February 10, 2015 | News

Elderly with higher education are less likely to use long-term care

© mickyso / Fotolia.de

In a new study, MPIDR-researcher Olga Grigorieva has shown that people with higher education are less likely to use long-term care than people with lower education.

Olga Grigorieva analyzed the impact of socioeconomic status on the transition to statutory long-term care. This kind of analysis is interesting for policy makers, and more generally society, in most industrialized countries: As the proportion of elderly rises, we are increasingly faced with the problem of financing long-term care provision. Knowledge of the educational structure and the impact of education on care use may help us in evaluating potential care needs and the costs in meeting these needs.

The results have been published in the book Health Among the Elderly in Germany - New Evidence on Disease, Disability and Care Need (Beiträge zur Bevölkerungswissenschaft Vol. 46, 11/2014).

Her study differs in several ways from previous works: Education was used for the first time ever in analyzing the factors affecting the use of statutory long-term care in Germany. She also considered people living in private households as well as elderly living in institutions. To know if a person needed care, she used an uncommon measure of care use: receiving cash benefit for home care (Pflegegeld). She analyzed a large sample of data on elderlies aged 65 and older from the German Microcensus Panel Data (2001-2004) to study two aspects of care use: First, she wanted to know if there is an effect of education on the incidence of care use, which is the number of new cases per population at risk in a given year. Second, she analyzed the impact of education on the prevalence in care utilization, defined as the proportion of people having received benefits throughout the study period. She also looked at differences in care use by education between men and women and Eastern and Western Germany.

Olga Grigrorieva’s results reveal that education does matter, both for the incidence and prevalence in long-term care use, though the effect is stronger for the prevalence of care use, and these results are true regardless of sex or region. Gender as such has no effect on care use. The association between education and care utilization is more pronounced among men than it is among women, and this might be linked to greater socioeconomic inequalities in health among men. As to regional differences, elderly from Eastern Germany are at higher risk of utilizing care than their Western German peers, and this holds for both genders.

The scientist found another factor that has a strong impact on the transition to care: Marital status. In terms of the incidence in care use, a change in marital status during the period of observation increases the risk of transition. And men and women differ considerably: Being a single man increases the risk of transition more than two-fold (exactly 2.3) compared to married men. Widowhood increases the risk for women; they are 1.3 times more likely to receive benefits than married females.

Olga Grigorieva’s findings show that we might have to rethink our calculations of long-term care provision in a population that is aging, even though it is problematic to draw conclusions from these calculations: “It is not easy to know if people with higher education levels will require less care, since they are assumed to be healthier or if they will require more care, as they are predicted to live longer compared to individuals with lower education.” 

The Max Planck Institute for Demographic Research (MPIDR) in Rostock is one of the leading demographic research centers in the world. It's part of the Max Planck Society, the internationally renowned German research society.