In a pickle: A longitudinal study exploring the association between membership in the sandwich generation and health behaviors

Background/Objectives. The number of midlife adults caring for multiple generations has been on the rise, and an important question is whether providing care for multiple generations has effects on physical health and health behaviors. We explored the association between membership in the sandwich generation and five health behaviors: checking the food label for health value when buying foods, using a seat belt, choosing foods based on health value, exercising regularly, and cigarette smoking.

Methods. We selected participants from a longitudinal study who reported the number of hours spent providing care to multiple generations and provided data in a previous survey (n=4286). Sequential regression analyses were used to explore the unique effect of sandwich generation membership on health behaviors above and beyond other health behavior correlates.

Results. Compared to those who cared for a single generation, multigenerational caregivers were less likely to check food labels (adjusted odds ratio [AOR] = 0.79; 95% confidence interval [CI] = 0.67, 0.92), use seat belts (AOR = 0.69; 95% CI = 0.57, 0.83), and choose foods based on health values (AOR = 0.84; 95% CI = 0.72, 0.98), and they smoked more cigarettes per day (Poisson beta = 0.109; standard error = 0.043).

Conclusions. Multigenerational caregivers engaged in fewer healthy behaviors than did single generation caregivers or non-caregivers. As the U.S. population continues to age, and increasing numbers of individuals are faced with the challenge of being sandwiched, encouraging healthy behaviors among caregivers has the potential to prevent significant illness and premature mortality.