Does Family Caregiving Complement Formal Care? Daughters and Parental Survival After a Severe Health Shock

Elin Colmsjö (), Francesco Ruggieri () and Matteo Saccarola ()
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Elin Colmsjö: Research Institute of Industrial Economics (IFN), Postal: Research Institute of Industrial Economics, Box 55665, SE-102 15 Stockholm, Sweden, https://www.ifn.se/en/researchers/ifn-researcher/elin-colmsjo/
Francesco Ruggieri: University of Vriginia
Matteo Saccarola: University of Chicago

No 1570, Working Paper Series from Research Institute of Industrial Economics

Abstract: We study how informal family caregiving and formal care interact after severe parental health shocks, and whether they operate as substitutes or complements. Using Danish administrative data, we compare parents of only children who experience a stroke at the same age and differ only in the gender of their child.

Before the stroke, parents of daughters and parents of sons follow similar health trajectories, with comparable levels of pre-existing conditions and healthcare utilization. After the stroke, a survival gap opens and grows, and parents of daughters are 1.5 percentage points more likely to be alive by year five. Over the same period, daughters adjust more than sons along several margins: they become more likely to live near their parents, less likely to be married, and have fewer children, consistent with greater involvement in informal caregiving. Crucially, parents of daughters use more physical rehabilitation, an elective type of formal care that requires sustained engagement. Rather than crowding out formal provision, daughters appear more likely to help parents navigate and use professional services. Informal and formal care can therefore operate, at least in part, as complements in the response to severe health shocks.

Keywords: Long-term care; Health shocks; Stroke; Mortality; Gender; Family (search for similar items in EconPapers)
JEL-codes: D13 I11 I18 J14 J16 (search for similar items in EconPapers)
Pages: 48 pages
Date: 2026-10-23
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