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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. Gaétan Lafortune & Gaëlle Balestat, 2007. "Trends in Severe Disability Among Elderly People: Assessing the Evidence in 12 OECD Countries and the Future Implications," OECD Health Working Papers 26, OECD Publishing.
    2. Annamaria Simonazzi, 2009. "Care regimes and national employment models," Cambridge Journal of Economics, Cambridge Political Economy Society, vol. 33(2), pages 211-232, March.
    3. Esping-Andersen, Gosta, 1999. "Social Foundations of Postindustrial Economies," OUP Catalogue, Oxford University Press, number 9780198742005.
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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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