Demographic and socioeconomic modifiers of the association between caregiving intensity and caregiver health: Evidence from a national caregiving survey

Informal caregiving is an integral component of the health care system, saving the national economy over $300 billion annually.  Although the relationships between caregiving intensity and caregiver health are well-established, research suggests that this association may vary by socio-demographic factors with potential implications for designing programs and policies to protect caregiver health.  We examined how the association between caregiving intensity and caregiver health varies by several sociodemographic factors using the National Study of Caregiving (NSOC).  Using logistic regression, we modeled physical health effects on caregiving intensity using four intensity measures: an ordinal composite measure of caregiving duration, hours per week, and number of activities and instrumental activities of daily living involved in caregiving, stratified by race/ethnicity, income, sex, and age, adjusted for confounders.  The association between caregiving intensity and health problems was higher in males (OR 1.54, 95%CI 1.26-1.89) than females (OR 1.28, 95%CI 1.12, 1.47), higher in whites (OR 2.73, 95%CI 1.83, 4.08) than in African-Americans (OR 1.46, 95%CI 0.90, 2.34) and those of “other” races and ethnicities (OR 1.33, 95%CI 0.17, 10.7), and slightly higher in households with annual incomes of at least $50,000 (OR 1.51, 95%CI 1.24, 1.84) than in lower-income households (OR 1.39, 95%CI 1.12, 1.73).  The association was significant in caregivers age 50+ (OR 1.40, 95%CI 1.13-1.74), but not for caregivers <50 (OR 1.18, 95%CI 0.95, 1.46).  These findings emphasize the need to move from one-size-fits-all programs to address caregiver burden to approaches more tailored for the specific health needs of subpopulations of caregivers.