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The “Costs” of informal care: an analysis of the impact of elderly care on caregivers’ subjective well-being in Japan

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Abstract

This paper examines the impact of providing informal care to elderly parents on caregivers’ subjective well-being using unique data from the “Preference Parameters Study” of Osaka University, a nationally representative survey conducted in Japan. The estimation results indicate heterogeneous effects: while informal elderly care does not have a significant impact on the happiness level of married caregivers regardless of whether they take care of their own parents or parents-in-law and whether or not they reside with them, it has a negative and significant impact on the happiness level of unmarried caregivers. These findings call for more attention to be paid to unmarried caregivers, who presumably receive less support from family members and tend to be more vulnerable to negative income shocks than their married counterparts.

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Notes

  1. See Bauer and Spousa-Poza (2015) for a comprehensive survey of the literature on the impact of informal caregiving on caregivers’ employment, health, and family life.

  2. As commonly done in happiness studies, the three terms—subjective well-being, happiness, and life satisfaction—are used interchangeably in this paper.

  3. OECD data (https://data.oecd.org/pop/elderly-population.htm, accessed on September 24, 2015).

  4. Nakamura and Sugawara (2014) argue that the main explanation for this rise in the number of aged population without any children in the 2000s is that there had been an increase in the number of married women who did not bear any children.

  5. Although the Japanese LTCI system has largely followed the example of the German system, it incorporates Scandinavian-style community-based management, in which municipalities act as insurers. Based on the national government’s guidelines, each municipality administers LTCI and sets insurance premiums for its residents (Tsutsui and Muramatsu 2005, 2007).

  6. The computer aided standardized needs-assessment system categorizes people into seven levels of needs. The Care Needs Certification Board, a local committee consisting of health, medical, and welfare experts, then reviews this initial assessment and determines its appropriateness (Tsutsui and Muramatsu 2005). There are currently two levels for those who require support only (Support Levels 1 and 2) and five levels for those who require long-term care (Care Levels 1–5). This support/care level determines the amount of benefits that each person is entitled to receive.

  7. The data in this paragraph come from the “Status Report on the Long-Term Care Insurance Projects (Kaigo Hoken Jigyou Jyokyo Houkoku) (Fiscal Year 2013)”, Ministry of Health, Labour and Welfare (http://www.mhlw.go.jp/topics/kaigo/toukei/joukyou.html, accessed on September 30, 2015).

  8. Those who availed themselves of two or more types of services are double counted here.

  9. See Bauer and Spousa-Poza (2015) for a comprehensive survey of the literature on the impact of informal caregiving on caregivers’ employment, health, and family.

  10. The OLS and ordered logit regressions were estimated separately for married and unmarried individuals and the results of the OLS and ordered logit regressions were similar in both cases. The regression results for the ordered logit models are available from the author upon request.

  11. It is equally possible that those who find helping others fulfilling are more likely to decide to take care of their elderly parents than those who do not. We investigated this possible selection bias using information on whether or not respondents feel happy when they do something that would benefit/help others, which was contained in the survey data used for the empirical analysis. The t test results show that there is no significant difference in the tendency of providing care to elderly parents (or parents-in-law) between those people who find helping others fulfilling and those who do not. Similar test results were obtained for both the married and unmarried samples.

  12. An application of this procedure can be found, for example, in Adams et al. (2009).

  13. Although the 2011 wave also collected information on parental care, the way the key question was asked was different between the 2011 and 2013 waves. It was therefore not possible to conduct a panel data analysis using these two waves.

  14. See Frey and Stutzer (2002) and Clark et al. (2008) for a comprehensive survey of the literature on the determinants of the level of happiness.

  15. Table 3 of Appendix 1 briefly describes how the variables are constructed. Readers may also refer to Niimi (2015) for a more detailed description of the variables as she constructs similar variables to those used in the present study based on the 2013 wave of the Preference Parameters Study to examine the determinants of happiness inequality in Japan.

  16. Given that our unmarried sample contains individuals who are divorced or widowed in addition to those who are never married, there might be some divorced or widowed respondents, particularly the latter, who provide care to their parents-in-law even though they are no longer with their spouse. Unfortunately, for divorced or widowed respondents, we do not have information on whether they provide care to their parents-in-law. We therefore need to assume in this paper that those who are no longer with their spouse do not provide care to their parents-in-law.

  17. Irregular employees include those who are working as a part-time worker, temporary worker, fixed-term worker, or dispatched worker from a temporary agency. These irregular jobs tend to be low paid and insecure in comparison with regular employment.

  18. See Table 3 of Appendix 1 for how these variables were constructed. Similar variables were used as proxies for risk aversion, time preference, and altruism in the existing literature on the happiness of the Japanese (e.g., Ohtake 2012; Tsutsui et al. 2009; Yamane et al. 2008).

  19. According to the estimation results from the probit model of caregiving behavior, being female has a positive and significant effect on the likelihood of providing care to parents-in-law, though it does not have a significant effect on the probability of providing care to own parents in either the married or unmarried sample (see Table 4 of Appendix 2).

  20. To examine whether daughters-in-law are adversely affected by the provision of care to parents-in-law, we tried including an interaction term between the caregiving variable (parents-in-law) and the female dummy variable, but the coefficient on the interaction term was statistically insignificant.

  21. The estimation results from the probit model of the determinants of providing care to own parents also indicate that having a child has a negative and significant effect on the probability of taking care of own parents among unmarried individuals (see Table 4 of Appendix 2).

  22. Regression results of the instrumental variables models as well as the specification test results are in Tables 5 and 6 of Appendix 2.

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Acknowledgments

The empirical work undertaken in this paper utilizes micro data from the Preference Parameters Study of Osaka University’s twenty-first century COE Program ‘Behavioral Macrodynamics Based on Surveys and Experiments’ and its Global COE Project ‘Human Behavior and Socioeconomic Dynamics.’ I acknowledge the program/project’s contributors—Yoshiro Tsutsui, Fumio Ohtake and Shinsuke Ikeda. I am also grateful to two anonymous referees, Charles Yuji Horioka, Niny Khor and Eric D. Ramstetter as well as participants of the 2016 Economics, Health and Happiness Conference; Department of Economics Symposium of Kadir Has University; Tuesday Seminar Series of Nagoya City University; workshop of the Research Center for Aging Economy and Society, Graduate School of Economics and Management, Tohoku University; seminar of the Center for Advanced Economic Study, Faculty of Economics, Fukuoka University; and seminar of the Department of Economics, Deakin Business School, Deakin University for their invaluable comments. This work was supported by JSPS (Japan Society for the Promotion of Science) KAKENHI Grant Number 15H01950, a project research grant from the Asian Growth Research Institute, and a grant from the MEXT Joint Usage/Research Center on Behavioral Economics of the Institute of Social and Economic Research, Osaka University.

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  1. Asian Growth Research Institute, 11-4 Ohtemachi, Kokurakita-ku, Kitakyushu, Fukuoka, 803-0814, Japan

    Yoko Niimi

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Correspondence to Yoko Niimi.

Appendices

Appendix 1: Variable descriptions

Table 3 Description of Variables
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Appendix 2: IV estimation results

Table 4 First-stage binary (probit) model estimation
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Table 5 First-stage results for IV (2SLS)
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Table 6 Second-stage results for IV (2SLS)
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Niimi, Y. The “Costs” of informal care: an analysis of the impact of elderly care on caregivers’ subjective well-being in Japan. Rev Econ Household 14, 779–810 (2016). https://doi.org/10.1007/s11150-016-9333-1

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