The present study examines the level and trajectory of social support provision by older adults for other households while taking into account personal health and sociodemographic factors. We found different baseline levels and trajectories of social support provision across regions. Furthermore, the effect of gender, number of living children, education level and marital status on social support provision were moderated by region. As expected, we found a decreasing trend of social support provision across time across all age groups. Factors that were associated with the trajectory of social support provision included gender, age at baseline, education level, marital status, self-rated health and region. Additionally, we observed large inter-individual variations of social support provision.
There are complex interactions of individual, societal and structural level factors that influence the provision of social support [5]. Poor health is the most apparent personal factor of decline in the provision of social support among older adults. As their physical and cognitive functions deteriorate with age [10], older people become more dependent and are therefore more likely to receive support rather than provide it.
Prior analysis of SHARE data showed that in Greece, Spain, and Italy, a considerable increase in dependency (measured as limitation in activities of daily living -ADL) was observed between ages 50 and 70 years. Similar increases occurred at older age among people older than 70 years in Sweden and Switzerland [27]. This could partly explain the lower probability of support provision in southern European reported in this study. Our findings also demonstrated that poor self-perceived health was associated with a faster decline in the probability of social support provision over time. In addition, we found decline to be faster among older adults compared to their younger counterparts. This may relate to the higher levels of poor self-perceived health as reported by the older adults.
Effect of social network on social support
The majority of social support exchange happens within personal social networks [5], thus understanding a personal social network and its determinants may give an insight into social support as well. A personal social network is influenced by personal characteristic e.g. age, gender, education and economic status. It is also shaped by the higher structural level factors such as culture, social change and politics [5].
An individual’s social networks throughout his or her life course are dynamic. Attempts to explain how personal social networks change over time has for instance been presented in the socioemotional selectivity theory [28] and social convoy theory [29]. Socioemotional selectivity theory postulates that social network change is motivated by a perspective on how much remaining time is left to live. Thus, as people age and perceive their time to be getting shorter, they focus on relationships that satisfy emotional regulation goals (e.g. family and close confidants). While according to convoy theory, people maintain social relationships that could escort them through their life course, like a convoy. In the centre of this convoy is the stable relationship, such as that with family [29]. While at the periphery of the convoy there are less-stable relationships (e.g. acquaintances). These peripheral networks are more likely to decrease due to circumstances such as those resulting from life events (e.g. job entry, marriage, parenthood, and loss of a spouse) [26].
Our prediction models showed that in all regions, for the three age cohorts tested, as people age their probability of providing support decreases. Moreover, the rate of this decline was faster among the older cohorts. Besides the effects of personal health, this pattern may relate to the smaller social network size people tend to have as they age. The decline in social network size and the change in its composition could mean a smaller pool of potential support recipients. Interestingly, we found that children, parents, and spouses remained as the main beneficiaries of support throughout the eleven years follow-up of this study. These results indicated that family networks were quite stable across time thereby supporting the socioemotional selectivity and social convoy theories.
Gender also has a substantial influence on social networks, possibly as the effects of distinct life experiences in men and women [15]. The traditional gender roles of women as homemakers and men as breadwinners affects social network characteristics. Women tend to have more contact with friends and family [30]. Furthermore, due to the gendered division of labour within the household, women may gain an increased network when they enter parenthood than men do. Meanwhile, men appeared to benefit more from an occupational network than women [31]. The present study showed that gender difference in the probability of support provision was more apparent in southern Europe. These findings may be explained by a lower female participation in the labour force in this region [32].
Previous studies have reported that, compared to men, women tend to be the main care provider for the family. This pattern holds even among older adults in advanced age [33, 34], similar to findings in the southern European region. However, our findings also showed that men had a higher probability of support provision than women among those with baseline age over 60 years in the northern region and 70 years in the central region. Similarly, a study among the older population in the UK reported that after age 70, men had a higher prevalence of social provision than women [35].
Furthermore, in assessing gender difference in support provision, we should consider the type of support provided and the relationship between support providers and beneficiaries. Compared to men, women provide more intensive personal care. In this study, we analysed all types of social supports (i.e. practical household help, personal care, paperwork-related help) together. This procedure possibly masked the gender difference in support provision. The most common type of support in all regions was practical household help (Table B1 in the additional file). However, the highest prevalence of personal care in the southern region may contribute to the gender difference in support provision we observed in this region.
We can also view the present findings through a supply and demand perspective, in that low support provision was due to there being less demand for support. Many adults in their mid-life (40-59 years old) may experience demand to support their children and parents simultaneously (they are referred to as the pivot generation) [34, 35]. Thus, it was not surprising that we found the highest probability of support provision between the ages of 50-60 years old in all regions. Then, when their children have become independent and their parents have passed away, or are receiving formal care, the support demand will decrease and so does the provision of support.
