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Caring for mom and neglecting yourself? The health effects of caring for an elderly parent

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  • Norma B. Coe
  • Courtney Harold Van Houtven

Abstract

We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, using the death of the care recipient and sibling characteristics. We also carefully control for baseline health and work status of the adult child. We explore flexible specifications, such as Arellano-Bond estimation techniques. Continued caregiving over time increases depressive symptoms and decreases self-rated health for married women and married men. In addition, the increase in depressive symptoms is persistent for married women. While depressive symptoms for single men and women are not affected by continued caregiving, there is evidence of increased incidence of heart conditions for single men, and that these effects are persistent. Robustness checks indicate that these health changes can be directly attributable to caregiving behavior, and not due to a direct effect of the death of the mother. The initial onset of caregiving has modest immediate negative effects on depressive symptoms for married women and no immediate effects on physical health. Negative physical health effects emerge 2 years later, however, suggesting that there are delayed effects on health that would be missed with a short recall period. Initial caregiving does not affect health of married men. Published in 2009 by John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1512
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 18 (2009)
Issue (Month): 9 ()
Pages: 991-1010

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Handle: RePEc:wly:hlthec:v:18:y:2009:i:9:p:991-1010

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Steven Stern & Maxim Engers, . "Long-Term Care and Family Bargaining," Virginia Economics Online Papers 320, University of Virginia, Department of Economics.
  2. K. Bolin & B. Lindgren & P. Lundborg, 2007. "Informal and Formal Care among Single-living Elderly in Europe," Tinbergen Institute Discussion Papers 07-031/3, Tinbergen Institute.
  3. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
  4. Arellano, Manuel & Bond, Stephen, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," Review of Economic Studies, Wiley Blackwell, vol. 58(2), pages 277-97, April.
  5. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
  6. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single-living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409.
  7. Charles, Kerwin Kofi & Sevak, Purvi, 2005. "Can family caregiving substitute for nursing home care?," Journal of Health Economics, Elsevier, vol. 24(6), pages 1174-1190, November.
  8. Heitmueller, Axel, 2004. "The Chicken or the Egg? Endogeneity in Labour Market Participation of Informal Carers in England," IZA Discussion Papers 1366, Institute for the Study of Labor (IZA).
  9. Hiedemann, Bridget & Stern, Steven, 1999. "Strategic play among family members when making long-term care decisions," Journal of Economic Behavior & Organization, Elsevier, vol. 40(1), pages 29-57, September.
  10. Currie, Janet & Madrian, Brigitte C., 1999. "Health, health insurance and the labor market," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 50, pages 3309-3416 Elsevier.
  11. Van Houtven, Courtney Harold & Norton, Edward C., 2008. "Informal care and Medicare expenditures: Testing for heterogeneous treatment effects," Journal of Health Economics, Elsevier, vol. 27(1), pages 134-156, January.
  12. Steven Stern & Tennille J. Neuharth, 2000. "Shared Caregiving Responsibilities of Adult Siblings with Elderly Parents," Virginia Economics Online Papers 323, University of Virginia, Department of Economics.
  13. Edward C. Norton & Courtney Harold Van Houtven, 2006. "Inter-vivos Transfers and Exchange," Southern Economic Journal, Southern Economic Association, vol. 73(1), pages 157–172, July.
  14. Heitmueller, Axel & Inglis, Kirsty, 2007. "The earnings of informal carers: Wage differentials and opportunity costs," Journal of Health Economics, Elsevier, vol. 26(4), pages 821-841, July.
  15. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
  16. Steven Stern, 1995. "Estimating Family Long-Term Care Decisions in the Presence of Endogenous Child Characteristics," Journal of Human Resources, University of Wisconsin Press, vol. 30(3), pages 551-580.
  17. Kathleen M. McGarry, 1998. "5. Caring for the Elderly: The Role of Adult Children," NBER Chapters, in: Inquiries in the Economics of Aging, pages 133-166 National Bureau of Economic Research, Inc.
  18. Nickell, Stephen J, 1981. "Biases in Dynamic Models with Fixed Effects," Econometrica, Econometric Society, vol. 49(6), pages 1417-26, November.
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Cited by:
  1. Hendrik Schmitz & Matthias Westphal, 2013. "Short- and Medium-term Effects of Informal Care Provision on Health," Ruhr Economic Papers 0426, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
  2. Van Houtven, Courtney Harold & Coe, Norma B. & Skira, Meghan M., 2013. "The effect of informal care on work and wages," Journal of Health Economics, Elsevier, vol. 32(1), pages 240-252.
  3. Li-Jung Ku & Sally Stearns & Courtney Houtven & George Holmes, 2012. "The health effects of caregiving by grandparents in Taiwan: an instrumental variable estimation," Review of Economics of the Household, Springer, vol. 10(4), pages 521-540, December.
  4. Meliyanni Johar & Shiko Maruyama, 2010. "Intergenerational Cohabitation in Modern Indonesia: Filial Support and Dependence," Discussion Papers 2010-07, School of Economics, The University of New South Wales.
  5. Elenka Brenna & Cinzia Di Novi, 2013. "Is caring for elderly parents detrimental to women’s mental health? The influence of the European North-South gradient," DISCE - Working Papers del Dipartimento di Economia e Finanza def4, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
  6. Young Kyung Do & Edward C. Norton & Sally Stearns & Courtney H. Van Houtven, 2013. "Informal Care and Caregiver's Health," NBER Working Papers 19142, National Bureau of Economic Research, Inc.
  7. Goltz, Andreas & Arnault, Louis, 2014. "Can formal home care reduce the burden of informal care for elderly dependents? Evidence from France," Economics Papers from University Paris Dauphine 123456789/13164, Paris Dauphine University.
  8. HwaJung Choi, 2011. "Parents’ Health and Adult Children’s Subsequent Working Status: A Perspective of Intergenerational Transfer and Time Allocation," Journal of Family and Economic Issues, Springer, vol. 32(3), pages 493-507, September.
  9. Edward C. Norton & Lauren Hersch Nicholas & Sean Sheng-Hsiu Huang, 2013. "Informal Care and Inter-vivos Transfers: Results from the National Longitudinal Survey of Mature Women," NBER Working Papers 18948, National Bureau of Economic Research, Inc.
  10. Schmitz, Hendrik & Stroka, Magdalena A., 2013. "Health and the double burden of full-time work and informal care provision — Evidence from administrative data," Labour Economics, Elsevier, vol. 24(C), pages 305-322.
  11. Cinzia Di Novi & Rowena Jacobs & Matteo Migheli, 2013. "The quality of life of female informal caregivers: from Scandinavia to the Mediterranean Sea," Working Papers 084cherp, Centre for Health Economics, University of York.
  12. Kuo-Liang Chang & George Langelett & Andrew Waugh, 2011. "Health, Health Insurance, and Decision to Exit from Farming," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 356-372, June.

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