1. Who Cares ? Geographical Variation in Informal Care-giving in England and Wales Harriet Young, Stamatis Kalogirou & Emily Grundy London School of Hygiene & Tropical Medicine

2. Background Demographic changes: increasing proportion of very old people in population - although socio-geographic variation in this; growing ethnic diversity. Social/economic changes: concerns of possible weakening of family support; increase in women’s employment Policy and legislative changes: increased emphasis on community care & more recognition of need to support caregivers.

3. Objectives To examine for England and Wales: Distribution of caregivers in 2001 Characteristics of caregivers (age, ethnicity, employment, health, deprivation) Ratios of proportion of population with ill health to those care-giving First stage of a wider project using the ONS LS to analyse antecedents of caregiving.

4. 2001 Census: caregiving question “Do you look after, or give any help or support to family members, friends, neighbours or others because of long term physical or mental ill-health or disability, or problems related to old age ?” (Do not count anything you do as part of your paid employment) No Yes, 1-19 hours a week Yes, 20-49 hours a week Yes, 50+ hours a week

5. Data and Methods 2001 census data for England & Wales Data from CASWEB Census commissioned output for ethnicity data MS EXCEL & GIS (ArcView) Care giving: 20+ hours per week. Population living in private households

6. Objective 1 Distribution of caregivers in 2001

7. Proportion providing care for 20+ hours per week in England and Wales Local Authority level: Range:0.95 - 6.23 % Mean: 3.16 % S.D.: 0.85%

8. Objective 2 Characteristics of caregivers in 2001

9. Age of carers Mean age of carers: 53.6 Mean age of male carers: 55.7 Mean age of female carers: 52.2

10. Proportion of different ethnic groups who are carers (20 hours plus) by Government Office Region MeanMin-Max White3.412.5 - 4.7 Indian3.392.8 – 4.2 Ba&Pa3.953.3 - 4.3 Black2.632.0 – 3.7

11. Proportion of female informal care givers (20+ hours per week) who also work full time Local Authority level: Range: 9.6 – 23.0 % Mean: 15.1% S.D.: 2.4 % Note that these results only include those aged 16-74 years old

12. Proportion of all carers (20+ hours) who have poor self rated general health Local Authority level: Range: 9.4 – 23.9 % Mean: 16.1 % S.D.: 2.85 %

13. Index of Multiple Deprivation for 2000 ward level index: made up of 33 indices from 6 domains: income employment health education housing service access Local Authority score: population weighted average of ward scores

14. Index of Multiple Deprivation Proportion of population providing care for 20+ hours per week

16. Objective 3 Ratios of proportion of population with ill health to those care-giving

17. Proportion of whole population aged over 80 with a limiting long term illness Local Authority level: Range: 1.3 – 4.9 % Mean: 2.52 % S.D.: 0.55 %

18. Ratio of carers aged 50-59 to population aged 80+ with a limiting long term illness Local Authority level: Range: 37.6 – 151.6 Mean: 84.43 per 1000 S.D.: 21.3 * results presented as number of carers per 1000 individuals with llti’s

19. Limitations and Conclusions Areas with higher proportions of carers also seem to have higher deprivation and poorer general health. In other areas there may a higher likelihood of combining employment and care. Limitations: use of area based measure: deprivation cross sectional analysis unable to distinguish between types of care provision. Useful starting point for future analysis. Use of the ONS LS will allow us to carry out in depth analysis at the individual level.

20. Acknowledgements & Bibliography 2001 Census and Boundary data is the Crown Copyright. Crown copyright material is reproduced with the permission of the Controller of HMSO This research is funded by the 2001 Census Program of the Joseph Rowntree Foundation. Hutton and Hirst (2001) Caring relationships over time. Social Policy Research Unit. York. Mir & Tovey (2002) Cultural competency: professional action and South Asian carers. J Manag Med 16(1): 7-19 Index of Multiple deprivation: http://www.odpm.gov.uk/stellent/groups/odpm_urbanpolicy/docu ments/downloadable/odpm_urbpol_021680.pdf http://www.odpm.gov.uk/stellent/groups/odpm_urbanpolicy/docu ments/downloadable/odpm_urbpol_021680.pdf