In this brief, authors Reagan Baughman and Jon Hurdelbrink examine the relationship between macroeconomic conditions, as measured by the national unemployment rate, and utilization of long-term care, as measured by respondents’ reports in the Health and Retirement Study of what type of care they received in the past month to help with daily activities. Long-term care for older adults can take the form of nursing home care, formal (paid) home care, or informal (unpaid) home care. Almost 1 in 5 individuals over the age of 65 gets some type of help with activities of daily living such as bathing, dressing, and self-feeding, or with instrumental activities of daily living such as preparing hot meals and taking medications. The authors report that the utilization of long-term informal care services by Americans over age 65 is estimated to have declined by 6.75 percent during the Great Recession. This decrease was driven by a drop in informal care provided at home for free, usually by adult children or spouses. One reason that the elderly use less care during recessions is that they are in slightly better health than they would be/are when the unemployment rate is lower. The fraction of those over 65 who report fair or poor health decreased by 6.6 percent during the Great Recession. Better health reduces the need for care. That recessions are associated with better health for certain individuals, especially the elderly, is one of the more unexpected findings to come from research on the relationship between the economy and health.

Publication Date

Winter 2-13-2018


National Issue Brief No. 132


Durham, N.H. : Carsey School of Public Policy, University of New Hampshire

Document Type



Copyright 2018. Carsey School of Public Policy. These materials may be used for the purposes of research, teaching, and private study. For all other uses, contact the copyright holder.





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