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Health of migrant care-givers across Europe: what is the role of origin and welfare state context?

Published online by Cambridge University Press:  05 December 2018

Judith Kaschowitz
Institute for Sociology, TU Dortmund University, Dortmund, Germany


Across Europe a rising number of migrants are reaching higher ages. As old age is related to care dependency, care-giving within migrant families is becoming more important. To date, little research has focused on health outcomes for migrant care-givers. Theories and empirical evidence suggest differences in the relationship of care-giving and health between migrants and non-migrants due to differences in support, income, norms and values. Furthermore, across Europe the degree of formal care supply and the obligation to provide informal care vary considerably and presumably lead to different health outcomes of care-giving in different countries. Based on data from the Survey of Health, Ageing and Retirement in Europe (Waves 1, 2, 4, 5 and 6) and the English Longitudinal Study of Ageing (Waves 2–6), this paper studies the relationship between informal care-giving inside the household and health for migrant and non-migrant care-givers across Europe and analyses changes in health. In most countries migrant care-givers are in worse self-perceived and mental health compared to non-migrant care-givers. When controlling for important influences no differences in the relationship between health and care-giving for migrants and non-migrants can be found. Moreover, care-giving deteriorates mental health irrespective of origin. The country models showed that for non-migrants care-giving is most detrimental in Southern welfare states whereas for migrants care-giving is also burdening in Nordic welfare states.