The effect of a welfare state regime and family ties on social support provision
The effect of a welfare state on intergenerational support is mainly related to its policies that could support individuals to be independent and not require support from family, e.g. the availability of formal care for older people may release their children from the obligation to provide personal care. Thus, the provision of social support was expected to be higher in southern Europe where social services are limited. However, we found that social support provision was most prevalent in countries that have generous welfare policies (Sweden and Denmark) and least prevalent in countries in southern Europe. Nonetheless, in all regions the main recipients of support were respondents’ parents, children, and current or ex-partners (Table B2 in the additional file).
The present study did not represent the provision of personal care within a family. But, a side-analysis on personal care provision for household members in SHARE, not reported here, revealed that the prevalence of this type of support was at its highest in southern Europe and its lowest in northern Europe. These results indicate the importance of family characteristics, especially household composition, in explaining the trend of support provision.
Family is one of the central institutions in society that determine the interaction between welfare state policies and individual social practices [36]. Moreover, the degree of shared responsibility between the state, the market and the family in ensuring citizens’ welfare is one of the characteristics that differentiate one welfare regime from another [23]. The present study shows that the majority of families in the northern region were characterised by the highest average number of living children and grandchildren but the lowest average household size and proportion of co-residence. These patterns are in contrast with the southern European region that had the largest average household size and highest proportion of respondents who co-resided with their parents or children.
Moreover, the results of multilevel analysis showed that household size (in all regions) and number of living children in southern and central regions had a negative association with support provision. While in the northern region, the effect of the number of living children had the opposite effect. These findings indicate that the lower prevalence of support provision observed in central and southern regions could be due to their main support-beneficiaries who were likely to live with them in the same household. These findings are in line with Fokkema’s family typology [37]. This typology suggests that, while the most common family type in Europe is familialism (characterised by support for family obligation norm in which parents and children have frequent contact and live in close proximity), this type was more common in southern European countries. On the other hand, supportive at distance type (characterised by refusal of family obligation norms, parents and children living apart from each other but still with frequent contact) was more prevalent in northern Europe.
One interesting aspect when discussing the interaction between a welfare state and the family in the provision of support is whether generous social services substitute or complement family solidarity [17]. The substitution, or crowd-out, thesis refers to negative interaction between social service provision and family solidarity [38, 39]. Our results, however, are in line with previous research that supports a complementary thesis [40, 17]. For the majority of older adults in this study, family solidarity was still strong even though they did not live in the same household. Availability of social services in generous welfare regimes tends to lead to shared responsibility between family and state [39]. This arrangement results in a specialisation of the type of intergenerational support exchanged [40, 41]. Using SHARE data, Schmid et. al. reported that in countries with more generous social services, adult children, regardless of their gender, were more likely to provide sporadic support than intensive support [42].
The rates of decline in probability of support provision also differ by region, with the northern European countries showing a steeper decline. The welfare state policies may contribute to this regional difference. Across European countries, active pivot generations were more prevalent in northern countries [43]. The generous welfare state in the northern region may support adult children being independent earlier. The system also provides formal care for frail parents thus releasing pivot generations from their obligation to provide support earlier than in other regions.
The multilevel analysis showed a quite large inter-individual variation in the level and trajectory of support provision. This inter-individual variation remains in the sensitivity analysis that used ‘region’ as the third level in the multilevel analysis. These results indicate that while culture and welfare state policies may influence personal relationships, social support exchange is a personal experience that is highly affected by personal factors and circumstances.
Strengths and limitations
The main strength of the present study is the use of five waves of panel data from SHARE. Panel study records all changes at individual level throughout follow-up time, therefore the shift in the results may reflect the real change in the phenomena studied. In our case, the trajectory of support provision observed may reflect the real decrease in social support provision as people age, not because of the difference in sample characteristics.
In addition, all countries participated in SHARE using a standardised questionnaire, allowing for a valid comparison across countries. However, we also acknowledge that all variables in this study are self-reported, thus true values may be under- or over-estimated.
Social support provision in this study was measured using a single-item measure. Therefore, our results need to be interpreted with caution as they may not capture all dimensions of social support provision measured using more comprehensive instruments.
The value of self-perceived health, which has been widely used, has also been scrutinised for its sensitivity to bias. People with different cultures and languages may have different perspectives in rating their health. For example, compared to Danes and Swedes, Germans need to be much healthier to rate their health as very good [44]. However, we argue that the use of self-perceived health in the present study did not reduce the validity of our results as our study does not aim to compare health status across European regions. Additionally, even though we found that the prevalence of good health varied across regions, its effect was not moderated by region.
Another limitation of this study was related to attrition that could lead to selection bias. Thus, limiting the generalisability of the present results. To avoid the effect of selection bias due to death, this study only includes respondents who participated in at least waves one and six. Around 3.27% of those respondents had missing data in the variables studied and were excluded from analysis. We found that respondents who were included in the analysis and those who were excluded due to missing data shared a similar sociodemographic characteristic (ion F in the additional file).