Aging, Health, and Care: the Geography of Residential Proximity Between Parents and Adult Children

老龄化、健康和护理：父母和成年子女之间的居住邻近地理

• 批准号: 10211093
• 负责人: Stipica Mudrazija
• 金额: $ 99.72万
• 依托单位: URBAN INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10211093
• 关键词: Address; Adult; Adult Children; Age; Aging; Altruism; Alzheimer' s Disease; Alzheimer' s disease related dementia; Attention; Caring; Characteristics; Child; Child Care; Complement; Complex; Data; Data Files; Dementia; Deterioration; Dimensions; Economics; Emotional; Ethnic Origin; Etiology; Family; Geography; Government Agencies; Health; Health Status; Health and Retirement Study; Healthcare; Heterogeneity; Housing; Impaired cognition; Incentives; Individual; Institutes; Joints; Knowledge; Literature; Location; Long-Term Care; Modeling; Nature; Outcome; Parents; Persons; Policies; Process; Race; Respondent; Role; Sampling; Services; Shapes; Social Work; Socioeconomic Status; Source; Spouses; Support System; United States; Variant; aging in place; aging population; base; care outcomes; care providers; care systems; caregiving; functional status; gender difference; health care service; health data; human old age (65+); informal care; insight; instrumental activity of daily living; migration; residence; response; service organization; sociodemographics; statistics

Abstract/Project Summary Population aging in the United States is increasing the number of people with long-term health problems and other care needs, leading to a crisis in long-term care (Bipartisan Policy Center 2014). Family care is a central component of the long-term services and supports system, and adult children are the most common providers of that care for frail older parents (Spillman et al. 2014). Geographic proximity between parents and adult children is an important determinant of informal care provision (Choi et al. 2015). This project uses data from the Health and Retirement Study on the geographic proximity between a respondent age 65 and older and each of their adult children, combined with information about whether each child provides any care for a parent who has care needs due to function limitations or cognitive decline. We obtain information about aging services organizations from the Urban Institute’s National Center for Charitable Statistics data and the HRS contextual data. Our approach combines theoretical insights from altruism models commonly used in the literature on parent-child transfers and support with insights from the migration literature used to understand location decisions. We address the following specific aims: Aim 1: Estimate separate reduced form models of the geographic proximity of adult children to their older parents as well as caregiving conditional on parental care needs (i.e., having a functional limitation and/or a cognitive impairment) as a function of parent and child economic and socio-demographic characteristics, characteristics of parent-child dyads, and characteristics of place, such as demographic composition, labor market opportunities, housing affordability, and availability of aging service organizations and care services. Aim 2: Model changes in geographic proximity between adult children and older parents as a function of changes in parent’s health and functional status and the same set of variables described above. Aim 3: Jointly model caregiving and location decisions (conditional on the need for care) to account for the interdependence of the two processes. This analysis would help us understand how the determinants of care might differ when residential proximity is modeled jointly with care decisions. This approach allows us to assess the role of characteristics of place, such as the supply of formal aging support and care services, as well as family and individual characteristics in shaping decisions about a child’s care provision and location. We have a particular focus on understanding these joint processes for parents whose care needs come from Alzheimer’s disease or related dementia. We also focus on differences by gender, race, and SES.

摘要/项目摘要 美国人口老龄化正在增加患有长期健康问题的人数和 其他护理需求，导致长期护理危机(两党政策中心，2014年)。家庭护理是一个中心 长期服务和支助系统的组成部分，成年子女是最常见的提供者 照顾虚弱的年迈父母(Spillman等人)2014年)。父母和成年人之间的地理位置接近 儿童是提供非正规护理的重要决定因素(Choi等人)。2015年)。 该项目使用了健康和退休研究中关于受访者之间的地理接近程度的数据 65岁及以上和他们的每个成年子女，并结合关于每个子女是否提供 对因功能受限或认知能力减退而有照顾需要的父母的任何照顾。我们获取信息 关于老年服务组织，来自城市研究所国家慈善统计数据中心和 HRS上下文数据。我们的方法结合了利他主义模型的理论见解 关于亲子转移和支持的文献，从过去的移徙文献中获得了见解 了解选址决策。我们致力于以下具体目标： 目标1：估计成年子女与其长辈在地理上的接近程度的单独简化模型 父母以及照顾有条件的父母照顾需要(即，具有功能限制和/或 认知障碍)作为父母和孩子的经济和社会人口特征的函数， 亲子二人组的特点，以及人口构成、劳动力等地点特点 市场机会、住房可负担性以及老年服务组织和护理服务的可用性。 目标2：成年子女和年长父母之间地理接近程度的模型变化 父母的健康和功能状态的变化以及上述相同的一组变量。 目标3：联合建模护理和地点决策(以护理需求为条件)，以考虑 这两个进程是相互依存的。这一分析将帮助我们理解医疗保健的决定因素 当居住距离与护理决策联合建模时，可能会有所不同。这种方法使我们能够评估 地方特点的作用，如提供正式的老龄支助和护理服务，以及家庭 以及影响儿童照料提供和地点决策的个体特征。 我们特别注重为那些需要照顾的父母理解这些联合过程。 阿尔茨海默病或相关痴呆症。我们还关注性别、种族和社会地位的差异。