THE EFFECT OF THE MEDICAID HOME CARE BENEFIT ONLONG-TERM CARE CHOICES OF THE ELDERLY

This paper analyses the impact of Medicaid home care benefits on the probability of nursing home entry and the use of formal and informal home care by disabled elderly remaining in the community. Using data from the National Long-Term Care Survey, I find evidence that Medicaid home care subsidies reduced the probability of nursing home entry among at-risk elderly using formal home care. Among non-in-stitutionalized persons, the subsidy increased the use of formal home care but led to substitution of informal with formal care for services that were non-medical in nature.     

The impact of “parent care” on female labor supply decisions

Data from the 1986–1988 Survey of Income and Program Participation panels were used to analyze how informal-caregiving of disabled elderly parents affected female labor supply. Instrumental variables analyses suggested that coresidence with a disabled parent leads to a large, significant reduction in work hours, due primarily to withdrawal from the labor force. Although the impact of nonhousehold member caregiving was insignificant, evidence of an effect was stronger when commitment of caregiving time was greater. Projections of female labor force participation rates should account for potential increases in caregiving demand due to the aging of the U.S. population.     

Socioeconomic status and health: a micro-level analysis of exposure and vulnerability to daily stressors

This study examines the interconnections among education--as a proxy for socioeconomic status--stress, and physical and mental healthy by specifying differential exposure and vulnerability models using data from The National Study of Daily Experiences (N = 1,031). These daily diary data allowed assessment of the social distribution of a qualitatively different type of stressor than has previously been examined in sociological stress research--daily stressors, or hassles. Moreover, these data allowed a less biased assessment of stress exposure and a more micro-level examination of the connections between stress and healthy by socioeconomic status. Consistent with the broad literature describing socioeconomic inequalities in physical and mental health, the results of this study indicated that, on any given day, better-educated adults reported fewer physical symptoms and less psychological distress. Although better educated individuals reported more daily stressors, stressors reported by those with less education were more severe. Finally, neither exposure nor vulnerability explained socioeconomic differentials in daily health, but the results clearly indicate that the stressor-health association cannot be considered independent of socioeconomic status.