Hanratty Barbara, Drever Frances, Jacoby Ann, Whitehead Margaret
Division of Public Health, University of Liverpool, L69 3GB Liverpool, UK.
Eur J Ageing. 2007 Feb 20;4(1):35-43. doi: 10.1007/s10433-007-0044-6. eCollection 2007 Mar.
Many countries in Europe are beginning to acknowledge the essential contribution of informal caregivers, as policy changes leave more people with greater needs being cared for in the community. Carers who are themselves retired are a vulnerable group. Compared to caregivers in younger age groups, a higher proportion have pre-existing disease; they may be more vulnerable to the adverse effects of caregiving on health, and many survive on low incomes. This study investigated whether ill health amongst older carers and hours of caregiving were greater in disadvantaged areas of England and Wales. We also estimated the cost of replacing this care with formal services. Data were analysed from the 2001 UK census, relating to 9.2 million males and females of pensionable age living outside of communal establishments in England and Wales. Thirteen percent of people over retirement age (1.2 million) provided care for others, more than half of whom (742,182) reported poor health. Pensioners provided care in all areas; the proportion giving care was higher in low deprivation (advantaged) areas, but both the numbers and proportion of pensioners in poor health providing many hours of care were greater in disadvantaged areas. The annual cost of replacing all informal with formal social care was estimated to lie between 14.8 and 43.9 billion Euros. Older carers are an essential support to welfare systems. If demographic shifts require any substitution of formal for informal care, this will place a significant burden on all areas, with the greatest needs likely to be in the disadvantaged areas.
随着政策变化使更多有更大需求的人在社区中得到照料，欧洲许多国家开始认识到非正式照料者的重要贡献。本身已退休的照料者是一个弱势群体。与较年轻年龄组的照料者相比，有更多比例的人患有既往疾病；他们可能更容易受到照料对健康产生的不利影响，而且许多人靠低收入维持生活。本研究调查了在英格兰和威尔士的贫困地区，老年照料者的健康不佳状况以及照料时长是否更多。我们还估计了用正规服务替代这种照料的成本。分析了来自2001年英国人口普查的数据，涉及英格兰和威尔士居住在非公共机构之外的920万达到领取养老金年龄的男性和女性。超过退休年龄的人中有13%（120万）为他人提供照料，其中一半以上（742,182人）报告健康状况不佳。养老金领取者在所有地区都提供照料；在低贫困（条件较好）地区提供照料的比例更高，但在贫困地区，健康状况不佳且提供大量照料时长的养老金领取者的数量和比例都更大。用正规社会照料替代所有非正规照料的年度成本估计在148亿至439亿欧元之间。老年照料者是福利系统的重要支撑。如果人口结构变化需要用正规照料替代非正规照料，这将给所有地区带来巨大负担，最贫困地区的需求可能最大。
