Informal Care and Caregiver's Health

Abstract

This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters-in-law are the prevalent source of caregivers for frail elderly parents and parents-in-law. A key insight of our instrumental variable approach is that having a parent-in-law with functional limitations increases the probability of providing informal care to that parent-in-law, but a parent-in-law’s functional limitation does not directly affect the daughter-in-law’s health. We compare results for the daughter-in-law and daughter samples to check the assumption of the excludability of the instruments for the daughter sample. Our results show that providing informal care has significant adverse effects along multiple dimensions of health for daughter-in-law and daughter caregivers in South Korea.

Will you still need me, will you still feed me when I'm 64? The health impact of caregiving to one's spouse

“…Three recent studies have addressed the endogeneity caused by selection bias using an instrumental variable approach to estimate a causal effect between caregiving and caregiver's health (Coe & Van Houtven, 2009;Do, Norton, Stearns, & Van Houtven, 2015;Heger, 2016). 5 Using data from the US Health and Retirement Survey on the characteristics of siblings and the death of the mother as instrumental variables, Coe and Van Houtven (2009) find significant negative effects on mental health and self-reported health (married respondents) and heart conditions (single men), both immediately and a few years later (depressive symptoms in married women only).…”

“…Specifically, they find a 15% increase in the mean score of their depression measure due to the onset of caregiving. Using South Korean data, Do et al (2015) instrument daughter-in-law's informal caregiving status by their parents-in-law's health endowments and conclude that caregiving increases the probability of reporting pain affecting daily activities, a fair or poor self-rated health and the out-of-pocket spending on outpatient care by the caregiver when seeking treatment. Heger (2016) studies the impact of providing care to a parent on being depressed for European SHARE respondents aged 50 to 70 years using fixed effects and using changes in the number of parents alive as an instrument.…”

“…Part of the differences in the findings may be the result of differences in the specific subpopulations studied- Coe and Van Houtven (2009) include all adults, Do et al (2015) only include married women, Heger (2016) only adults aged 50 to 70 years -and the fact that they use different instruments and thus estimate local average treatment effects for different groups of "compliers": respondents whose caregiving status is influenced by the instrument. The instruments used in these studies only apply to the case in which the children provide care to parents.…”

Bivariate risk attitudes, informal care and saving

“…7 Note that c(t) can also be used to represent out-of-pocket expenses on own healthcare use due to the stress arising from caregiving activities, as documented by Do et al (2013).…”

Investigating the relationship between formal and informal care: An application using panel data for people living together

“…If labour market effects were to increase the total cost of informal care, the effect of this on the health outcomes of the informal care recipient may outweigh this increase. Further research could examine if this is the case as there is already evidence to suggest that caregiving has a negative effect on an informal carers health (Do, Norton, Stearns, & Van Houtven, 2015). Similarly, without considering health outcomes, if formal and informal care together is cheaper or more expensive than nursing home care, this effect on total costs is important for health and social care budget allocations.…”