Older adults residing in rural areas are more likely to receive any family care than those in urban areas. From 2004 to 2016, a higher proportion of older adults in rural areas receive care from family caregivers exclusively while a lower proportion receive care from formal caregivers exclusively. When examining older adults in urban areas, we find the opposite — a higher proportion of urban adults rely exclusively on formal care and a lower proportion rely exclusively on family care in 2016 compared to 2004.
Disability
Rural Disparities in Use of Family and Formal Caregiving for Older Adults with Disabilities.
Miller, K. E. M., Ornstein, K. A., & Coe, N. B. (2023). Rural disparities in use of family and formal caregiving for older adults with disabilities. Journal of the American Geriatrics Society., 71(9), 2865–2870. https://doi.org/10.1111/jgs.18376
Informal And Formal Home Care For Older Adults With Disabilities Increased, 2004–16
Rates of informal home care use among older adults with disabilities increased from 2004 to 2016, such that in 2016 almost three-quarters of these adults received informal home care. Informal care remains the most common source of home care, even though formal home care use grew at almost twice the rate, with a 6-percentage-point increase to 36.9 percent in 2016.
Van Houtven CH, Taggert E, Konetzka RT, Coe NB: Informal and Formal Home Care Both Increased Between 2004 and 2016, Potentially Reducing Unmet Needs of Older Adults (Data Watch). Health Affairs. August 2020.
Coverage Gaps and Cost-Shifting for Work-Related Injury and Illness: Who Bears the Financial Burden?
This article details the ways in which financial burden imposed by work-related injury/illness, and points out areas which are under-researched to focus policy efforts where improvement is most needed.
Sears, JM, AT Edmonds, NB Coe, “Coverage Gaps and Cost-Shifting for Work-Related Injury and Illness: Who Bears the Financial Burden?” Medical Care Research and Review. 2019. April. DOI: 10.1177/1077558719845726. PMID: 31018756
Family Structure and Long-Term Care Insurance Purchase.
While it has long been assumed that family structure and potential sources of informal care play a large role in the purchase decisions for long-term care insurance (LTCI), current empirical evidence is inconclusive. Our study examines the relationship between family structure and LTCI purchase and addresses several major limitations of the prior literature by using a long panel of data and considering modern family relationships, such as presence of stepchildren. We find that family structure characteristics from one’s own generation, particularly about one’s spouse, are associated with purchase, but that few family structure attributes from the younger generation have an influence. Family factors that may indicate future caregiver supply are negatively associated with purchase: having a coresidential child, signaling close proximity, and having a currently working spouse, signaling a healthy and able spouse, that LTC planning has not occurred yet, or that there is less need for asset protection afforded by LTCI. Dynamic factors, such as increasing wealth or turning 65, are associated with higher likelihood of LTCI purchase.
Van Houtven, C, NB Coe, RT Konetzka. Family Structure and Long-Term Care Insurance Purchase. Health Economics. 2015. 24(S1), 58-73.
Workers' compensation: Poor quality health care and the growing disability problem in the United States
Franklin, GM, TM Wickizer, NB Coe, D Fulton-Kehoe. “Worker’s Compensation: Poor Quality Health Care and the Growing Disability Problem in the United States.” American Journal of Industrial Medicine. 2015. 58:245-251. PMID:25331746
How do People with Disabilities Cope While Waiting for Disability Insurance?
Disability Insurance waiting time varies from a few months to several years. We estimate the causal effect of longer waiting times on the use of five financial coping strategies. We find that SNAP benefits are the most responsive to longer waiting times. Moreover, while spousal employment is not responsive to longer wait times, spousal employment leads to longer waiting times, presumably because these applicants are more able to appeal. Together, these results suggest that coping strategies are used to both help applicants during the wait time and to extend the waiting time and increase their probability of success.
Coe, NB, S Lindner, K Wong, and AY Wu. “How do People with Disabilities Cope While Waiting for Disability Insurance?” IZA Journal of Labor Policy. 2014; 3(1). Doi: 10.1186/2193-9004-3-1.