Journal Article

The high cost of unpaid care by young people:health and economic impacts of providing unpaid care

Brimblecombe, Nicola, Cartagena Farias, Javiera, Knapp, Martin, Stevens, Madeleine, King, Derek

2020

Overview

Background Many countries worldwide have experienced reductions in provision of formal long-term care services amidst rising need for care. Provision of unpaid care, meanwhile, has grown. This includes care provided by young people. Care responsibilities can affect a young people’s health, education and employment. We aimed to investigate the impacts on the employment and health of young people aged 16 to 25 of providing care, and the associated individual and public expenditure costs. Methods We examined employment, earnings and health impacts for individuals, and a range of economic impacts for society, focusing on young people aged 16 to 25 providing unpaid care in England. We applied regression analysis to data from three waves of the UK Household Longitudinal Study (2013/2015, 2014/2016, and 2015/2017) to compare employment and health outcomes among carers and non-carers, and two-part Generalised Linear Models to estimate costs. To address potential selection bias, we then used propensity score matching methods to explore outcomes for a matched sub-sample of young adult carers who started providing care at baseline (2014/16). Results Young people aged 16 to 25 who provided care at baseline (2014/16) were less likely to be in employment, had lower earnings from paid employment, and had poorer mental and physical health at follow-up (2015/17) compared to young people of the same age who were not providing care at baseline.. There were substantial costs to the state of young adults providing care from lower tax revenue, welfare benefit payments, and health service use. In aggregate, these costs amounted to £1048 million annually in 2017. Conclusions High individual impacts and costs to the state of providing unpaid care, and the potential of such impacts to compound existing inequalities, have many implications for policy and practice in the health, social care, employment and welfare benefits sectors. In particular, the findings reinforce the case for reducing the need for young people to provide unpaid care, for example through better provision of formal care services, and to provide ongoing support for those young people who do provide care. As impacts are seen in a number of domains, support needs to be multidimensional.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Age / Analysis / Biostatistics / Caregivers / Caregivers - economics / Child & adolescent mental health / Clinical outcomes / Correlation analysis / Costs / Data Collection / Disability / Earnings / Economic aspects / Economic conditions / Economic impact / Economics / Education / Employment / Employment - economics / England / Environmental Health / Epidemiology / Expenditures / Family Characteristics / Family relations / Female / Government spending / Health / Health aspects / Health care costs / Health care expenditures / Health education / Health Expenditures / Health policies / Health services / Health services utilization / Health status / Households / Humans / Income / Inequality / Linear analysis / Long term health care / Long-term care / Longitudinal Studies / Male / Medicine / Medicine & Public Health / Mental health / Mental health services / Payments / Population / Profits / Propensity / Public Health / Regression analysis / Research Article / Selection bias / Self employment / Social inequality / Social services / Social Welfare / Studies / systems and management in high-income countries / Tax revenues / Taxation / Unemployment / Unpaid / Unpaid/informal care / Vaccine / Welfare benefits / Young Adult / Young adults / Youth / Youth employment