262188 Hidden in Plain Sight: Paid Caregivers are California's Most Vulnerable Caregivers

Tuesday, October 30, 2012 : 3:18 PM - 3:30 PM

Geoffrey Hoffman, MPH , Department of Health Services, U.C.L.A., Los Angeles, CA
Steven P. Wallace, PhD , UCLA Center for Health Policy Research, Los Angeles, CA
Background: Caregiving can have serious economic implications for caregivers, affecting their employment, income, and health insurance. These economic effects of caregiving may not be equally distributed across all caregivers, however. For those whose main employment is caregiving, the dangers of economic insecurity may be even greater compared to informal, unpaid caregivers. Paid Medicaid caregivers may be particularly vulnerable.

Objectives: To compare measures of economic security among paid Medicaid caregivers and unpaid caregivers in California.

Methods: Using the 2009 California Health Interview Survey, the sample included 502 paid Medicaid caregivers and 10,500 unpaid caregivers. Survey-weighted multivariate OLS and logistic regression models were specified to estimate differences in monthly income, food insecurity, job tenure, and current uninsurance, adjusting for age, gender, and education. Relative risks (RR) are reported for dichotomous outcomes.

Results: Unadjusted monthly incomes of paid Medicaid caregivers were half those of unpaid caregivers ($1,970 vs. $4,222). 57% lived at or below near poverty (<200% FPL). Half of paid Medicaid caregivers owned a home compared to two-thirds of unpaid caregivers. After adjustment for respondent characteristics, paid Medicaid caregivers reported lower monthly incomes (-$979), greater food insecurity (RR: 1.56), were half as likely to work at the same job 10 or more years (RR: .53) and were more likely to be uninsured (RR: 1.61) compared to unpaid caregivers.

Conclusions: Compared to unpaid caregivers, paid Medicaid caregivers are vulnerable across a number of economic indicators. Recent state funding cuts for senior supportive services may exacerbate these disparities among caregivers.

Learning Areas:
Communication and informatics
Diversity and culture
Public health or related public policy
Public health or related research

Learning Objectives:
Describe how paid caregivers of Medicaid recipients are substantially more economically vulnerable compared to the unpaid caregiver population.

Keywords: Aging, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a 2nd year doctoral student in the Department of Health Services at the U.C.L.A. School of Public Health. I also received my M.P.H. from U.C.L.A. Prior to pursuing a PhD I was a Presidential Management Fellow working at the Office of Geriatrics and Extended Care at the Veterans Health Administration and was hired to work as an analyst in health care financing for the Office of Domestic Policy at the Congressional Research Service.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.