Speakers
Courtney Harold Van Houtven received her B.S., University of California at Davis, her M.Sc. from the University of Minnesota, and her Ph.D. from the University of North Carolina at Chapel Hill. Dr. Van Houtven completed an Agency for Health Care Policy and Research post-doctoral fellowship at the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill. She joined the Center for Excellence in Health Services Research and Development in Primary Care at the Durham Veteran’s Administration in 2003. She is also an Associate Professor in General Internal Medicine, Department of Medicine, Duke University Medical Center. In 2007-2008 she was a visiting assistant professor of economics at Tilburg University, The Netherlands. Dr. Van Houtven’s aging and economics research interests encompass how family caregiving affects health care utilization, expenditures, health and wealth outcomes of care recipients and caregivers. A current Career Development Awardee from VA HSR&D (2006-2012), she is testing the feasibility of an incentivized skills training program for family caregivers of Veteran patients referred to community-based long-term care. She is also examining the financial effects of Polytraumatic injuries to OEF/OIF services members on family members. Her most recent grant from the Social Security Administration allowed her to examine the labor responses of married individuals involved in joint caregiving of elderly parents and in-laws (Coe and Skira, co-authors). In a new R-01 from The National Institutes of Nursing Research, NIH, as PI Dr. Van Houtven is examining the relationship between family structure, informal caregiving, and long-term care insurance and long-term care use. In addition, Dr. van Houtven has performed economic evaluations of health behavior trials (H. Bosworth, PI) and caregiving trials (LL. Davis, PI). In a recently accepted article at The Gerontologist (Van Houtven, Thorpe et al, in press), the team examined the effects of a caregiver skills training trial on out of pocket health care costs for the caregiver, and found that the trial did not substantially alter the costs faced by caregivers.
Details
Cross-sectional evidence in the United States finds that informal caregivers have less attachment to the labor force. The causal mechanism is unclear: do children who work less become informal caregivers, or are children who become caregivers working less? Using longitudinal data from the Health and Retirement Study, Dr. Van Houtven and colleagues sought to identify the relationship between informal care and work in the United States, both on participation in the labour force and on the amount of time spent working, and examining wage effects. With econometric techniques this study was able to control for unmeasured individual factors that would affect these choices and examine the effects for men and women separately. They found a modest decreases (2.4 percentage points) in the likelihood of working for male caregivers providing personal care. Female chore caregivers, meanwhile, are more likely to be retired. For female care providers who remain working, they found that women decrease work by 3 to 10 hours per week and face a 3 percent lower wage than non-caregivers. There was little effect of caregiving on working men’s hours or wages. These estimates suggest that the opportunity costs to informal care providers are important to consider when making policy recommendations about the design and funding of public long-term care programs. The results show that adult children who provide care informally to their parents or in-laws face substantial opportunity costs. If policy-makers aim to enable more people to combine both caregiving and work, more flexible work arrangements or generous leave policies may be needed.
Resources
Webcast: http://mediasite.otn.ca/Mediasite/Play/bc3e86d9b15040fbaa8244ae0e40ec311d?catalog=fd668812-d87c-47f9-b1ba-6d979fed9af4