CAPÍTULO 3: ANÁLISIS Y DISEÑO DEL SISTEMA
4.1 Implementación
4.1.2 Diagramas de Componentes
Being an intensive caregiver has a negative effect on the probability of being employed in the Nordic countries. However, the classification was somewhat arbitrarily defined as providing care at least 30 hours a month. Looking at different operationalizations of intensive care in the probit estimation in Table 15 reveals that providing care less than ”5 hours or more a month” has no negative significant effect. Figure 3 shows the marginal effects with the confidence intervals from Table 15. Comparing the different coefficients, the relationship when increasing the number of care hours does not change as much as one would expect. From caring 15 to 35 hours or more a month, the coefficients are essentially the same while standard errors are increasing. This could indicate that the effect of caregiving is very small. Only looking at women, the effect increases with care intensity, yet men and women do not statistically significantly differ in this effect (results are available on request). There were furthermore no country differences between the different operationalizational levels.
Figure 3: Marginal effects of different operationalizations of intensive caregiving
Another explanation could be that the question asked abour care is very vague. The definition of givingcare in the dataset includes going for a walk with the parents or doing some paperwork during weekends. This type of caregiving should not have any or only small effects on the probability of being employed. Personal daily care such as helping
the parent get dressed, which probably implies considerable time commitments during the week, could have larger effects. It is not possible to disentangle these different forms of care in the dataset. Assuming that the stable relationship between caring 20 hours or more and caring 35 hours or more comes from helping with administrative or small amounts of household work, the results seem reasonable.
Table 15: Different operationalizations of intensive care and its effect on employment
(1) (2) (3) (4) (5) (6) (7)
VARIABLES 5 hours 10 hours 15 hours 20 hours 25 hours 30 hours 35 hours
parentintensiveX -0.044** -0.047** -0.091*** -0.095*** -0.066* -0.087** -0.095**
(0.017) (0.020) (0.026) (0.029) (0.035) (0.038) (0.046) age 0.089*** 0.088*** 0.088*** 0.088*** 0.088*** 0.088*** 0.088***
(0.003) (0.003) (0.003) (0.003) (0.003) (0.003) (0.003) agesq -0.001*** -0.001*** -0.001*** -0.001*** -0.001*** -0.001*** -0.001***
(3.73e-05) (3.73e-05) (3.73e-05) (3.73e-05) (3.73e-05) (3.73e-05) (3.73e-05)
female -0.006 -0.007 -0.005 -0.005 -0.007 -0.007 -0.007
(0.012) (0.012) (0.012) (0.012) (0.012) (0.012) (0.012) highed 0.051*** 0.051*** 0.051*** 0.052*** 0.052*** 0.052*** 0.052***
(0.013) (0.013) (0.013) (0.013) (0.013) (0.013) (0.013) lowed -0.074*** -0.073*** -0.072*** -0.072*** -0.072*** -0.072*** -0.072***
(0.024) (0.024) (0.024) (0.024) (0.024) (0.024) (0.024) highincome 0.152*** 0.151*** 0.151*** 0.151*** 0.151*** 0.151*** 0.151***
(0.013) (0.013) (0.013) (0.013) (0.013) (0.013) (0.013) lowincome -0.135*** -0.135*** -0.135*** -0.135*** -0.135*** -0.135*** -0.135***
(0.015) (0.015) (0.015) (0.015) (0.015) (0.015) (0.015)
capital 0.013 0.013 0.013 0.013 0.014 0.014 0.014
(0.015) (0.015) (0.015) (0.015) (0.015) (0.015) (0.015)
married -0.013 -0.014 -0.014 -0.015 -0.015 -0.014 -0.014
(0.013) (0.013) (0.013) (0.013) (0.013) (0.013) (0.013)
children -0.007 -0.007 -0.007 -0.008 -0.007 -0.007 -0.007
(0.007) (0.007) (0.007) (0.007) (0.007) (0.007) (0.007) sweden 0.130*** 0.130*** 0.130*** 0.131*** 0.130*** 0.130*** 0.130***
(0.014) (0.014) (0.0135) (0.014) (0.014) (0.014) (0.014) norway 0.040*** 0.040*** 0.041*** 0.041*** 0.040*** 0.040*** 0.040***
(0.014) (0.014) (0.014) (0.014) (0.014) (0.014) (0.014)
Observations 6,112 6,112 6,112 6,112 6,112 6,112 6,112
Standard errors in parentheses. Marginal effects after probit regressions.
