The causal effects of caregiving on the spousal carer’s health, life satisfaction, and employment

Abstract

In light of the development of the long-term care insurance policy in China, an emerging issue of concern is whether and how to compensate the families of those who need help with activities of daily living (ADLs) and who are cared for by family carers. It is therefore important and urgent to understand the effects of caregiving on family carers’ health and life satisfaction as well as the financial cost of family caregiving. Despite expanding research investigating the association between caregiving and family carers’ health and life satisfaction, both internationally and within the specific context of China, a consistent conclusion has not been reached. In addition, especially little is known about the effects of caregiving on older spousal carers’ employment or working hours. Consequently, this thesis aims to examine the effects of caregiving on older spousal carers’ health, life satisfaction, employment, and working hours in China. The findings of this thesis are based on two separate empirical analyses using data from waves 2015 and 2018 of the China Health and Retirement Longitudinal Study. Using a fixed effects triple difference model, the first analysis shows that caregiving had negative effects on female spousal carers’ self-rated health and had positive effects on female spousal carers’ ability to perform instrumental activities of daily living (IADLs), after controlling for time-invariant characteristics, the potential carers’ willingness and ability to provide care, and their spouses’ care needs status. The first analysis also shows that potential carers who were willing and able to provide care in waves 2015 and 2018 experienced a lesser deterioration of their own ability to perform IADLs than those who were unwilling or unable to provide care in waves 2015 and 2018, independently of performing caregiving activities. In addition, potential carers whose spouses reported needing help with ADLs in wave 2018 had a greater deterioration of their own ability to perform IADLs than those whose spouses did not report needing help with ADLs in wave 2018, independently of performing caregiving activities. The second analysis, employing a fixed effects two-stage least squares model, in which the number of difficulties the potential carer’s spouse reported needing help with and whether the potential carer’s spouse reported poor or very poor health are used as instrumental variables, shows that caregiving had negative effects on male spousal carers’ work participation. These results imply that policy makers need to pay more attention to older spousal carers’ health and seek ways to delay the onset of those older carers’ own need for long-term care. Moreover, although stopping work may be associated with an individual’s personal motivation to provide care, the results of the second empirical analysis support the introduction of financial compensation to family carers to replace the wages forgone amongst those who cease paid employment in order to take up unpaid family care responsibilities.

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Identifiers

ORCID for Haiyu Jin: orcid.org/0000-0001-7812-9945

ORCID for Athina Vlachantoni: orcid.org/0000-0003-1539-3057

ORCID for Maria Evandrou: orcid.org/0000-0002-2115-9358

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