Yi Yang, Gu Jinghong, Xu Qinglin, Gu Hai
Center for Health Policy and Management Studies, School of Government, Nanjing University, Nanjing, China.
Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY, United States.
Front Public Health. 2025 May 14;13:1601077. doi: 10.3389/fpubh.2025.1601077. eCollection 2025.
Many informal caregivers at working age and face the dual burden of providing care and working. This study examines how China's long-term care insurance (LTCI) pilot programs affect the labor-force participation of adult children who may provide informal care to parents.
We analyze four waves (2011, 2013, 2015, and 2018) of micro panel data from the China Health and Retirement Longitudinal Study and exploit the staggered rollout of LTCI pilots across cities from 2012 to 2017. A difference-in-differences design estimates the causal impact of LTCI implementation on labor-force participation of adult children, with robustness checks and subgroup analyses by gender, age, cohabitation status, and skill level.
Implementation of LTCI significantly increases the likelihood of adult children remaining in the labor force. Mechanism analysis indicates this effect is driven by both reduced caregiving time (substitution effect) and improved expectations of future support (anticipation effect). The positive impact is particularly strong among men, individuals under 45 years old, cohabitation without parents, and lower-skilled workers.
Expanding LTCI can effectively alleviate the caregiving-employment conflict and enhance labor participation of adult children. To maximize workforce and social welfare benefits, policymakers should expand LTCI coverage, strengthen community care services, and focus support on high-burden caregiver groups.
许多处于工作年龄的非正式照料者面临着提供照料和工作的双重负担。本研究考察了中国长期护理保险(LTCI)试点项目如何影响可能为父母提供非正式照料的成年子女的劳动力参与情况。
我们分析了来自中国健康与养老追踪调查的四期微观面板数据(2011年、2013年、2015年和2018年),并利用了2012年至2017年LTCI试点项目在各城市的逐步推行情况。采用双重差分设计估计LTCI实施对成年子女劳动力参与的因果影响,并通过性别、年龄、同居状况和技能水平进行稳健性检验和亚组分析。
LTCI的实施显著提高了成年子女留在劳动力市场的可能性。机制分析表明,这种影响是由照料时间减少(替代效应)和对未来支持的期望改善(预期效应)共同驱动的。这种积极影响在男性、45岁以下的个体、与父母不同居的人以及低技能工人中尤为明显。
扩大LTCI可以有效缓解照料与就业的冲突,提高成年子女的劳动力参与率。为了使劳动力和社会福利效益最大化,政策制定者应扩大LTCI覆盖范围,加强社区照料服务,并将支持重点放在高负担照料者群体上。