Abstract
BackgroundThe number of people in need of care in Germany has been rising since decades, which is related to an increasing need and relevance of informal caregiving. Likewise, the number of people with a migration background has been increasing. This study aims to analyse the impact of informal caregiving on physical health in comparative perspective for Ethnic German Immigrants (EGI) – the largest and oldest immigrant group in Germany – and non-migrant Germans (NMG).MethodsThe sample was drawn from the years 2000–2018 of the German Socio-Economic Panel (n = 26,354). NMG (n = 24,634) and EGI (n = 1,720) were categorized into non-caregivers (n = 24,379) and caregivers (n = 1,975), where the latter were distinguished by 1) their caregiving status and history (current, former, and never caregiver) and 2) the number of years in the caregiver role. Generalized Estimating Equations were applied to examine main effects and the interaction effects of caregiving status and migration background for changes in physical health (n = 102,066 observations).ResultsAdjusting for socioeconomic, household related, and individual characteristics, NMG and EGI had similar caregiving patterns and physical health. However, the interaction between migration background and caregiving revealed significantly higher declines in physical health for currently caregiving EGI. Sensitivity analyses indicated that particularly socioeconomic resources moderated this effect.ConclusionsFindings suggest that caregiving is associated with declines in physical health, particularly in the long term and for EGI. This implies that care-related disadvantages accumulate over time and that the association of caregiving, health and associated determinants are culturally diverse and shaped by migration background. Both the health disadvantages of caregivers and EGI might be mitigated by a positive social and socioeconomic setting, which highlights the relevance of supporting structures and benefits for these subgroups.
Highlights
The number of people in need of care in Germany has been rising since decades, which is related to an increasing need and relevance of informal caregiving
Adjusting for household characteristics in Model 2, care-related health disadvantages were reduced, but remained significant, and differences by migration background were almost the same (EGI: -0.55; 95% 95% Confidence Interval (CI): -0.77, -0.32) (Table 3, Model 2; Additional File 2, Model 2)
Socioeconomic, household, and individual characteristics partially mediated the effect caregiving has on physical health, whereas older ages, lower levels of education, low incomes and income decreases, unemployment and leaving full-time occupation – and socioeconomic characteristics – were associated with physical health declines
Summary
The number of people in need of care in Germany has been rising since decades, which is related to an increasing need and relevance of informal caregiving. Georges BMC Public Health (2022) 22:121 informal care can be demanding and research reports a negative impact of caregiving on the caregiver’s physical and psychological health [4,5,6] Another current demographic development concerns the growing number of people with migrant status in many European countries [7, 8], who gradually will reach care-relevant ages and will require LTC. The majority of people with limitations do not receive state benefits, i.e. irrespective of disability no care level has been requested or approved Both groups usually live and are cared for at home, informal home care is a central pillar of the German care system [10, 11]. This informal care is provided by 9% of the adult German population [12], 61% of which within households, usually by close relatives, by children (37%) or partners (32%) [13]
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