Determinants of Trajectories of Informal Caregiving in later life. Evidence from England.

Although long-term consequences of informal care provision are well investigated, fewer studies have examined trajectories of informal care provision among older people and the socioeconomic, demographic, health, and family characteristics associated with them. We use data from four waves of the English Longitudinal Study of Ageing, with 6,561 respondents followed for 6 years (2012/3 to 2018/9). We used group-based trajectory modelling to group people's provision of care over time into a finite number of distinct trajectories of caregiving. Using multinomial logistic regressions, we then investigated characteristics associated with these trajectories. Four distinct trajectories were identified representing "stable intensive", "increasing intensive", "decreasing", and "stable no care". Results suggest that, although there are socioeconomic, demographic, and health differences across the trajectories of caregiving (with younger women in good health and poorer socioeconomic status more likely to care intensively throughout), family characteristics are their main drivers. Respondents who live alone, with no children, and no parents alive are more likely to never provide care, whereas those with older parents and who live with adults in poor health are more likely to provide stable intensive care. Also, changes in family characteristics (e.g. death of parents, widowhood, or deterioration of the partner's health) are associated with trajectories representing increases or decreases of caregiving over time. Overall, trajectories of informal caregiving undertaken by older people are varied and these patterns are mostly associated with both the availability and health of family members, suggesting that the needs factors represent the most immediate reason for caregiving commitments.

Do Health and Well-Being Change Around the Transition to Informal Caring in Early Adulthood? A Longitudinal Comparison Between the United Kingdom and Germany.

PURPOSE: Providing care in early adulthood may have long-term consequences, given the importance of this life stage for life-course transitions. This study aimed to analyze how the transition into caring during young adulthood (17-29 years old) influenced health and life satisfaction in the United Kingdom and Germany. METHODS: Datasets were from 10 annual waves of the UK Household Longitudinal Study and the German Socioeconomic Panel between the years 2009-2018. We used propensity score matching to match young adult carers (YACs) to similar noncarers to address the endogeneity of unpaid care provision. Then we applied piecewise growth curves to observe changes in self-rated health (United Kingdom N = 2,851; Germany N = 454) and life satisfaction (United Kingdom N = 2,263; Germany N = 449) between YAC and noncarers before, during, and after the onset of care. We assessed carer status, weekly hours spent on care, and duration of care. RESULTS: In the United Kingdom, life satisfaction decreased and the probability of reporting poor health increased after becoming a YAC, particularly for those who reported caring for more weekly hours. However, no such differences were found between YAC and noncarers in Germany. DISCUSSION: The onset and intensity of caring responsibilities during early adulthood influenced health and life satisfaction in the United Kingdom but not in Germany. One possible interpretation for these differences may be attributed to the different welfare contexts in which YACs are providing informal care. Our results highlight the importance of identifying and supporting the needs of young adults who are providing informal care while making key life-course transitions.

Life history data from the gateway to global ageing data platform: resources for studying life courses across Europe.

Research from a range of disciplines highlights the need to adopt a life course perspective that considers earlier life courses to explain outcomes in later life (e.g. later life health, cognitive ageing or retirement behaviour). This includes a more comprehensive assessment of earlier life courses over time and of how they are shaped by societal and political contexts. But quantitative data with detailed information on life courses that allow to address these questions are rare. Or, in case the data are available, the data are rather difficult to handle and appears to be underused. This contribution introduces the harmonized life history data from the gateway to global ageing data platform from two European Surveys, SHARE and ELSA, with data from 30 European countries. Besides providing some details on the collection of life history data in the two surveys, we also describe the way how raw data were rearranged in a user-friendly state sequence format and additionally give some examples based on the resulting data. This illustrates the potential of collected life history data from SHARE and ELSA, clearly going beyond the description of single aspects of the life course. By providing harmonized data of two prominent studies on ageing in Europe in a user-friendly format, the gateway to global ageing data platform provides a unique data source that is easily accessible for research, and permits to study life course and their links to later life in a cross-national perspective.

Self-rated health of university students in Germany-The importance of material, psychosocial, and behavioral factors and the parental socio-economic status.

Introduction: Health inequalities start early in life. The time of young adulthood, between late teens and early twenties, is especially interesting in this regard. This time of emerging adulthood, the transition from being a child to becoming an adult, is characterized by the detachment from parents and establishing of an own independent life. From a health inequality perspective, the question about the importance of the socio-economic background of parents is important. University students are an especially interesting group. Many students come from a privileged background and the question of health inequality among university students has not yet been properly studied. Methods: Based on the National Educational Panel Study (NEPS), we analyzed health inequalities among 9,000 students in Germany (∅ 20 years in the first year of their studies) over a period of 8 years. Results: We found that most university students (92%) in Germany reported a good and very good health. Yet, we still found substantial health inequalities. Students whose parents had a higher occupational status reported less health problems. Additionally, we observed that health inequalities had indirect impact on health via health behavior, psychosocial resources, and material conditions. Discussion: We believe our study is an important contribution to the understudied subject of students' health. We see the impact of social inequality on health among such a privileged group like university students as an important sign of the importance of health inequality.

