The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

How Brazil’s Retreat from Childbearing Is Making Elder Care Difficult

Bryce J. Christensen and Nicole M. King

The global retreat from childbearing is making life harder for the very public-health officials whose long-standing advocacy of contraceptives has helped create the problem. The challenge these officials now face is that of finding care for an aging population when ever fewer young people are available to take on the task. To see just what this challenge looks look, readers might turn to a study recently published by public-health scholars at the Universidade Federal de Minas Gerais and the Fundação Oswaldo Cruz in Brazil. Focused on the possibilities for caring for Brazil’s growing population of older adults, this new study raises hard questions about the difficulties of providing cost-free informal care for this population in a social setting reshaped by surging female employment and shrinking family size.  

The authors of the new study begin their inquiry keenly aware that “meeting the demand for the care for older adults is a growing concern in different societies,” including Brazil. “Aging of the population is the most important demographic change observed around the world in recent decades,” the researchers remark, acknowledging that “this demographic change raises concerns about the ability of social systems to meet the growing demand for long-term care due to the increase of functional limitations in the older age groups.” Earlier research has shown that in North America, Asia, and Europe, care for older citizens suffering from functional limitations is “performed predominantly by informal caregivers (unpaid family and friends).” Are such informal caregivers equal to the task of caring for Brazil’s growing population of older men and women? 

To answer that question, the researchers scrutinize data collected in 2013 from 23,815 men and women age 60 and over who participated in a national health survey. The researchers especially attend to the data for the 5,978 survey participants who reported needing assistance in performing the normal activities of daily living.

Statistical analysis establishes that most of the Brazilian seniors needing care received it from informal rather than professional caregivers. More specifically, about four-fifths (81.8%) of those needing care received it from informal providers, compared to just one-twentieth (5.8%) receiving it from professional caregivers and about the same fraction (6.8%) receiving it from a combination of informal and professional caregivers. Sadly, about one in seventeen (5.7%) of the older Brazilians needing care did not receive it from anyone at all.     

And unfortunately, the researchers see reason to worry that the number of older Brazilians needing but not receiving care will grow in the years ahead. The authors of the new study fear that that “availability of informal care . . . [will] decrease in the near future, as a result of the reduction in the size of families, of the increase in the number of couples without children, and of the increased participation of women in the labor market.”  

Underscoring their “concerns about the future availability of informal care,” the researchers emphasize the social consequences of “the reduction in the size of families and [the] increase in the number of childless couples, which are significant recent demographic changes in Brazil.”

Curiously, in Brazil—and elsewhere—public-health officials press their contraceptive crusade with unflagging zeal.  

(Maria Fernanda Lima-Costa et al., “Informal and Paid Care for Brazilian Older Adults [National Health Survey, 2013],” Revista De Saúde Pública 51 (Suppl 1) [2017]: 6s, Web.)