*** p<0.01, ** p<0.05, * p<0.1
9 Conclusion
Using data from an internet survey in 2010, this thesis finds no significant effects of informal parental care on employment regardless of intensity. This may be due to the fact that care is defined very broadly. Intensive poroviders of informal parental care
are however significantly less likely to be employed in all Nordic countries. No gender and country differences were found in this relationship, suggesting that these countries are very similar in this respect. There is no evidence of an endogeneity problem in the relationship between provision of informal parental care and employment in the Nordic countries. Thus, reversed causality should not be a problem in this relationship. This means that the labor market decision is not influenced by a possible future care obligation.
Regarding policy recommendations, the results suggest that promoting small amounts of informal care (up to 5 hours a month) could help release the financial pressure of the demographic transition without reducing the tax base or harming the goal of balanced labor force participation. Support for informal carergivers should be targeted to those described as intensive caregivers to help them better combine work and care duties. Deci-sion makers should consider the opportunity costs of intensive providess of informal care.
One example of opportunity costs is a reduced employment probability. Consequences of a lower employment probability include limited job opportunities with depressed wage rates and lower returns of work, as well as lower pension entitlements in the future. El-dercare arrangements can therefore have profound economic, social, and psychological implications.
The results from this thesis should be considered in the context of current and proposed policy changes in all three countries. A recent trend affecting the care sector in Denmark for example is that more emphasis is put on self-care and on preventive and health-promoting activities (Schulz, 2010). It is therfore crucial to follow the developments of eldercare policies in the three countries further to see whether they start to move in different directions.
Since people probably first adjust their working hours before deciding to not work at all, it would have been good to also have data on work hours to see how large the effects are in the intensive margin, especially because working hours are more flexible in the Nordic countries than in the rest of Europe (e.g., Brewster et al., 1997 reviewing the literature on flexible working in Europe). Panel data to investigate whether caregivers retire early and whether there are effects of starting and ending a care commitment would also be helpful. There are no studies on whether there is a difference between short-term and long-term informal caregiving in the Nordic countries. Using a sample from Spain,
Casado Mar´ına et al. (2011) found that caregiving lasting longer than one year has negative effects on employment while starting caregiving does not. Further, it would be good to also investigate whether different forms of informal care, such as weekend or weekday help, have different effects on employment. It would be interesting to look at the total amount of care a person receives to see whether formal and informal care are used more as substitutes or complements, and which forms of informal care are provided the most in the Nordic countries. To my knowledge, there is no comparable study on gender differences in the effect of informal care on labor force outcomes. Knowing whether there are gender differences in other countries and whether there is homogeneity in this effect between the European countries would help answer the question of whether the goal of a balanced labor force is influenced by informal care policies.
Some Swedish and Norwegian municipalities use user fees to cover parts of their care costs. Research in these two countries investigating the effect of these user fees in different municipalities will give more insight into the topic. There is already a study in Sweden from Socialstyrelsen (2005) finding that middle-income individuals who live alone refrain more from services than their counterparts in other income classes. Among individuals living together with someone, it is more common to refrain among those in the lower-income class. There are no previous studies on this topic in Norway. A larger user fee in a municipality may lead to a larger supply of informal care, pointing to a substitution effect of formal and informal care. In addition, user fees may affect men and women differently.
Men could be more sensitive to price changes due to greater substitution possibilities because they receive help from their partner to a larger extent than women do (H¨ojg˚ard and Mossler, 2001), while women may be more sensitive to price changes due to lower incomes.
To sum up, intensive elderly care has a statistically significant negative effect on employ-ment while there is no effect of elderly care in general in Norway, Sweden, and Denmark.
