Differences in the effects of informal family caregiving on health and life satisfaction between wives and husbands as caregivers

• Author: Midori Wakabayashi,Wataru Kureishi
• DOI: http://doi.org/10.1111/rode.12390
• Published date: 01 August 2018
• Date: 01 August 2018

SPECIAL ISSUE ARTICLE

Differences in the effects of informal family

caregiving on health and life satisfaction between

wives and husbands as caregivers

Midori Wakabayashi

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Wataru Kureishi

2

1

Tohoku University, Sendai-Shi, Miyagi,

Japan

2

National Institute of Population and

Social Security Research, Chiyoda-ku,

Tokyo, Japan

Correspondence

Midori Wakabayashi Tohoku University,

27-1 Kawauchi, Aoba-ku, Sendai-Shi,

Miyagi 980-8576, Japan.

Email: midwak@tohoku.ac.jp

Funding information

A Grant-in-Aid for Scientific Research,

Grant/Award Number: 16H03607,

16K03730

Abstract

We analyze whether or not informal family caregiving

worsens caregivers’health and life satisfaction among

Japanese married middle-aged and elderly individuals

from the Japanese Study of Aging and Retirement. Unlike

previous studies, we distinguish between wives and hus-

bands as caregivers and between one’s own and one’s

spouse’s parents as care recipients. We find women’s

depressive state is negatively associated with caregiving

for spousal parents both in our instrumental variable esti-

mations and fixed-effect panel analysis, and also find

women’s life satisfaction is negatively associated with

caregiving for spousal parents in our fixed-effect panel

analysis, though only marginally so. However, as our

results are marginally significant, caregiving for either

own or spousal parents does not seem to matter much for

caregiver’s health or life satisfaction. All that can be said

for certain in our paper is that men’s subjective health,

depressive state, and life satisfaction are generally less

sensitive to informal care, for both spousal and own par-

ents, than that of women.

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INTRODUCTION

Not only in developed but also in developing countries, the rapid aging of populations will lead to

an increase in nursing care service (UNFPA & HelpAge International, 2012). Developed countries’

early experience with long-term care ahead of other countries offers policy implications for mid -

dle-income countries (Campbell, 2014). In particular, in Japan, as society ages, the need for care

DOI: 10.1111/rode.12390

Rev Dev Econ. 2018;22:1063–1080. wileyonlinelibrary.com/journal/rode ©2018 John Wiley & Sons Ltd

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provision increases with the number of elderly people who require care for longer periods. In addi-

tion, because of the aging of family caregivers and a change in family structure from multigenera-

tional co-residence to nuclear family residence, the situation has become urgent for Japanese

families in which the individuals responsible for care are older. Therefore, mandatory public long-

term care insurance was introduced in Japan in April 2000 to provide social support for elderly

people in need of care.

However, a decade and a half after the introduction of mandatory public long-term care insur-

ance, people continue to provide care for elderly relatives themselves. According to the Compre-

hensive Survey of Living Conditions, which was conducted by the Ministry of Health, Labour and

Welfare in 2013, most caregivers were family members either living with (61.6%) or not living

with (9.6%) care recipients, while the proportion of care service providers was only 14.8%. More-

over, most caregivers were spouses (26.2%), then children (21.8%), and finally children-in -law

(11.2%).

Another aspect relevant to issues of development economics or economic development is that

informal family caregiving is a responsibility commonly taken on by women in Japan and other

developing Asian countries. In fact, in the above-mentioned survey in Japan, examination of pro-

portions of caregivers according to sex showed that 68.7% were women. Similarly, Liu et al.

(2010) show that Chinese women confront competing demands for care among elderly parents and

between older parents and young children, and, in the Philippines, the majority were daughter care-

givers living with their elderly parents (Varona, Saito, Takahashi, & Kai, 2007).

Furthermore, families experience difficulty managing the heavy burden of providing informal

family care. According to the 2013 Survey on Life Protection, which was conducted by the Japan

Institute of Life Insurance, 82.1% of respondents felt anxious about providing informal care for

their parents or relatives. In addition, examination of specific details regarding anxiety indicated

that the proportion of respondents who reported that they felt anxious and experienced physical

and mental burden in their families (64.9%) was highest followed by respondents who reported

economic burden in their families (52.6%; multiple answers). Furthermore, the 2013 Comprehen-

sive Survey of Living Conditions asked respondents whether providing informal care for and living

with relatives was stressful, and 69.4% responded “yes”while only 27.7% responded “no.”With

respect to the reasons for this stress, the most common was sickness in those providing informal

care for family members (reported by 72.6% of men and 78.3% of women). According to Oshio

(2014, 2015), provision of informal care for family members is a major factor in mental health

problems in middle-aged and elderly individuals.

In this paper, we analyze whether or not informal family caregiving worsens caregivers’health

and life satisfaction. We conduct both cross-sectional and panel analyses with married middle-aged

and elderly individuals from the Japanese Study of Aging and Retirement (JSTAR), a survey of

middle-aged and elderly people aged 50–75.

The current study is novel in that it distinguishes between men and women as caregivers and

their own parents and spouses’parents as care recipients. This distinct treatment enables us to

adopt the instrumental variable (IV) approach—that is, we use sibling information, whether or not

parents are alive or dead, and the age of the parents as IVs. Coe and Van Houtven (2009) use sib-

ling and family characteristics, and they are immutable to the child (caregivers) to control for the

endogeneity of becoming a caregiver. We make use of the increased probability of provision of

informal care for parents resulting from the lack of a direct effect of parents’and siblings’charac-

teristics on caregivers’health and life satisfaction.

The rest of this paper is organized as follows. Section 2 provides a description of related litera-

ture and studies. Sections 3 and 4 provide a discussion on the estimation method and data used in

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