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. 2017 May 1;72(3):510-521.
doi: 10.1093/geronb/gbv038.

Unequal Inequalities: The Stratification of the Use of Formal Care Among Older Europeans

Marco Albertini  1 , Emmanuele Pavolini  2
Affiliations

Unequal Inequalities: The Stratification of the Use of Formal Care Among Older Europeans

Marco Albertini et al. J Gerontol B Psychol Sci Soc Sci. .

Abstract

Objectives: The general aim of the article is to incorporate the stratification perspective into the study of (long-term) care systems. In particular, 3 issues are investigated: the extents to which (a) personal and family resources influence the likelihood of using formal care in later life; (b) the unequal access to formal care is mediated by differences in the availability of informal support; (c) the relationship between individuals' resources and the use of formal care in old age varies across care regimes and is related to the institutional design of long-term care policies.

Method: Data from Waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe for 4 countries: Denmark, Germany, France, and Italy, and population aged at least 65 (N = 9,824) were used. Population-averaged logit models were used.

Results: Logit models revealed that in terms of access to formal care: an individual's educational level plays a limited role; family networks function similarly across the countries studied; in general, financial wealth does not have a significant effect; there is a positive relation between income and the use of formal care in Germany and Italy, and no significant relation in France and Denmark; home ownership has a negative effect in Germany and Denmark. On accounting for informal care, inequality associated with individuals' economic resources remains substantially unaltered.

Discussion: The study shows that care systems based on services provision grant higher access to formal care and create lower inequalities. Moreover, countries where cash-for-care programs and family responsibilities are more important register inequalities in the use of formal care. Access to informal care does not mediate the distribution of formal care.

Keywords: Aging; Care regimes; Europe; Formal care; Inequality; Long-term care.

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