Elderly Ethnic Danes’ and Immigrants’ Use of Public Care Services
Eigil Boll Hansen, June 2009, AKF
Summary
The purpose of the analyses in this working paper was to examine whether elderly immigrants from non-Western countries received a greater or lesser amount of public care and assistance services than elderly citizens who were Danish by birth, after allowing for differences in age and other socio¬economic variables.
The population studied consisted of persons aged 65 or over and resident in the Municipality of Copenhagen on 1 January 2007. Analyses were performed of their use of personal care services, practical assistance and care homes in 2007. Information on use of personal care services, practical assistance and residential care facilities was made available by the Municipality of Copenhagen, and was linked at Statistics Denmark with demographic data and information on education and occupation, consumption data from the National Health Insurance Service, and days of hospitalisation.
The analyses were performed partly as logistic regressions and partly as linear regressions, making it possible to determine the significance with regard to use of public care and assistance services of being of immigrant background, while at the same time controlling for differences in other factors. The analyses revealed the following:
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Elderly immigrants received public care and assistance services less frequently than Danish-born over-65s. They had a lesser tendency to receive these both in general and as regards each of the three service types – residential care facilities, personal care and practical assistance.
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If only domiciliary care is considered, then the practical assistance component of the care and assistance services used tended to be less for elderly immigrants than for elderly ethnic Danes. This indicates that a greater proportion of their need for practical assistance was being met from other sources.
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Elderly immigrants who received care and assistance had a smaller volume (in money terms) of practical assistance than did Danish-born over-65s, while the volume of personal care services they received was not significantly less than that received by elderly ethnic Danes. Elderly immigrants from non-Western countries who had lived in Denmark for more than ten years in this study actually received a greater volume of personal care services than elderly ethnic Danes.
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There was also a difference between elderly immigrants, with those from non-Western countries receiving public care and assistance services less frequently than those from Western countries. This was true in relation to residential care facilities, personal care and practical assistance.
Lastly, elderly immigrants who had lived in Denmark for more than ten years were more frequent recipients of public care and assistance services than those that had lived in Denmark for less than ten years. In the analyses this was clearest in elderly immigrants from non-Western countries.
The results do not provide explanations of the observed differences between elderly ethnic Danes and elderly immigrants, but the patterns seen could indicate that two factors are relevant to immigrants’ lesser use of public care and assistance services, namely, knowledge of the availability of these services and a higher degree of coverage by family members of elderly immigrants’ needs for help than is the case with ethnic Danes. The longer the immigrants had lived in Denmark, the more closely their consumption resembled that of ethnic Danes. On the one hand, this could be explained by longer residence leading to increased familiarity with the availability of public care and assistance services. On the other hand, it could mean that many years’ life in Denmark had led some elderly immigrants and their families to adapt to Danish ways, with the generations living separately and the daughters and daughters-in-law of the elderly going out to work, so that their attitude to helping family members had become more like that of ethnic Danes. We have not been able to determine to what extent either knowledge of the availability of public care and assistance services or changes in lifestyle play the greater role.
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