Abstract
BackgroundNearly 50 million Americans provide informal care to an older relative or friend. Many are members of the “sandwich generation”, providing care for elderly parents and children simultaneously. Although evidence suggests that the negative health consequences of caregiving are more severe for sandwiched caregivers, little is known about how these associations vary by sociodemographic factors.MethodsWe abstracted data from the Behavioral Risk Factor Surveillance System to determine how the association between caregiving and health varies by sociodemographic factors, using ordinal logistic regression with interaction terms and stratification by number of children, income, and race/ethnicity.ResultsThe association between informal caregiving and health varied by membership in the “sandwich generation,” income, and race/ethnicity. This association was significant among subjects with one (OR = 1.13, 95% CI [1.04, 1.24]) and two or more children (OR = 1.17, 95% CI = 1.09, 1.26]), but not in those without children (OR = 1.01, 95% CI [0.97, 1.05]). Associations were strongest in those earning $50,000-$75,000 annually, but these income-dependent associations varied by race/ethnicity. In Whites with two or more children, the strongest associations between caregiving and health occurred in lower income individuals. These trends were not observed for Whites without children.ConclusionsOur findings suggest that the added burden of caregiving for both children and elderly relatives may be impacted by income and race/ethnicity. These differences should be considered when developing culturally appropriate interventions to improve caregiver health and maintain this vital component of the US health care system.
Highlights
50 million Americans provide informal care to an older relative or friend
From the 440,314 total participants who completed the telephone interview, complete data were available for 292,813 individuals who were included in the final analysis
Examining two-way interactions of race, income, and number of children with caregiving status and their association with selfreported health status, we found that the associations between caregiving and self-reported health varied considerably by number of children
Summary
50 million Americans provide informal care to an older relative or friend. Many are members of the “sandwich generation”, providing care for elderly parents and children simultaneously. The United States (US) population aged 65 years and older is expected to increase from 34 million in 2006 [1] to 71 million by the year 2030 [2] Within this population are a growing number of elderly persons with chronic health conditions who require special social services and/or informal caregiving by family members and friends. Women are more likely to leave their jobs once they begin providing care. Both of these options have long-term financial implications for caregivers, including an immediate loss of income and/or potential savings [1]
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