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21-04-2024

Impact of caregiving on mental, self-rated, and physical health: evidence from the China health and retirement longitudinal study

Auteurs: Qing Su, Lijun Fan

Gepubliceerd in: Quality of Life Research

Abstract

Objectives

Given the escalating demand for care services, understanding the impact of informal caregiving, providing unpaid care for family members, on own health is essential. This study longitudinally analyzed the association of caregiving (and different caregiver types) with mental, physical, and self-rated health. Urban–rural, gender, and employment heterogeneity were further investigated.

Method

Based on three-wave data (2011, 2013, and 2018) from the China Health and Retirement Longitudinal Study, we used growth curve models to assess the impact of informal caregiving (providing care to family members) and caregiver types (caregivers to grandchildren, parents, spouses, or multiple family members) on three health outcomes (depressive symptoms, self-rated health, and activities of daily living limitations).

Results

Our study included 13,377 individuals. Results showed a negative correlation of caregiving with mental, physical, and self-rated health. Compared to noncaregivers, spousal caregivers and multiple caregivers were both associated with worsening mental, self-rated, and physical health. In contrast, adult child caregivers were only negatively associated with mental health, and grandparent caregiving did not significantly affect any health outcomes. Further heterogeneity analysis showed that gender did not moderate the relationship between caregiving and health, whereas the negative association between caregiving and health was more pronounced among the rural population and those employed in agriculture.

Discussion

Findings from the present study suggest that caregiving is detrimental to health, and recommend considering caregiver type when examining caregiving and health. These findings have vital implications for policymakers in addressing the challenges of structuring and implementing a sustainable informal care system.

Alleen toegankelijk voor geautoriseerde gebruikers

van Groenou, M. B., Glaser, K., Tomassini, C., & Jacobs, T. (2006). Socio-economic status differences in older people’s use of informal and formal help: A comparison of four European countries. Ageing & Society, 26(5), 745–766. https://doi.org/10.1017/S0144686X06005241CrossRef

Li, J., & Song, Y. (2019). Formal and informal care. In D. Gu & M. E. Dupre (Eds.), Encyclopedia of gerontology and population aging (pp. 1–8). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-69892-2_847-1CrossRef

Yang, W., & Tang, S. Y. (2021). Is informal care sufficient to meet the long-term care needs of older people with disabilities in China? Evidence from the China health and retirement longitudinal survey. Ageing & Society, 41(5), 980–999. https://doi.org/10.1017/s0144686x1900148xCrossRef

Xu, H. W. (2019). Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents. Social Science & Medicine, 229, 106–116. https://doi.org/10.1016/j.socscimed.2018.05.047CrossRef

Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583–594. https://doi.org/10.1093/geront/30.5.583CrossRefPubMed

Mackay, C., & Pakenham, K. I. (2012). A stress and coping model of adjustment to caring for an adult with mental illness. Community mental health journal, 48(4), 450–462. https://doi.org/10.1007/s10597-011-9435-4CrossRefPubMed

Pinquart, M., & Sorensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18(2), 250–267. https://doi.org/10.1037/0882-7974.18.2.250CrossRefPubMed

Berglund, E., Lytsy, P., & Westerling, R. (2015). Health and wellbeing in informal caregivers and non-caregivers: A comparative cross-sectional study of the Swedish a general population. Health and Quality of Life Outcomes, 13, 109. https://doi.org/10.1186/s12955-015-0309-2CrossRefPubMedPubMedCentral

Schulz, R., O’Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes. The Gerontologist, 35(6), 771–791. https://doi.org/10.1093/geront/35.6.771CrossRefPubMed

10.

Allen, A. P., Curran, E. A., Duggan, A., Cryan, J. F., Chorcorain, A. N., Dinan, T. G., Molloy, D. W., Kearney, P. M., & Clarke, G. (2017). A systematic review of the psychobiological burden of informal caregiving for patients with dementia: Focus on cognitive and biological markers of chronic. Neuroscience & Biobehavioral Reviews, 73, 123–164. https://doi.org/10.1016/j.neubiorev.2016.12.006CrossRef

11.

Vitaliano, P. P., Zhang, J. P., & Scanlan, J. M. (2003). Is caregiving hazardous to one’s physical health? A meta-analysis. Psychological Bulletin, 129(6), 946–972. https://doi.org/10.1037/0033-2909.129.6.946CrossRefPubMed

12.

Gangl M. (2010). Causal inference in sociological research. In K. S. Cook & D. S. Massey (Eds.), Annual Review of Sociology, Vol 36 (Vol. 36, pp. 21–47). doi: https://doi.org/10.1146/annurev.soc.012809.102702

13.

Hirst, M. (2005). Carer distress: A prospective, population-based study. Social Science & Medicine, 61(3), 697–708. https://doi.org/10.1016/j.socscimed.2005.01.001CrossRef

14.

Coe, N. B., & Van Houtven, C. H. (2009). Caring for mom and neglecting yourself? The health effects of caring for an elderly parent. Health Economics, 18(9), 991–1010. https://doi.org/10.1002/hec.1512CrossRefPubMed

15.

Heger, D. (2017). The mental health of children providing care to their elderly parent. Health Economics, 26(12), 1617–1629. https://doi.org/10.1002/hec.3457CrossRefPubMed

16.