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Aichberger, MC, Schouler-Ocak, M, Mundt, A, Busch, MA, Nickels, E, Heimann, HM, Ströhle, A, Reischies, FM, Heinz, A and Rapp, MA (2010) Depression in middle-aged and older first generation migrants in Europe: results from the Survey of Health, Ageing and Retirement in Europe (SHARE). European Psychiatry: The Journal of the Association of European Psychiatrists 25, 468475.CrossRefGoogle Scholar
Amrhein, L, Heusinger, J, Ottovay, K and Wolter, B (2015) Die Hochaltrigen: Expertise zur Lebenslage von Menschen im Alter über 80 Jahren. Forschung und Praxis der Gesundheitsförderung 47, 1242.Google Scholar
Aranda, MP and Knight, BG (1997) The influence of ethnicity and culture on the caregiver stress and coping process: a sociocultural review and analysis. The Gerontologist 37, 342354.CrossRefGoogle ScholarPubMed
Assari, S, Moazen-Zadeh, E, Lankarani, MM and Micol-Foster, V (2016) Race, depressive symptoms, and all-cause mortality in the United States. Frontiers in Public Health 4, 18.CrossRefGoogle ScholarPubMed
Avendano, M, Jürges, H and Mackenbach, JP (2009) Educational level and changes in health across Europe: longitudinal results from SHARE. Journal of European Social Policy 19, 301316.CrossRefGoogle Scholar
Bambra, C, Pope, D, Swami, V, Stanistreet, D, Roskam, A, Kunst, A and Scott-Samuel, A (2009) Gender, health inequalities and welfare state regimes: a cross-national study of 13 European countries. Journal of Epidemiology & Community Health 63, 3844.CrossRefGoogle ScholarPubMed
Bordone, V and de Valk, HAG (2016) Intergenerational support among migrant families in Europe. European Journal of Ageing 13, 259270.CrossRefGoogle ScholarPubMed
Börsch-Supan, A, Brandt, M, Hunkler, C, Kneip, T, Korbmacher, J, Malter, F, Schaan, B, Stuck, S and Zuber, S (2013) Data resource profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). International Journal of Epidemiology 42, 9921001.CrossRefGoogle Scholar
Botsford, J, Clark, CL and Gibb, CE (2011) Research and dementia, caring and ethnicity: a review of the literature. Journal of Research in Nursing 16, 437449.CrossRefGoogle Scholar
Broese van Groenou, MI and de Boer, A (2016) Providing informal care in a changing society. European Journal of Ageing 13, 271279.CrossRefGoogle Scholar
Broese van Groenou, MI, de Boer, A and Iedema, J (2013) Positive and negative evaluation of caregiving among three different types of informal care relationships. European Journal of Ageing 10, 301311.CrossRefGoogle ScholarPubMed
Brüderl, J and Ludwig, V (2014) Fixed-effects panel regression. In Best, H and Wolf, C (eds), The Sage Handbook of Regression Analysis and Causal Inference. London: Sage, pp. 327358.Google Scholar
Castro-Costa, E, Dewey, M, Stewart, R, Banerjee, S, Huppert, F, Mendonca-Lima, C, Bula, C, Reisches, F, Wancata, J, Ritchie, K, Tsolaki, M, Mateos, R and Prince, M (2007) Prevalence of depressive symptoms and syndromes in later life in ten European countries. The SHARE study. British Journal of Psychiatry 191, 393401.CrossRefGoogle ScholarPubMed
Cichy, KE, Stawski, RS and Almeida, DM (2014) A double-edged sword: race, daily family support exchanges, and daily well-being. Journal of Family Issues 35, 18241845.CrossRefGoogle ScholarPubMed
Ciobanu, RO, Fokkema, T and Nedelcu, M (2016) Ageing as a migrant: vulnerabilities, agency and policy implications. Journal of Ethnic and Migration Studies 43, 164181.CrossRefGoogle Scholar
Coe, NB and Van Houtven, CH (2009) Caring for mom and neglecting yourself? The health effects of caring for an elderly parent. Health Economics 18, 9911010.CrossRefGoogle ScholarPubMed
Colombo, F, Llena-Nozal, A, Mercier, J and Tjadens, F (2011) Help Wanted? Providing and Paying for Long-term Care (OECD Health Policy Studies). Paris: OECD Publishing.CrossRefGoogle Scholar
Comas-Herrera, A, Wittenberg, R and Pickard, L (2010) The long road to universalism? Recent developments in the financing of long-term care in England. Social Policy & Administration 44, 375391.CrossRefGoogle Scholar
Courtin, E, Knapp, M, Grundy, E and Avendano-Pabon, M (2015) Are different measures of depressive symptoms in old age comparable? An analysis of the CES-D and Euro-D scales in 13 countries. International Journal of Methods in Psychiatric Research 24, 287304.CrossRefGoogle ScholarPubMed
Dilworth-Anderson, P, Williams, IC and Gibson, BE (2002) Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980–2000). The Gerontologist 42, 237272.CrossRefGoogle Scholar
Esping-Andersen, G (1990) The Three Worlds of Welfare Capitalism. Princeton, NJ: Princeton University Press.Google Scholar
European Commission (2011) Demography Report 2010. Older, More Numerous and Diverse Europeans. Luxembourg: Publications Office of the European Union.Google Scholar
Evandrou, M (2000) Social inequalities in later life: the socio-economic position of older people from ethnic minority groups in Britain. Population Trends 101, 1118.Google Scholar
Fennelly, K (2007) The healthy migrant effect. Minnesota Medicine 90, 5153.Google ScholarPubMed
Geddes, A and Scholten, P (2016) The Politics of Migration & Immigration in Europe. Los Angeles, CA: Sage.CrossRefGoogle Scholar
Genet, N, Kroneman, M and Boerma, W (2013) Explaining governmental involvement in home care across Europe: an international comparative study. Health Policy 110, 8493.CrossRefGoogle Scholar
Goodenough, WH (1999) Outline of a framework for a theory of cultural evolution. Cross-cultural Research 33, 84107.CrossRefGoogle Scholar
Haberkern, K, Schmid, T and Szydlik, M (2015) Gender differences in intergenerational care in European welfare states. Ageing & Society 35, 298320.CrossRefGoogle Scholar