Socioeconomic differences in informal caregiving in Europe.

Disclosing socioeconomic differences in informal care provision is increasingly important in aging societies as it helps to identify the segments of the population that may need targeted support and the types of national investments to support family caregivers. This study examines the association between individual-level socioeconomic status and informal care provision within the household. We also examine the role of contextual factors, income inequality, and the generosity of social spending, to identify how macro-level socioeconomic resource structures shape individuals' provision of care to household members. We use pooled data from the Survey of Health, Ageing and Retirement in Europe (SHARE, waves 1, 2, 4, 5, 6) and the English Longitudinal Study of Ageing (ELSA, waves 2, 3, 4, 6, 7). Poisson regression multilevel models estimate the associations between household socioeconomic status (education, income, and wealth), and country socioeconomic resources (income inequality and social spending as a percentage of GDP), and the likelihood of older adults' informal care provision within the household. Results indicate that lower individual socioeconomic resources-education, income, and wealth-were associated with a higher incidence of older adults' informal care provision within the household. At the macro-level, income inequality was positively associated while social spending was negatively associated with older adults' care provision within the household. Our findings suggest that socioeconomically disadvantaged groups are more likely to provide informal care, which may reinforce socioeconomic inequalities. At the national level, more equitable resource distribution and social spending may reduce intensive family caregiving.

School-to-work and school-to-university transition and health inequalities among young adults: a scoping review.

OBJECTIVES: The main objective was to systematically map evidence regarding the emergence of health inequalities in individuals aged 16-24 years during school-to-work and school-to-university transition (STWT). Second, we aimed to summarise the evidence on potential effects of contextual and compositional characteristics of specific institutional contexts entered during STWT on health and health behaviours. DESIGN: Scoping review. STUDY SELECTION: Relevant literature was systematically searched following the methodological framework proposed by Arksey and O'Malley. Ovid MEDLINE and Web of Science, and websites of the International Labour Organization and National Institute for Occupational Safety and Health were searched, using a predetermined search strategy. Articles in English or German published between 1 January 2000 and 3 February 2020 were considered. DATA EXTRACTION: To collect the main information from the selected studies, a data extraction spreadsheet was created. Data were summarised and grouped into five health outcomes and five institutional contexts (school, vocational training, university, work, unemployment). RESULTS: A total of 678 articles were screened for inclusion. To be able to draw a picture of the development of various health outcomes over time, we focused on longitudinal studies. Forty-six prospective studies mapping health-related outcomes during STWT were identified. Higher family socioeconomic position (SEP) was associated with higher levels of health behaviour and lower levels of health-damaging behaviour, but there was also some evidence pointing in the opposite direction. Disadvantaged family SEP negatively impacted on mental health and predicted an adverse weight development. There was limited evidence for the outcomes physical/somatic symptoms and self-rated health. Meso-level characteristics of the institutional contexts identified were not systematically assessed, only individual-level factors resulting from an exposure to these contexts, rendering an analysis of effects of contextual and compositional characteristics on health and health behaviours impossible. CONCLUSIONS: This scoping review demonstrated a wide range of health inequalities during STWT for various health outcomes. However, knowledge on the role of the core institutional contexts regarding the development of health inequalities is limited.

The role of pension contributions in explaining inequalities in depressive symptoms. Results from SHARE.

Aims: Research has established solid evidence that socioeconomic position impacts health. It is, however, still debated to what extent characteristics of entire employment histories are associated with health inequalities later on. This study investigates associations between contributing to pension schemes throughout entire employment histories and depressive symptoms in older men and women. Methods: We use retrospective life history data from the Survey of Health, Ageing and Retirement in Europe (SHARE), collected in 2008-2009 from retired men and women. Data include detailed information on previous employment histories (between age 25 and 60 years) that allows us to measure labour market involvements and pension contributions during past working lives. In addition, we measure elevated depressive symptoms using EURO-D. Results: We observe that employed work without contributing to pension schemes is associated with elevated depressive symptoms for women, even when taking the current household income into consideration. For men (but not for women), self-employed work without pension contributions is linked to elevated depressive symptoms. Conclusions: Our results indicate that studies linking previous employment participation to health after labour market exit should not only consider whether a person worked, but also whether he or she contributed to a pension scheme. In addition, our study points to interesting gender differences, where pension contributions matter most for women in employed work and for men in self-employed work.

Adverse Employment Histories, Later Health Functioning and National Labor Market Policies: European Findings Based on Life-History Data From SHARE and ELSA.