This thesis does not find any gender and country differences, and there seems to be no endogeneity problem in the Nordic countries.
References
Alber, J. & K¨ohler, U. (2004), ‘Health and care in an enlarged Europe. European foun-dation for the improvement of living and working conditions’, Dublin, Ireland,[Online]
Available at: http://www. eurofound. eu. int/pubdocs/2003/107/en/1/ef03107en. pdf (accessed 30 Sept. 2009) .
Amemiya, T. (1978), ‘The estimation of a simultaneous equation generalized probit model’, Econometrica: Journal of the Econometric Society pp. 1193–1205.
Amemiya, T. (1979), ‘The estimation of a simultaneous-equation Tobit model’, Interna-tional Economic Review pp. 169–181.
Anttonen, A. & Sipilae, J. (1996), ‘European social care services: is it possible to identify models?’, Journal of European Social Policy 6(2), 87–100.
Arber, S. & Ginn, J. (1995), ‘Gender differences in the relationship between paid employ-ment and informal care’, Work, Employemploy-ment & Society 9(3), 445–471.
Bettio, F. & Plantenga, J. (2004), ‘Comparing care regimes in Europe’, Feminist eco-nomics 10(1), 85–113.
Bolin, K., Lindgren, B. & Lundborg, P. (2007), ‘Informal and formal care among single-living elderly in Europe’, Health economics 17(3), 393–409.
Bolin, K., Lindgren, B. & Lundborg, P. (2008), ‘Your next of kin or your own career?: Car-ing and workCar-ing among the 50+ of Europe’, Journal of Health Economics 27(3), 718–
738.
Bonsang, E. (2009), ‘Does informal care from children to their elderly parents substitute for formal care in Europe?’, Journal of Health Economics 28(1), 143–154.
Brewster, C., Mayne, L. & Tregaskis, O. (1997), ‘Flexible working in Europe: A review of the evidence’, MIR: Management International Review pp. 85–103.
Byrne, D., Goeree, M. S., Hiedemann, B. & Stern, S. (2009), ‘Formal home helth care, informal care and family decision making’, International Economic Review 50(4), 1205–
1242.
Cameron, A. C. & Trivedi, P. K. (2009), ‘Microeconomics using Stata’, Lakeway Drive, TX: Stata Press Books .
Carmichael, F. & Charles, S. (1998), ‘The labour market costs of community care’, Journal of Health Economics 17(6), 747–765.
Carmichael, F. & Charles, S. (2003a), ‘Benefit payments, informal care and female labour supply’, Applied Economics Letters 10(7), 411–415.
Carmichael, F. & Charles, S. (2003b), ‘The opportunity costs of informal care: does gender matter?’, Journal of Health Economics 22(5), 781–803.
Carmichael, F., Charles, S. & Hulme, C. (2010), ‘Who will care? Employment participa-tion and willingness to supply informal care’, Journal of Health Economics 29(1), 182–
190.
Carmichael, F., Conell, G., Hulme, C. & Sheppard, S. (2004), ‘Who cares and at what cost? The incidence and the opportunity costs of informal care’, Management and Management Science Research Institute Working Paper 209(05).
Carmichael, F., Hulme, C., Sheppard, S. & Connell, G. (2008), ‘Work-life imbalance:
Informal care and paid employment in the UK’, Feminist Economics 14(2), 3–35.
Casado-Mar´ın, D., Garc´ıa-G´omez, P. & L´opez-Nicol´as, ´A. (2011), ‘Informal care and labour force participation among middle-aged women in Spain’, SERIEs: Journal of the Spanish Economic Association 2(1), 1–29.
Charles, K. K. & Sevak, P. (2005), ‘Can family caregiving substitute for nursing home care?’, Journal of Health Economics 24(6), 1174–1190.
Crespo, L. (2006), ‘Caring for parents and employment status of European mid-life women’, Documentos de Trabajo (CEMFI) (15), 1.
Crespo, L. & Mira, P. (2010), ‘Caregiving to elderly parents and employment status of European mature women’, Documentos de Trabajo (CEMFI) (7), 1.
