Health expectancy and its uses

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Capability to care and work: when dual roles intersect

Ageing in place is a cost-effective policy solution to eldercare that reflects a dominant positive ageing discourse of choice and independence. It satisfies older people's preference to remain at home and be involved in their community, but depends upon the provision of care and support for frail elders, particularly the oldest-old, who require assistance to achieve these goals. The traditional provision of unpaid eldercare by female relatives is changing as women are increasingly working outside the home, and they have to choose between, or manage, dual roles of caregiving and paid work. Negative effects on health, paid employment, and finances are associated with the intersection of eldercare and employment. Solutions involve reducing or relinquishing paid employment, which would have financial, social, physical, and emotional ramifications in the future. However, being able to successfully accommodate both roles provides a sense of satisfaction and fulfilment. To understand the complexity of managing the tension between work and eldercare requires a detailed analysis of unpaid caregivers’ daily lives. This paper presents findings about eldercare provision and paid work, derived from two qualitative studies that used a participatory methodology for an in-depth exploration of caregivers’ health. The participants’ stories demonstrate that rather than reflecting on access to a range of options, caregivers’ choices are constrained, and involve trading work and other capabilities for the capability to care. Providing care for a loved elder was the first priority, followed by paid work. Having the capability to maintain a healthy and balanced life was the caregivers’ lowest priority. Unpaid informal care has benefits for elders, and it is a valued emotional relationship for caregivers; however, future social policy should address the difficulties that caregiving creates in people's lives along with focusing on the benefits that such care offers in terms of positive population ageing

Factors explaining the geographical differences in Disability Free Life Expectancy in Spain

OBJECTIVE—To study the geographical variations in Disability Free Life Expectancy (DFLE) at birth (DFLEb) and at 65 years (DFLE65) in Spain and to identify the main factors that explain these variations.
DESIGN—Ecological study with the 50 provinces of Spain as the units of analysis. Sullivan's method is used to calculate DFLE for each province based on information from the death registry and the survey on disabilities, impairments and handicaps. Information on the independent variables—socioeconomic level, factors related with the health system and risk factors—was taken from various sources.
MAIN OUTCOME MEASURE—Simple correlation coefficients were obtained between each dependent variable (DFLEb and DLFE65) and the independent variables. Two multiple linear regression models were fit to obtain the best set of factors that explain the geographical distribution of DFLEb and DLFE65.
RESULTS—Both DFLEb and DLFE65 vary widely among provinces. The multiple linear regression analysis shows that the illiteracy rate, the percentage of the unemployed and the percentage of smokers in the population were the main factors associated with the geographical variation of DFLE. The models explained approximately 40% of the variance for DFLEb and 30% for DLFE65.
CONCLUSIONS—The results obtained show the influence of education, the unemployment rate and smoking on the geographical differences of DFLE. The DFLE indicators are shown to be valid for use in health policy.


Keywords: Disability Free Life Expectancy; geographical difference