Haberkern, K and Szydlik, M (2008) Pflege der Eltern – Ein europäischer Vergleich. KZfSS Kölner Zeitschrift für Soziologie und Sozialpsychologie 60, 82105.CrossRefGoogle Scholar
Hunkler, C, Kneip, T, Sand, G and Schuth, M (2015) Growing old abroad: social and material deprivation among first- and second-generation migrants in Europe. In Börsch-Supan, A (ed.), Ageing in Europe – Supporting Policies for an Inclusive Society. Berlin: De Gruyter, pp. 199208.Google Scholar
Idler, EL and Kasl, SV (1995) Self-ratings of health: do they also predict change in functional ability? Journals of Gerontology: Psychological Sciences and Social Sciences 50B, 344353.CrossRefGoogle Scholar
Jenkins Rahrig, K, Kabeto, MU and Langa, KM (2009) Does caring for your spouse harm one's health? Evidence from a United States nationally-representative sample of older adults. Ageing & Society 29, 277293.CrossRefGoogle Scholar
Kaschowitz, J and Brandt, M (2017) Health effects of informal caregiving across Europe: a longitudinal approach. Social Science & Medicine 173, 7280.CrossRefGoogle ScholarPubMed
Knight, BG and Sayegh, P (2010) Cultural values and caregiving: the updated socio-cultural stress and coping model. Journals of Gerontology: Psychological Sciences and Social Sciences 65B, 513.CrossRefGoogle Scholar
Koopmans, R (2009) Trade-offs between equality and difference: immigrant integration, multiculturalism and the welfare state in cross-national perspective. Journal of Ethnic and Migration Studies 36, 126.CrossRefGoogle Scholar
Lanari, D, Bussini, O and Minelli, L (2015) Self-perceived health among eastern European immigrants over 50 living in Western Europe. International Journal of Public Health 60, 2131.CrossRefGoogle ScholarPubMed
Lawrence, V, Murray, J, Samsi, K and Banerjee, S (2008) Attitudes and support needs of Black Caribbean, South Asian and White British carers of people with dementia in the UK. British Journal of Psychiatry 193, 240246.CrossRefGoogle ScholarPubMed
Lin, I-F, Fee, HR and Wu, H-S (2012) Negative and positive caregiving experiences: a closer look at the intersection of gender and relationships. Family Relations 61, 343358.CrossRefGoogle Scholar
Litwin, H, Stoeckel, KJ and Roll, A (2014) Relationship status and depressive symptoms among older co-resident caregivers. Aging & Mental Health 18, 225231.CrossRefGoogle ScholarPubMed
Marmot, M, Oldfield, Z, Clemens, S, Blake, M, Phelps, A, Nazroo, J, Steptoe, A, Rogers, N and Banks, J (2015) English Longitudinal Study of Ageing: Waves 0–6, 1998–2013. Colchester, UK: UK Data Service.Google Scholar
Moffatt, S, Higgs, P, Rummery, K and Rees Jones, I (2012) Choice, consumerism and devolution: growing old in the welfare state(s) of Scotland, Wales and England. Ageing & Society 32, 725746.CrossRefGoogle Scholar
Pearlin, LI, Mullan, JT, Semple, SJ and Skaff, MM (1990) Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist 30, 583594.CrossRefGoogle ScholarPubMed
Pinquart, M and Sörensen, S (2005) Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. The Gerontologist 45, 90106.CrossRefGoogle ScholarPubMed
Prince, MJ, Reischies, FM, Beekman, AT, Fuhrer, R, Jonker, C, Kivela, S-L, Lawlor, BA, Lobo, A, Magnusson, H, Fichter, M, van Oyen, H, Roelands, M, Skoog, I, Turrina, C and Copeland, JR (1999) Development of the EURO-D scale – a European Union initiative to compare symptoms of depression in 14 European centres. British Journal of Psychiatry 174, 330338.CrossRefGoogle ScholarPubMed
Radloff, LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.CrossRefGoogle Scholar
Sand, G and Gruber, S (2018) Differences in subjective well-being between older migrants and natives in Europe. Journal of Immigrant and Minority Health 20, 8390.CrossRefGoogle ScholarPubMed
Sayegh, P and Knight, BG (2011) The effects of familism and cultural justification on the mental and physical health of family caregivers. Journals of Gerontology: Psychological Sciences and Social Sciences 66B, 314.CrossRefGoogle Scholar
Solé-Auró, A and Crimmins, EM (2008) Health of immigrants in European countries. International Migration Review 42, 861876.CrossRefGoogle ScholarPubMed
Solé-Auró, A, Guillén, M and Crimmins, EM (2012) Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE. European Journal of Health Economics 13, 741754.CrossRefGoogle ScholarPubMed
Stolz, E (2015) Social Inequality in Formal Long-term Care Utilisation in Old Age. A Comparative Analysis of 15 European Countries. Salzburg, Austria: Paris-Lodron-Universität Salzburg.Google Scholar
Tolkacheva, N, Broese van Groenou, MI, de Boer, A and van Tilburg, T (2011) The impact of informal caregiving networks on adult children's care-giver burden. Ageing & Society 31, 3451.CrossRefGoogle Scholar
United Nations Statistics Division (2018) Methodology. Standard Country or Area Codes for Statistical Use (M49). Geographic Regions. Available at Scholar
Verbakel, E (2014) Informal caregiving and well-being in Europe: what can ease the negative consequences for caregivers? Journal of European Social Policy 24, 424441.CrossRefGoogle Scholar
Wagner, M and Brandt, M (2018) Long-term care provision and the well-being of spousal caregivers: an analysis of 138 European regions. Journals of Gerontology: Psychological Sciences and Social Sciences 73B, e24e34.CrossRefGoogle Scholar
Warnes, AM, Friedrich, K, Kellaher, L and Torres, S (2004) The diversity and welfare of older migrants in Europe. Ageing & Society 24, 307326.CrossRefGoogle Scholar
Willis, R (2012) Individualism, collectivism and ethnic identity: cultural assumptions in accounting for caregiving behaviour in Britain. Journal of Cross-cultural Gerontology 27, 201216.CrossRefGoogle ScholarPubMed

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