Transcript Who Cares? Geographical variation in informal care-giving in England and Wales

Who Cares ?
Geographical Variation in
Informal Care-giving in
England and Wales
Harriet Young, Stamatis Kalogirou & Emily Grundy
London School of Hygiene & Tropical Medicine
Background



Demographic changes: increasing
proportion of very old people in population although socio-geographic variation in this;
growing ethnic diversity.
Social/economic changes: concerns of
possible weakening of family support;
increase in women’s employment
Policy and legislative changes: increased
emphasis on community care & more
recognition of need to support caregivers.
Objectives
To examine for England and Wales:
 Distribution of caregivers in 2001
 Characteristics of caregivers (age, ethnicity,
employment, health, deprivation)
 Ratios of proportion of population with ill
health to those care-giving
First stage of a wider project using the ONS
LS to analyse antecedents of caregiving.
2001 Census: caregiving
question

“Do you look after, or give any help or
support to family members, friends,
neighbours or others because of long term
physical or mental ill-health or disability, or
problems related to old age ?”
(Do not count anything you do as part of your
paid employment)
•
•
•
•
No
Yes, 1-19 hours a week
Yes, 20-49 hours a week
Yes, 50+ hours a week
Data and Methods


2001 census data for England & Wales
Data from


CASWEB
Census commissioned output for ethnicity
data

MS EXCEL & GIS (ArcView)

Care giving: 20+ hours per week.
Population living in private households

Objective 1
Distribution of caregivers in 2001
Proportion
providing care for
20+ hours per
week in England
and Wales
Local Authority level:
Range:0.95 - 6.23 %
Mean: 3.16 %
S.D.: 0.85%
% caring 20+ hrs M&F
0.95 - 2.4
2.4 - 2.95
2.95 - 3.56
3.56 - 4.42
4.42 - 6.23
Objective 2
Characteristics of caregivers in
2001
Age of carers
Distribution of carers (20 hrs+) by
agegroup in England and Wales
• Mean age of
carers: 53.6
100000
50000
0
5
10 to 9
to
1
15 4
-1
20 9
-2
25 4
30 2 9
35 3 4
-3
40 9
-4
45 4
-4
50 9
-5
55 4
-5
60 9
-6
65 4
-6
70 9
-7
75 4
-7
80 9
-8
85 4
-8
9
90
+
• Mean age of
female carers:
52.2
150000
number of carers
• Mean age of male
carers: 55.7
200000
age group
Proportion of
different ethnic
groups who are
carers (20 hours
plus) by
Government
Office Region
Mean
Min-Max
White
3.41
2.5 - 4.7
Indian
3.39
2.8 – 4.2
Ba&Pa
3.95
3.3 - 4.3
Black
2.63
2.0 – 3.7
Ethnic Group
White
Indian
Bangadeshi and pakistani
Black
Proportion of
female informal
care givers (20+
hours per week)
who also work full
time
Local Authority level:
Range: 9.6 – 23.0 %
Mean: 15.1%
S.D.: 2.4 %
Note that these results only include
those aged 16-74 years old
% f/t emp of f carers
9.6 - 12.7
12.7 - 14.4
14.4 - 16.1
16.1 - 18.5
18.5 - 23
Proportion of all
carers (20+ hours)
who have poor self
rated general
health
Local Authority level:
Range: 9.4 – 23.9 %
Mean: 16.1 %
S.D.: 2.85 %
% of all carers in pr health
9.4 - 12.6
12.6 - 14.8
14.8 - 16.9
16.9 - 19.5
19.5 - 23.9
Index of Multiple Deprivation
for 2000

ward level index: made up of 33 indices
from 6 domains:







income
employment
health
education
housing
service access
Local Authority score: population weighted
average of ward scores
Index of Multiple Deprivation
IMD
4.4 - 14.4
14.4 - 22.4
22.4 - 32.3
32.3 - 45.6
45.6 - 61.3
Proportion of population
providing care for 20+ hours
per week
% caring 20+ hrs M&F
0.95 - 2.4
2.4 - 2.95
2.95 - 3.56
3.56 - 4.42
4.42 - 6.23
index of multiple deprivation
Correlation between deprivation index and
percent of population caring for 20+ hours
70.00
60.00
50.00
40.00
30.00
R2 = 0.6136
20.00
local authority
10.00
.00
0.00
Linear (local authority)
2.00
4.00
6.00
% of popn caring for 20+ hours
8.00
Objective 3
Ratios of proportion of population with
ill health to those care-giving
Proportion of whole
population aged
over 80 with a
limiting long term
illness
Local Authority level:
Range: 1.3 – 4.9 %
Mean: 2.52 %
S.D.: 0.55 %
% of 80+ with llti
1.2 - 1.9
1.9 - 2.4
2.4 - 2.8
2.8 - 3.5
3.5 - 4.9
Ratio of carers
aged 50-59 to
population aged
80+ with a limiting
long term illness
ratio carers 50-59:
llti's 80+ /1000 of latter
37.6 - 63.9
63.9 - 79.1
79.1 - 95.8
95.8 - 115.9
115.9 - 151.6
Local Authority level:
Range: 37.6 – 151.6
Mean: 84.43 per 1000
S.D.: 21.3
* results presented as
number of carers per 1000
individuals with llti’s
Limitations and Conclusions



Areas with higher proportions of carers also
seem to have higher deprivation and poorer
general health.
In other areas there may a higher likelihood
of combining employment and care.
Limitations:





use of area based measure: deprivation
cross sectional analysis
unable to distinguish between types of care
provision.
Useful starting point for future analysis.
Use of the ONS LS will allow us to carry out
in depth analysis at the individual level.
Acknowledgements & Bibliography





2001 Census and Boundary data is the Crown Copyright.
Crown copyright material is reproduced with the permission of
the Controller of HMSO
This research is funded by the 2001 Census Program of the
Joseph Rowntree Foundation.
Hutton and Hirst (2001) Caring relationships over time. Social
Policy Research Unit. York.
Mir & Tovey (2002) Cultural competency: professional action
and South Asian carers. J Manag Med 16(1): 7-19
Index of Multiple deprivation:
http://www.odpm.gov.uk/stellent/groups/odpm_urbanpolicy/docu
ments/downloadable/odpm_urbpol_021680.pdf