192 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2013 vol. 37 no. 2© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia

doi: 10.1111/1753-6405.12043

Costs of being a carer: labour force participation and lost earnings among older working-aged Australians

Deborah Schofield, Rupendra Shrestha, Emily CallanderNHMRC Clinical Trials Centre, University of Sydney, New South Wales

Julie BylesResearch Centre for Gender, Health and Ageing, Faculty of Health, University of Newcastle, New South Wales

Merel KimmanNHMRC Clinical Trials Centre, University of Sydney, New South Wales

The demand for care for disabled, ill and elderly people is

projected to grow significantly1-4 around the world. This care can be

provided in both formal and informal settings: formally by people

employed in the health care sector and informally by relatives or

friends. Informal carers are generally not paid for their caring

responsibilities, but these responsibilities can have an impact on

the capacity of the carer to undertake paid employment.5 We have

examined the association between being a carer and labour force

participation for those aged 45 years and over, and analysed the

effect of being a carer on their household income. We undertook a

cross-sectional analysis of the baseline data of the 45 and Up Study

participants6 aged 45 to 64 years.

Of the 265,515 people surveyed, excluding those who

independently volunteered to participate in the study, 162,590

(43.1% males) were aged between 45 and 64 years. Among them,

7.8% of men and 14.3% of women reported regularly caring for

a sick or disabled person. The likelihood of becoming a regular

carer increased with age. Of regular carers, 34.9% either reported

that they were full-time carers or spending 35 or more hours per

week for caring.

Full-time carers were less likely to be working full-time and more

likely to be out of the labour force than non-carers. Although part-

time carers were also less likely to be in full-time work and more

likely to be not working than non-carers, the differences were not as

large as the differences between full-time and part-time carers (with

77.5% of part-time carers working full time and 8.1% not working,

versus 41.9% of full-time carers working full time and 39.4% not

working). Women were more likely to be either in part-time work

or not working, compared to men of the same age group.

Both part-time and full-time carers were less likely to be

employed full time than non-carers. The male part time carers were

significantly less likely to be in full time employment (OR 0.79,

95% CI 0.70-0.88) than non-carers. The odds of being in full-time

employment were even lower for full-time carers (OR 0.15, 95% CI

0.13-0.18). Similar results were found for females. Part-time carers

were more likely to be in part-time employment than non-carers –

statistically significant for females (OR 1.10, 95% CI 1.03-1.18)

but not for males.

When full-time carers reported a fair or poor health status, they

had an even lower chance of being in full-time employment or

part-time employment. Male full-time carers who had poor health

status only had 0.06 (95% CI 0.04-0.07) times the odds of being

in full-time employment and 0.17 (95% CI 0.13-0.23) times the

odds of being in part-time employment of the non-carers who had

excellent health status. For female full-time carers who also had

poor health status, the odds of being in full-time and part-time

employment were respectively 0.07 (95% CI 0.06-0.09) and 0.15

(95% CI 0.12-0.18) times the odds for female non-carers who had

excellent health status.

Full-time carers were likely to have lower household income

than non-carers. Among those married or living with a partner,

27.2% of full-time carers had an annual household income of less

than $20,000, compared to only 7.1% of non-carers. By contrast,

41% of non-carers had an annual household income of greater than

$70,000, whereas only 12.6% of full-time carers had this level of

household income.

Being a full-time or part-time carer significantly reduces an

individual’s labour force participation rate relative to their peers.

These results are consistent with other studies that have found that

carers generally have lower rates of labour force participation, both

within Australia and internationally.7-13 The effort of the individuals

who give up their own time and their own employment to provide

care for another should be recognised for the vital service they

provide to society. The significant costs as a result of informal care

to both individuals and governments also need to be recognised.

AcknowledgementsThis study was supported by the Study of Economic and

Environmental Factors in health (SEEF) project funded by the

National Health and Medical Research Council Preventive

Healthcare and Strengthening Australia’s Social and Economic

Fabric Strategic Award. We thank all the 45 and Up Study

participants and The Sax Institute for providing the data. The 45

and Up Study is managed by the Sax Institute in collaboration

with major partner Cancer Council NSW, and other partners: the

NSW Division of the National Heart Foundation of Australia; the

NSW Department of Health; beyondblue: the national depression

initiative; Ageing, Disability and Home Care, NSW Department of

Human Services; and UnitingCare Ageing.

References1. Percival R, Kelly S. Who’s Going to Care? Informal Care and An Ageing

Population. Canberra (AUST): University of Canberra, National Centre for Social and Economic Modelling (NATSEM); 2004.

2. Disability Rights Commission, Equal Opportunities Commission, Carers UK. The Future: Who Carers? Leeds (UK): University of Leeds; 2006.

3. The Scotish Government. The Future of Unpaid Care in Scotland: Headline Report and Recommendations. Edinburgh (SCO): The Scottish Executive; 2006.

4. Pickard L, Wittenberg R, Comas-Herrara A, King D, Malley J. Care by Spouses, Care by Children: Projections of Informal Care for Older People in England to 2031. Soc Policy Soc. 2007;6(3):353-66.

5. Carmichael F, Charles S. The opportunity costs of informal care: does gender matter? J Health Econ. 2003;22(5):781-803.

6. 45 and Up Study Collaborators. Cohort profile: the 45 and Up Study. Int J Epidemiol. 2008;37(5):941-7.

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2013 vol. 37 no. 2 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 193© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia

7. Australian Institute of Health and Welfare. Carers in Australia: Assisting Frail Older People and People with a Disability. Canberra (AUST): AIHW; 2004.

8. de Vaus D. Diversity and Change in Australian Families: Statistical Profiles. Canberra (AUST): Australian Institute of Family Studies; 2004.

9. Lee C, Gramotnev H. Transitions into and out of caregiving: Health and social characteristics of mid-age Australian women. Psychol Health. 2007;22(2): 193-209.

10. Carmichael F, Charles S. The labour market costs of community care. J Health Econ. 1998;17(6):747-65.

11. Heitmueller A, Michaud P. Informal Care and Employment in England: Evidence from the British Household Panel Survey. IZA Discussion Paper No.: 2010. Bonn (DEU): Institute for the Study of Labor (IZA); 2006.

12. Pavalko EK, Artis JE. Women’s Caregiving and Paid Work: Causal relationships in late midlife. Journal of Gerontol. 1997;52b(4s):170-9.

13. Speiss CK, Schnieder U. Interactions between care-giving and paid work hours. Ageing Soc. 2003;23:41-68.

Correspondence to: Professor Deborah Schofield, NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Locked Bag 77, Camperdown, NSW 1450; e-mail: deborah.schofield@ctc.usyd.edu.au

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