Dentinger, E. & Clarkberg, M. (2002), ‘Informal caregiving and retirement timing among men and women: Gender and caregiving relationships in late midlife’, Journal of Family Issues 23(7), 857–879.
Do, Y. K. (2008), ‘The Effect of informal caregiving on labor market outcomes in South Korea’.
Doty, P., Jackson, M. E. & Crown, W. (1998), ‘The impact of female caregivers’ employ-ment status on patterns of formal and informal eldercare’, The Gerontologist 38(3), 331–
341.
DST (2012), Statistics Denmark.
URL: http://www.dst.dk/en/Statistik/emner/befolkning-og-befolkningsfremskrivning.aspx, accessed 01/2-2013
Economic Policy Committee (2011), The 2012 Ageing Report: Underlying assumptions and projection methodologies, 4 edn.
Esping-Andersen, G. & Korpi, W. (1986), ‘From poor relief to institutional welfare states:
the development of Scandinavian social policy’, International Journal of Sociology pp. 39–74.
Ettner, S. L. (1995), ‘The impact of parent care on female labor supply decisions’, De-mography 32(1), 63–80.
Ettner, S. L. (1996), ‘The opportunity costs of elder care’, Journal of Human Resources pp. 189–205.
Eurostat (2000), Eurostat new national baseline population scenarios, Luxembourg.
Fukushima, N., Adami, J. & Palme, M. (2010), The long-term care system for the elderly In Sweden, Technical report, ENEPRI Research Report.
Gujarati, D. N. (2003), ‘Basic econometrics’, New York: MeGraw-Hill pp. 363–369.
Hancock, R., Comas-Herrera, A., Wittenberg, R. & Pickard, L. (2003), ‘Who will pay long-term care in the UK? Projections linking macro-and micro-simulation models’, Fiscal Studies 24(4), 387–426.
Heckman, J. J. (1979), ‘Sample selection bias as a specification error’, Econometrica:
Journal of the Econometric Society pp. 153–161.
Heitmueller, A. (2007), ‘The chicken or the egg?: Endogeneity in labour market partici-pation of informal carers in England’, Journal of Health Economics 26(3), 536–559.
Heitmueller, A. & Inglis, K. (2007), ‘The earnings of informal carers: Wage differentials and opportunity costs’, Journal of Health Economics 26(4), 821–841.
Heitmueller, A. & Michaud, P.-C. (2006), ‘Informal care and employment in England:
evidence from the British Household Panel Survey’.
H¨ojg˚ard, U. & Mossler, K. (2001), ‘Avgifter och minskade servicesatser: Tillgodoses
¨
aldres behov [Fees and reduced service prices: for the benefits of the elderly]’.
V¨alf¨ardsBulletinen 2.
Imbens, G. W. & Angrist, J. D. (1994), ‘Identification and estimation of local average treatment effects’, Econometrica: Journal of the Econometric Society pp. 467–475.
Jakobsson, N., Hansen, T. & Kotsadam, A. (2012), ‘Er det en sammenheng mellom formell og uformell omsorg i Norge? [Is there a connection between formal and informal care in Norway?]’, Tidsskrift for Velferdsforskning. 15 (3).
Jakobsson, N., Kotsadam, A. & Szebehely, M. (2013), ‘Informal eldercare and care for disabled children in the Nordic countries: prevalence and relation to employment’, Nordic Journal of Social Research 4.
Johnson, R. W. (2006), ‘A profile of frail older Americans and their caregivers’, The Urban Institute .
Johnson, R. W. & Lo Sasso, A. T. (2000), ‘The trade-off between hours of paid employ-ment and time assistance to elderly parents at midlife’, The Urban Institute .
Johnson, R. W., Toohey, D. & Wiener, J. M. (2007), ‘The retirement project’, Women 30, 35.
Karoly, L. A. & Panis, C. W. (2004), The 21st century at work: Forces shaping the future workforce and workplace in the United States, Vol. 164, Rand Corporation.
Kautto, M. (1999), Nordic social policy: Changing welfare states, Routledge.
