. East Lansing: Michigan State University.Google Scholar
  61. Zantomio, F. (2013). Older people’s participation in extra-cost disability benefits. Journal of Health Economics, Elsevier, 32, 320–330.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Economic and FinanceCatholic University of the Sacred HeartMilanItaly
  2. 2.Department of EconomicsCa’ Foscari University of VeniceVeniceItaly

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