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  • Although the findings in this paper contribute

    2018-11-07

    Although the findings in this paper contribute new insights to our understanding of the complex relationship between informal care provision and health, nevertheless the study poses certain limitations which necessitate caution in the interpretation of the findings. Firstly, the nature of the data which is drawn from the UK Census means that it is not possible to determine the duration of the caring role between the two time points. Therefore, it is possible that an individual who is providing care at both 2001 and 2011 may have experienced periods of non-caring over the decade between the two Censuses, just as an individual who is classified as a non-carer at both 2001 and 2011 may have provided care for a bafilomycin a1 autophagy of time between the two Census points. Such data limitations mean that we can only interpret the findings and examine the dynamics of informal care provision in relation to the two time points and not in the in-between period; thus caring at both 2001 and 2011 is best viewed as a repeated rather than a continuous activity. Secondly, the dataset does not allow for the identification of the care recipient or the exploration of the quality of the relationship between the carer and the care recipient, both of which are important dimensions affecting the caring activity (Keene & Prokos, 2008). Information on the nature of the care provided (e.g. physical, psychological, emotional) is also lacking, which may have a bearing on the association under study (Brown et al., 2003; Maher & Green, 2002). Thirdly, no information is known on the carer\'s access to formal support or their use of services provided by the state or purchased in the private sector, which may affect their provision of informal care in relation to specific tasks (e.g. employment of extra care assistance within the home) (Robards, Vlachantoni, Evandrou, and Falkingham, 2015). Such support may ‘buffer’ any adverse impacts of caring on the health of the carer. Fourthly, although the use of the self-reported measures of general health and the report of a LLTI have proven to be reliable indicators of individuals’ health status (Doran et al., 2003), nevertheless a more detailed examination of the carer\'s health would require additional measures of both their physical and mental condition (see for example Kenny, King, & Hall, 2014). Finally, the fact that we are able to investigate the relationship between caring and the carer\'s health over time does not allow us to draw conclusions about the direction of causality between the two, and due caution should be applied in the interpretation of results in Table 3 and Fig. 1 in this paper.
    Acknowledgements and funding The authors wish to acknowledge the support of colleagues in the Engineering and Physical Sciences Research Council (EPSRC) Care Life Cycle (CLC) project (Grant number EP/H021698/1) and the Economic and Social Research Council (ESRC) Centre for Population Change (CPC) (Grant numbers RES-625-28-0001 and ES/K007394/1) at the University of Southampton. The permission of the Office for National Statistics to use the Longitudinal Study is gratefully acknowledged, as is the help provided by staff of the Centre for Longitudinal Study Information & User Support (CeLSIUS). CeLSIUS is supported by the ESRC Census of Population Programme (Award Ref: ES/K000365/1). The authors alone are responsible for the interpretation of the data. The Carstairs Index has previously been used in conjunction with the ONS LS (see Boyle, Norman and Rees, 2004; Norman & Boyle, 2014; Norman, Boyle and Rees, 2005).
    Introduction Despite the interest and controversy regarding the effects of breast cancer screening programs, little is known about subsequent changes related to socioeconomic inequality in mortality. Different research groups (Kalager et al., 2009; Kalager, Zelen, Langmark, & Adami, 2010; Olsen et al., 2012) have investigated the introduction of public screening in Norway; however, their principal aims were to examine the overall impacts of the program on mortality and not to describe change according to interactions with sociodemographic characteristics. Previously published studies on breast cancer and socioeconomic status (SES) have emphasized the relationship between the incidence of cancer, patient mortality, and breast cancer mortality in the general population. However, while the incidence of breast cancer and breast cancer mortality among the general population has been shown to concentrate among women with a higher SES (Braaten, Weiderpass, Kumle, & Lund, 2005; Menvielle et al., 2011; Pudrovska, Carr, McFarland, & Collins, 2013; Robsahm & Tretli, 2005; Strand et al., 2007; Strand, Tverdal, Claussen, & Zahl, 2005), this is not so for breast cancer mortality among patients.