Kooreman, P. & Wunderink, S. (1997), The economics of household behaviour, Macmillan Press, London.
Kotsadam, A. (2011), ‘Does informal eldercare impede women’s employment? The Case of European welfare states’, Feminist Economics 17(2), 121–144.
Kotsadam, A. (2012), ‘The employment costs of caregiving in Norway’, International Journal of Health Care Finance and Economics pp. 1–15.
Kraus, M., Riedel, M., Mot, E., Willem´e, P., R¨ohrling, G. & Czypionka, T. (2010), A typology of long-term care systems in Europe, Centre for European Policy Studies.
Krevers, B., Magnusson, H., Johansson, L. & Oeberg, B. (2006), ‘Services for supporting family carers of older dependent people in Europe: characteristics, coverage and usage’, EUROFAMCARE. The National Survey Report for Sweden (Deliverable No 18).
Lee, L.-F. (1991), Amemiya’s generalized least squares and tests of overidentification in simultaneous equation models with qualitative or limited dependent variables, Tech-nical report, Center for Economic Research, Department of Economics, University of Minnesota.
Leigh, A. (2010), ‘Informal care and labor market participation’, Labour Economics 17(1), 140–149.
Lilly, M. B., Laporte, A. & Coyte, P. C. (2007), ‘Labor market work and home care’s unpaid caregivers: a systematic review of labor force participation rates, predictors of labor market withdrawal, and hours of work’, Milbank Quarterly 85(4), 641–690.
McLanahan, S. & Monson, R. A. (1990), Caring for elderly: Prevalence and consequences, Center for Demography and Ecology, University of Wisconsin.
Michaud, P.-C., Heitmueller, A. & Nazarov, Z. (2010), ‘A dynamic analysis of informal care and employment in England’, Labour Economics 17(3), 455–465.
Mortensen, J., Spiess, C. K., Schneider, T., Costa-Font, J. & Patxot, C. (2004), Health care and female employment: A potential conflict, Technical report, European Network of Economic Policy Research Institutes.
Motel-Klingebiel, A., Tesch-Roemer, C. & Von Kondratowitz, H.-J. (2005), ‘Welfare states do not crowd out the family: evidence for mixed responsibility from comparative anal-yses’, Ageing and Society 25(6), 863–882.
OECD (2005), ‘The OECD Health Project: Long-term care for older people’. Paris.
OECD (2011), OECD Health Policy Studies Help Wanted? Providing and Paying for Long-Term Care, OECD Publishing.
OECD (2012), ‘OECD employment outlook’.
URL: http://www.oecd.org/els/emp/employmentoutlookstatisticalannex.htm, accessed 01/2-2013
OECD (2013), ‘Labour market statistics: Labour force statistics by sex and age: indica-tors’. OECD Employment and Labour Market Statistics.
Ogg, J. & Renaut, S. (2006), ‘The support of parents in old age by those born during 1945-1954: A European perspective’, Ageing and Society 26(5), 723–744.
Parker, G. (1990), With due care and attention: a review of research on informal care, Family Policy Studies Centre London.
Parker, G. (1993), ‘Disability, caring and marriage: The experience of younger couples when a partner is disabled after marriage’, British Journal of Social Work 23(6), 565–
580.
Pavalko, E. K. & Artis, J. E. (1997), ‘Women’s caregiving and paid work: Causal rela-tionships in late midlife’, The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 52(4), S170.
Pezzin, L. E. & Schone, B. S. (1999a), ‘Intergenerational household formation, female labor supply and informal caregiving: A bargaining approach’, Journal of Human Re-sources pp. 475–503.
Pezzin, L. E. & Schone, B. S. (1999b), ‘Parental marital disruption and intergenera-tional transfers: An analysis of lone elderly parents and their children’, Demography 36(3), 287–297.
Riedel, M. & Kraus, M. (2011), ‘The organisation of formal long-term care for the el-derly. Results from the 21 European country studies in the ANCIEN project’, ENEPRI Research Report 95.
