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Gender differences in access to community-based care: a longitudinal analysis of widowhood and living arrangements

Stefania Ilinca (ilinca@euro.centre.org), Ricardo Rodrigues, Stefan Fors, Eszter Zólyomi, Janet Jull, Johan Rehnberg, Afshin Vafaei and Susan Phillips
Additional contact information
Stefania Ilinca: European Centre for Social Welfare Policy and Research
Ricardo Rodrigues: University of Lisbon
Stefan Fors: Karolinska Institutet
Eszter Zólyomi: European Centre for Social Welfare Policy and Research
Janet Jull: European Centre for Social Welfare Policy and Research
Johan Rehnberg: Karolinska Institutet
Afshin Vafaei: Queen′s University
Susan Phillips: Queen′s University

European Journal of Ageing, 2022, vol. 19, issue 4, No 39, 1339-1350

Abstract: Abstract Persistent inequalities in access to community-based support limit opportunities for independent living for older people with care needs in Europe. Our study focuses on investigating how gender, widowhood and living arrangement associate with the probability of receiving home and community-based care, while accounting for the shorter-term associations of transitions into widowhood (bereavement) and living alone, as well as the longer–term associations of being widowed and living alone. We use comparative, longitudinal data from the Survey of Health, Ageing and Retirement in Europe (collected between 2004 and 2015 in 15 countries) specifying sex-disaggregated random-effects within-between models, which allow us to examine both cross-sectional and longitudinal associations among widowhood, living arrangements and community-based care use. We find widowhood and living alone are independently associated with care use for both older women and men, while bereavement is associated with higher probability of care use only for women. Socio-economic status was associated with care use for older women, but not for men in our sample. The gender-specific associations we identify have important implications for fairness in European long-term care systems. They can inform improved care targeting towards individuals with limited informal care resources (e.g. bereaved older men) and lower socio-economic status, who are particularly vulnerable to experiencing unmet care needs. Gender differences are attenuated in countries that support formal care provision, suggesting gender equity can be promoted by decoupling access to care from household and family circumstances.

Keywords: Long-term care; Bereavement; Informal caregiving; Europe; REWB models (search for similar items in EconPapers)
Date: 2022
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10433-022-00717-y

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