A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China.

Journal: PloS one

Volume: 13

Issue: 4

Year of Publication: 2018

Affiliated Institutions:  King's College London, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, London, United Kingdom. Psychogeriatric Unit, National Institute of Mental Health "Honorio Delgado Hideyo Noguchi", Lima, Peru. Peking University, Institute of Mental Health, Beijing, China. School of Development Studies, University of East Anglia, Norwich, United Kingdom. National Institute of Neurology and Neurosurgery of Mexico, Universidad Nacional Autónoma de México, Mexico City, Mexico. Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. Department of Sociology/Anthropology, Nnamdi Azikiwe University, Awka, Nigeria. Instituto de la Memoria, Depresión y Enfermedades de Riesgo (IMEDER), Lima, Peru. Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, Mexico City, Mexico.

Abstract summary 

While links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China.Households were classified from the evolution of the needs for care of older residents, over two previous community surveys, as 'incident care', 'chronic care' or 'no care', and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care).Household income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78-1.00) and government transfers (pCR 0.80, 95% CI 0.69-0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77-0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26-1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64-2.22) in care households.While endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people's needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age; incentivisation of informal care through compensation for direct and opportunity costs; and development of community care services to support, and, where necessary, supplement or substitute the central role of informal caregivers.

Authors & Co-authors:  Guerchet Maëlenn M MM Guerra Mariella M Huang Yueqin Y Lloyd-Sherlock Peter P Sosa Ana Luisa AL Uwakwe Richard R Acosta Isaac I Ezeah Peter P Gallardo Sara S Liu Zhaorui Z Mayston Rosie R Montes de Oca Veronica V Wang Hong H Prince Martin J MJ

Study Outcome 

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Statistics
Citations :  Hosseinpoor AR, Stewart Williams JA, Gautam J, Posarac A, Officer A, Verdes E et al. (2013) Socioeconomic inequality in disability among adults: a multicountry study using the World Health Survey. Am J Public Health 103: 1278–1286. doi: 10.2105/AJPH.2012.301115
Authors :  14
Identifiers
Doi : e0195567
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Aged
Other Terms
Study Design
Cohort Study,Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States