Rostgaard, T. & Szebehely, M. (2012), ‘Changing policies, changing patterns of care:
Danish and Swedish home care at the crossroads’, European Journal of Ageing pp. 1–9.
SCB (2012), Statistics Sweden.
URL: http://www.ssd.scb.se/databaser/makro/MainTable.asp?yp=tansss&xu=
C9233001&omradekod=BE&omradetext=Population&lang=2&langdb=2, accessed 01/2-2013
Schulz, E. (2010), The long-term care system for the elderly in Denmark, Technical Re-port 73, ENEPRI Research ReRe-port.
Simonazzi, A. (2009), Home care and cash transfers. Effects on the elderly care-female employment trade-off. unpublished.
URL: http://www.aiel.it/bacheca/SASSARI/papers/simonazzi.pdf, accessed 01/2-2013
Socialstyrelsen (2005), ‘Avgifter inom ¨aldre- och handikappomsorg [Fees in the elderly and handicapped care]’. L¨agesbeskrivning 2005, Stockholm.
Spiess, C. K. & Schneider, A. U. (2003), ‘Interactions between care-giving and paid work hours among European midlife women, 1994 to 1996’, Ageing and Society 23(1), 41–68.
Spillman, B. C. & Pezzin, L. E. (2002), ‘Potential and active family caregivers: Changing networks and the sandwich generation’, Milbank Quarterly 78(3), 347–374.
SSB (2012), Population statistics.
URL: http://www.ssb.no/english/subjects/02/, accessed 01/2-2013
Staiger, D. O. & Stock, J. H. (1997), ‘Instrumental variables regression with weak instru-ments’, Econometrica 65, 557–586.
Szebehely, M. (2005), ‘Care as employment and welfare provision - Child care and elder care in Sweden at the dawn of the 21st century’, Dilemmas of care in the Nordic welfare state: Continuity and change pp. 80–99.
Tarricone, R. & Tsouros, A. D. (2009), Home care in Europe: the solid facts, World Health Organization.
Toossi, M. (2006), ‘New look at long-term labor force projections to 2050’, Monthly Lab.
Rev. 129, 19.
Triantafillou, J. et al. (2010), ‘Informal care in the long-term care system’. INTERLINKS European Overview Paper. Athens, Vienna.
Twigg, J. & Atkin, K. (1994), Carers perceived: policy and practice in informal care, Open University Press Buckingham.
Van Houtven, C. H., Coe, N. & Skira, M. (2010), ‘The effect of informal care on work and wages’, Center for Retirement Research at Boston College Working Paper 23.
Van Houtven, C. H., Norton, E. C. et al. (2004), ‘Informal care and health care use of older adults’, Journal of health economics 23(6), 1159.
Viitanen, T. (2005), ‘Informal elderly care and women’s labour force participation across Europe’, ENEPRI Research Reports (13).
Wakabayashi, C. & Donato, K. M. (2005), ‘The consequences of caregiving: Effects on women‘s employment and earnings’, Population Research and Policy Review 24(5), 467–
488.
Wise, D. A. (2005), ‘Facing the age wave and economic policy: Fixing public pension systems with healthcare in the wings’, Fiscal Studies 26(1), 5–34.
Wolf, D. A. & Soldo, B. J. (1994), ‘Married women’s allocation of time to employment and care of elderly parents’, Journal of Human Resources pp. 1259–1276.
Wooldridge, J. M. (2009), Introductory econometrics: A modern approach, South-Western Pub.
Yang, Z., Norton, E. C. & Stearns, S. C. (2003), ‘Longevity and health care expendi-tures: the real reasons older people spend more’, The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 58(1), S2–S10.
Appendix
Question on care posed to the respondents
Have you helped a family member, relative, friend, or neighbor who needs help in everyday life due to long-term illness, disability, or old age at least once a month during the past year (e.g., with cleaning, paperwork, personal care, or going outside)?
1. Yes, husband/wife/cohabitant/partner 2. Yes, children
3. Yes, parents/parents-in-law
4. Yes, other relative, friend or neighbor 5. No
6. If yes, how many hours a month?