Socioeconomic Inequalities in Care Receipt at Older Ages: A Comparative European Study

Ginevra Floridi , University of Edinburgh
Ludovico Carrino, King's College London
Karen F. Glaser, King's College London

Despite increasing interest in long-term care (LTC) policies and recent reforms across Europe, our understanding of socioeconomic status (SES) inequalities in care use among older people across different LTC systems remains limited. We investigate inequalities in the receipt of domiciliary formal and informal care among individuals aged 65+ with disabilities, and how these inequalities vary across European LTC systems in 2015. We link data from comparable ageing surveys (SHARE and ELSA) with recently collected country- and regional-level indicators of various LTC system characteristics for 17 European countries. Using (Bayesian) multinomial multilevel models, we study (in)formal care receipt as a function of individual-level socioeconomic variables and macro-level LTC system indicators. We test for varying socioeconomic gradients in care use across different LTC systems through cross-level interactions. We find income and car ownership to be the strongest socioeconomic predictors of formal and informal care use among disabled older adults. Our preliminary findings indicate that, in countries with low levels of public LTC expenditure, individuals from low SES groups are most likely to rely exclusively on informal care, and least likely to rely on formal or mixed care. By contrast, we find no substantial socioeconomic gradients in care use at higher levels of LTC expenditure. These results suggest that more generous LTC systems may act to successfully redistribute access to domiciliary formal care across socioeconomic groups. However, in countries with limited LTC expenditure, inequalities in access to formal care may lead disadvantaged individuals to rely more heavily on support from kin and non-kin.

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 Presented in Session 53. Inequalities in Care Received and Provided