Aging, Health, and Care: the Geography of Residential Proximity Between Parents and Adult Children - Abstract/Project Summary Population aging in the United States is increasing the number of people with long-term health problems and other care needs, leading to a crisis in long-term care (Bipartisan Policy Center 2014). Family care is a central component of the long-term services and supports system, and adult children are the most common providers of that care for frail older parents (Spillman et al. 2014). Geographic proximity between parents and adult children is an important determinant of informal care provision (Choi et al. 2015). This project uses data from the Health and Retirement Study on the geographic proximity between a respondent age 65 and older and each of their adult children, combined with information about whether each child provides any care for a parent who has care needs due to function limitations or cognitive decline. We obtain information about aging services organizations from the Urban Institute’s National Center for Charitable Statistics data and the HRS contextual data. Our approach combines theoretical insights from altruism models commonly used in the literature on parent-child transfers and support with insights from the migration literature used to understand location decisions. We address the following specific aims: Aim 1: Estimate separate reduced form models of the geographic proximity of adult children to their older parents as well as caregiving conditional on parental care needs (i.e., having a functional limitation and/or a cognitive impairment) as a function of parent and child economic and socio-demographic characteristics, characteristics of parent-child dyads, and characteristics of place, such as demographic composition, labor market opportunities, housing affordability, and availability of aging service organizations and care services. Aim 2: Model changes in geographic proximity between adult children and older parents as a function of changes in parent’s health and functional status and the same set of variables described above. Aim 3: Jointly model caregiving and location decisions (conditional on the need for care) to account for the interdependence of the two processes. This analysis would help us understand how the determinants of care might differ when residential proximity is modeled jointly with care decisions. This approach allows us to assess the role of characteristics of place, such as the supply of formal aging support and care services, as well as family and individual characteristics in shaping decisions about a child’s care provision and location. We have a particular focus on understanding these joint processes for parents whose care needs come from Alzheimer’s disease or related dementia. We also focus on differences by gender, race, and SES.
