Who Cares ? Geographical Variation in Informal Care-giving in England and Wales

Harriet Young, Stamatis Kalogirou & Emily GrundyLondon 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

% caring 20+ hrs M&F0.95 - 2.42.4 - 2.952.95 - 3.563.56 - 4.424.42 - 6.23

Local Authority level:

Range:0.95 - 6.23 %

Mean: 3.16 %

S.D.: 0.85%

Objective 2

Characteristics of caregivers in 2001

Age of carers

• Mean age of carers: 53.6

• Mean age of male carers: 55.7

• Mean age of female carers: 52.2

Distribution of carers (20 hrs+) by agegroup in England and Wales

0

50000

100000

150000

200000

5 to

9

10 to

14

15-1

9

20-2

4

25- 2

9

30- 3

4

35- 3

9

40 -4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

4

85-8

990

+

age group

nu

mb

er o

f ca

rers

Proportion of different ethnic groups who are carers (20 hours plus) by Government Office Region

Ethnic GroupWhiteIndianBangadeshi and pakistaniBlack

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

Proportion of female informal care givers (20+ hours per week) who also work full time

% f/ t emp of f carers9.6 - 12.712.7 - 14.414.4 - 16.116.1 - 18.518.5 - 23

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

Proportion of all carers (20+ hours) who have poor self rated general health

% of all carers in pr health9.4 - 12.612.6 - 14.814.8 - 16.916.9 - 19.519.5 - 23.9

Local Authority level:

Range: 9.4 – 23.9 %

Mean: 16.1 %

S.D.: 2.85 %

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 Proportion of population providing care for 20+ hours per week

IMD4.4 - 14.414.4 - 22.422.4 - 32.332.3 - 45.645.6 - 61.3

% caring 20+ hrs M&F0.95 - 2.42.4 - 2.952.95 - 3.563.56 - 4.424.42 - 6.23

Correlation between deprivation index and percent of population caring for 20+ hours

R2 = 0.6136

.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

0.00 2.00 4.00 6.00 8.00

% of popn caring for 20+ hours

ind

ex o

f m

ult

iple

dep

riva

tio

n

local authority

Linear (local authority)

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

% of 80+ with llti1.2 - 1.91.9 - 2.42.4 - 2.82.8 - 3.53.5 - 4.9

Local Authority level:

Range: 1.3 – 4.9 %

Mean: 2.52 %

S.D.: 0.55 %

ratio carers 50-59:llti's 80+ / 1000 of latter

37.6 - 63.963.9 - 79.179.1 - 95.895.8 - 115.9115.9 - 151.6

Ratio of carers aged 50-59 to population aged 80+ with a limiting long term illness

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/documents/downloadable/odpm_urbpol_021680.pdf