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Causal effects of informal care and health on falls and other accidents among the elderly population in China

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Abstract

Purpose

This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g., traffic accidents) among elderly people. We also examine if there are heterogeneous impacts on elderly of different gender, urban status, and past accident history.

Methods

To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. We use longitudinal data from a representative national China Health and Retirement Longitudinal Study of people aged 45 and older in China. A total of 3935 respondents with two-wave data are included in our study. Each respondent is interviewed to measure health status and report their accident history. Mental health is assessed using CES-D questions.

Results

Our findings indicate that while informal care decreased the occurrence of accidents, poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history.

Conclusions

Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care of elders into account. Second, ease of birth policy and postponed retirement policy are urgently needed to meet the demands of informal care. Third, medical policies should attach great importance not only to physical health but also mental health of elderly parents especially for older people with accident history.

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Notes

  1. We have also conducted the same analysis on people who are 65+ and 80+, and our conclusion remains. Detailed estimation results are provided as supplementary materials.

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Funding

This study was funded by the “Fundamental Research Funds for the Central Universities” (HUST:2016YXZD0329) and the National Natural Science Foundation of China (91646104).

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Authors and Affiliations

  1. School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Hong Wu & Naiji Lu

  2. Federal Home Loan Mortgage Corporation, Mclean, USA

    Chenguang Wang

  3. Department of Family Medicine and Public Health, UC San Diego School of Medicine, La Jolla, CA, 92093, USA

    Xinming Tu

Authors
  1. Hong Wu
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  2. Naiji Lu
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  4. Xinming Tu
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Correspondence to Naiji Lu.

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Conflict of interest

All authors confirm that we have no conflicts of interest.

Ethical approval

Our data come from a national survey, which is made public to meet the needs of scientific research on the elderly. This study was approved by the Ethics Review Committee of Tongji Medical College, Huazhong University of Science and Technology.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Wu, H., Lu, N., Wang, C. et al. Causal effects of informal care and health on falls and other accidents among the elderly population in China. Qual Life Res 27, 693–705 (2018). https://doi.org/10.1007/s11136-017-1665-7

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