Social inequality and the risk of living in a nursing home: implications for the COVID-19 pandemic

Across EU countries, all available evidence suggests that the number of deaths linked to COVID-19 among those living in nursing homes has been extremely high. However, it is largely unknown to what extent income and education affect the probability of being a nursing home resident. If the probability of residing in a nursing home is stratified by socio-economic status, under the current COVID-19 pandemic socio-economic inequality in the probability of living in a nursing home could contribute to enlarge socio-economic inequalities in the risk of mortality with COVID-19. In this article, we investigate whether there are income and educational differences in the likelihood of being a resident in a nursing home across 12 European countries. We use SHARE data (waves 5-7) and compute logistic regression models for rare events. We find that low-educated individuals and those having household income below the national median are more likely to live in a nursing home. This general pattern holds across all the European countries considered. However, there is considerable uncertainty in our estimates due to a small sample size, and firm conclusions on how the effect of socio-economic characteristics varies across countries cannot be drawn. Still, there is some indication that educational and income differences are the largest in the Scandinavian countries (Denmark and Sweden) and the Netherlands, while the smallest ones are found in Italy, with the remaining countries laying in between.