OBJECTIVES: We investigate associations between adverse employment histories over an extended time period and health functioning in later life, and explore whether national labor market policies moderate the association. METHODS: We use harmonized life-history data from the Gateway to Global Aging Data on two European studies (SHARE and ELSA) linked to health beyond age 50 (men = 11,621; women = 10,999). Adverse employment histories consist of precarious, discontinued, and disadvantaged careers between age 25 and 50, and we use depressive symptoms, grip strength, and verbal memory as outcomes. RESULTS: Adverse employment histories between age 25 and 50 are associated with poor health functioning later in life, particularly repeated periods of unemployment, involuntary job losses, weak labor market ties, and disadvantaged occupational positions. Associations remain consistent after adjusting for age, partnership history, education and employment situation, and after excluding those with poor health prior to or during working life. We find no variations of the associations by national labor market policies. DISCUSSION: Our study calls for increased intervention efforts to improve working conditions at early career stages. Despite the importance in shaping employment histories, the role of national policies in modifying the impact of employment on health is less clear.

Multiple social roles in early adulthood and later mental health in different labour market contexts.

Work and family roles entail divergent responsibilities, which can be a source of conflict especially in young adulthood - the so-called "rush-hour" of life. Combining these multiple social roles can result in an accumulation of stress but also be a valuable resource for mental health. The aim of this study is to investigate combined employment, parenthood and partnership trajectories of men and women during early adulthood, and to analyse the relationship of these multiple roles with depressive symptoms at older age. We used harmonised data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) with retrospective information on employment, partnerships and parenthood histories between age 25 and 40 for 18,816 men and 24,686 women (n = 43,502). We applied sequence analysis and clustering to group trajectories into four clusters for women and three clusters for men. We then used multilevel models to analyse the links between combined employment and family roles and later mental health in different historical labour market contexts (indicated by female employment rates). Women and men who did not combine work and family roles between age 25 and 40 report higher levels of depression than those who combined work and family. Results differ by gender and labour market context, with stronger differences between women in countries with higher female employment rates. Overall, combining multiple roles in early adulthood is associated with decreased rather than increased risk for depressive symptoms in older Europeans.

The influence of living conditions in early life on life satisfaction in old age.

This article examines the influence of living conditions in early life on life satisfaction in old age in eleven Western European countries. It combines the influence of individual conditions, for example housing and family background, with country characteristics in the decade of birth. Using pooled data from the second and third wave of the Survey of Health, Ageing and Retirement in Europe, multilevel models show that early life living conditions have an influence on life satisfaction in old age. Furthermore, interaction effects between current and past living conditions show that adverse living conditions strengthen the effect of early life on life satisfaction in later life and therefore are an indication of cumulative inequality over the life course.

Tracing the origins of successful aging: the role of childhood conditions and social inequality in explaining later life health.

This study investigates the role of childhood conditions and social inequality in older Europeans' propensity to age successfully, controlling for later life risk factors. Successful aging was assessed following Rowe and Kahn's conceptualization, using baseline interviews from the first two waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). These data were merged with retrospective information on participants from 13 Continental European countries, collected as part of the SHARELIFE project. Our sample consists of 22,464 men and women, who are representative of the non-institutionalized population aged 50 or older (mean age: 63.3) in their respective country. Estimating multilevel logistic models, we controlled for demographics (age, sex), childhood conditions (SES, health, cognition), later life risk factors (various dimensions of SES and health behaviors), as well as social inequality (measured by country-specific Gini coefficients). There is an independent association of childhood living conditions with elders' odds of aging well. Higher parental SES, better math and reading skills, as well as self-reports of good childhood health were positively associated with successful aging, even if contemporary characteristics were controlled for. Later life SES and health behaviors exhibited the expected correlations with our dependent variable. Moreover, lower levels of income inequality were associated with a greater probability of meeting Rowe and Kahn's successful aging criteria. We conclude that unfavorable childhood conditions exhibit a harmful influence on individuals' chances to age well across all European welfare states considered in this study. Policy interventions should thus aim at improving the conditions for successful aging throughout the entire life course.

[Reciprocity between adult generations: family transfers over the life course]. / Reziprozität zwischen erwachsenen Generationen: Familiale Transfers im Lebenslauf.

Intergenerational relations are characterised by reciprocal transfers and solidarity over the shared life span. Children care for their elderly parents, and parents support their adult children financially, for example, during their education or when they start their own household and family. From a life course-perspective, we analysed mutual transfers between parents and their adult children: Are transfers balanced over the life course and family-stages? Do we find patterns of direct or indirect reciprocity? Which factors facilitate exchange, and which do not? Using multinomial multilevel regression analyses based on the Survey of Health, Ageing and Retirement in Europe (SHARE) we trace transfers of time and money between parents and adult children back to opportunity, need and family structures. Remaining differences between European countries are explained by cultural contextual structures, here: family expenditures. The exchange between generations is reciprocal, but not necessarily balanced in various phases of family life.