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Unequal Inequalities: The Stratification of the Use of Formal Care Among Older Europeans

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  • Marco Albertini
  • Emmanuele Pavolini

Abstract

Objectives:The general aim of the article is to incorporate the stratification perspective into the study of (long-term) care systems. In particular, 3 issues are investigated: the extents to which (a) personal and family resources influence the likelihood of using formal care in later life; (b) the unequal access to formal care is mediated by differences in the availability of informal support; (c) the relationship between individuals’ resources and the use of formal care in old age varies across care regimes and is related to the institutional design of long-term care policies.Method:Data from Waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe for 4 countries: Denmark, Germany, France, and Italy, and population aged at least 65 (N = 9,824) were used. Population-averaged logit models were used.Results:Logit models revealed that in terms of access to formal care: an individual’s educational level plays a limited role; family networks function similarly across the countries studied; in general, financial wealth does not have a significant effect; there is a positive relation between income and the use of formal care in Germany and Italy, and no significant relation in France and Denmark; home ownership has a negative effect in Germany and Denmark. On accounting for informal care, inequality associated with individuals’ economic resources remains substantially unaltered.Discussion:The study shows that care systems based on services provision grant higher access to formal care and create lower inequalities. Moreover, countries where cash-for-care programs and family responsibilities are more important register inequalities in the use of formal care. Access to informal care does not mediate the distribution of formal care.

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  • Marco Albertini & Emmanuele Pavolini, 2017. "Unequal Inequalities: The Stratification of the Use of Formal Care Among Older Europeans," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 72(3), pages 510-521.
    • Handle: RePEc:oup:geronb:v:72:y:2017:i:3:p:510-521.
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    References listed on IDEAS

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    1. Annamaria Simonazzi, 2009. "Care regimes and national employment models," Cambridge Journal of Economics, Cambridge Political Economy Society, vol. 33(2), pages 211-232, March.
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    1. Ginevra Floridi & Ludovico Carrino & Karen Glaser & Candace Kemp, 2021. "Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe [Demography of informal caregiving]," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(1), pages 121-132.
    2. Inés Calzada & Virginia Páez & Rafael Martínez-Cassinello & Andrea Hervás, 2023. "The Best Welfare Deal: Retirement Migrants as Welfare Maximizers," Societies, MDPI, vol. 13(4), pages 1-18, April.
    3. Erwin Stolz & Hannes Mayerl & Éva Rásky & Wolfgang Freidl, 2019. "Individual and country-level determinants of nursing home admission in the last year of life in Europe," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-10, March.
    4. Maria Gabriella Melchiorre & Sabrina Quattrini & Giovanni Lamura & Marco Socci, 2022. "Role and Characteristics of Personal Care Assistants of Frail Older People with Functional Limitations Ageing in Place in Italy," IJERPH, MDPI, vol. 19(7), pages 1-25, March.
    5. Maria Gabriella Melchiorre & Sabrina Quattrini & Giovanni Lamura & Marco Socci, 2021. "A Mixed-Methods Analysis of Care Arrangements of Older People with Limited Physical Abilities Living Alone in Italy," IJERPH, MDPI, vol. 18(24), pages 1-35, December.
    6. Javier Lera & Marta Pascual-Sáez & David Cantarero-Prieto, 2020. "Socioeconomic Inequality in the Use of Long-Term Care among European Older Adults: An Empirical Approach Using the SHARE Survey," IJERPH, MDPI, vol. 18(1), pages 1-14, December.
    7. Albuquerque, Paula C., 2022. "Met or unmet need for long-term care: Formal and informal care in southern Europe," The Journal of the Economics of Ageing, Elsevier, vol. 23(C).
    8. Nekehia T. Quashie & Melanie Wagner & Ellen Verbakel & Christian Deindl, 2022. "Socioeconomic differences in informal caregiving in Europe," European Journal of Ageing, Springer, vol. 19(3), pages 621-632, September.
    9. Georgia Casanova & Mirian Fernández-Salido & Carolina Moreno-Castro, 2023. "The Risk of Household Socioeconomic Deprivation Related to Older Long-Term Care Needs: A Qualitative Exploratory Study in Italy and Spain," Sustainability, MDPI, vol. 15(20), pages 1-15, October.
    10. Ricardo Rodrigues & Stefania Ilinca & Maša Filipovič Hrast & Andrej Srakar & Valentina Hlebec, 2022. "Care Task Division in Familialistic Care Regimes: A Comparative Analysis of Gender and Socio-Economic Inequalities in Austria and Slovenia," Sustainability, MDPI, vol. 14(15), pages 1-18, August.
    11. Maja Matanic Vautmans & Marijana Oreb & Sasa Drezgic, 2023. "Socioeconomic inequality in the use of long-term care for the elderly in Europe," Public Sector Economics, Institute of Public Finance, vol. 47(2), pages 149-176.
    12. Changyong Yang & Jianyuan Huang & Jiahao Yu, 2023. "Inequalities in Resource Distribution and Healthcare Service Utilization of Long-Term Care in China," IJERPH, MDPI, vol. 20(4), pages 1-17, February.

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