Lacey, R. E., McMunn, A., & Webb, E. (2019). Informal caregiving patterns and trajectories of psychological distress in the UK household longitudinal study. Psychological Medicine, 49(10), 1652–1660. https://doi.org/10.1017/s0033291718002222CrossRefPubMed

17.

Zwar, L., König, H.-H., & Hajek, A. (2018). Consequences of different types of informal caregiving for mental, self-rated, and physical health: Longitudinal findings from the German ageing survey. Quality of Life Research, 27(10), 2667–2679. https://doi.org/10.1007/s11136-018-1926-0CrossRefPubMed

18.

Liu, R. T., Chi, I. R., & Wu, S. Y. (2023). Impacts of caregiving on health of new spousal caregivers to older adults in the United States: A coarsened exact matching analysis. Journals of Gerontology Series B-Psychological Sciences and Social Sciences. https://doi.org/10.1093/geronb/gbad064CrossRefPubMedPubMedCentral

19.

Kaschowitz, J., & Brandt, M. (2017). Health effects of informal caregiving across Europe: A longitudinal approach. Social Science & Medicine, 173, 72–80. https://doi.org/10.1016/j.socscimed.2016.11.036CrossRef

20.

Hiel, L., Beenackers, M. A., Renders, C. M., Robroek, S. J. W., Burdorf, A., & Croezen, S. (2015). Providing personal informal care to older European adults: Should we care about the caregivers’ health? Preventive Medicine, 70, 64–68. https://doi.org/10.1016/j.ypmed.2014.10.028CrossRefPubMed

21.

Kiecolt-Glaser, J. K., Speicher, C. E., Glaser, R., Dura, J. R., & Trask, O. J. (1991). Spousal caregivers of dementia victims – longitudinal changes in immunity and health. Psychosomatic Medicine, 53(4), 345–362. https://doi.org/10.1097/00006842-199107000-00001CrossRefPubMed

22.

Lee, S., Colditz, G. A., Berkman, L. F., & Kawachi, I. (2003). Caregiving and risk of coronary heart disease in US women - A prospective study. American Journal of Preventive Medicine, 24(2), 113–119. https://doi.org/10.1016/s0749-3797(02)00582-2CrossRefPubMed

23.

Miyawaki, A., Tomio, J., Kobayashi, Y., Takahashi, H., Noguchi, H., & Tamiya, N. (2017). Impact of long-hours family caregiving on non-fatal coronary heart disease risk in middle-aged people: Results from a longitudinal nationwide survey in Japan. Geriatrics & Gerontology International, 17(11), 2109–2115. https://doi.org/10.1111/ggi.13061CrossRef

24.

Schulz, R., & Martire, L. M. (2004). Family caregiving of persons with dementia: Prevalence, health effects, and support strategies. The American journal of geriatric psychiatry: Official journal of the American Association for Geriatric Psychiatry, 12(3), 240–249.CrossRefPubMed

25.

Ory, M. G., Hoffman, R. R., Yee, J. L., Tennstedt, S., & Schulz, R. (1999). Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist, 39(2), 177–185. https://doi.org/10.1093/geront/39.2.177CrossRefPubMed

26.

Dassel, K. B., Carr, D. C., & Vitaliano, P. (2017). Does caring for a spouse with dementia accelerate cognitive decline? Findings from the health and retirement study. The Gerontologist, 57(2), 319–328. https://doi.org/10.1093/geront/gnv148CrossRefPubMed

27.

Lai, A. P., Richardson, J., Griffith, L., Kuspinar, A., & Smith-Turchyn, J. (2022). The impact of care-recipient relationship type on health-related quality of life in community-dwelling older adults with dementia and their informal caregivers. Quality of Life Research, 31(12), 3377–3390. https://doi.org/10.1007/s11136-022-03203-1CrossRefPubMed

28.

Pinquart, M., & Sorensen, S. (2011). Spouses, adult children, and children-in-law as caregivers of older adults: A meta-analytic comparison. Psychology and Aging, 26(1), 1–14. https://doi.org/10.1037/a0021863CrossRefPubMedPubMedCentral

29.

Chappell, N. L., Dujela, C., & Smith, A. (2014). Spouse and adult child differences in caregiving burden. Canadian Journal on Aging-Revue Canadienne Du Vieillissement, 33(4), 462–472. https://doi.org/10.1017/s0714980814000336CrossRef

30.

Oldenkamp, M., Hagedoorn, M., Slaets, J., Stolk, R., Wittek, R., & Smidt, N. (2016). Subjective burden among spousal and adult-child informal caregivers of older adults: Results from a longitudinal cohort study. BMC geriatrics, 16(1), 208. https://doi.org/10.1186/s12877-016-0387-yCrossRefPubMedPubMedCentral

31.

Penning, M. J., & Wu, Z. (2016). Caregiver stress and mental health: Impact of caregiving relationship and gender. The Gerontologist, 56(6), 1102–1113. https://doi.org/10.1093/geront/gnv038CrossRefPubMed

32.

Rigby, T., Ashwill, R. T., Johnson, D. K., & Galvin, J. E. (2019). Differences in the experience of caregiving between spouse and adult child caregivers in dementia with lewy bodies. Innovation in Aging, 3(3), igz027. https://doi.org/10.1093/geroni/igz027CrossRefPubMedPubMedCentral

33.

Pinquart, M., & Sorensen, S. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 61(1), P33–P45. https://doi.org/10.1093/geronb/61.1.P33CrossRefPubMed

34.

Yee, J. L., & Schulz, R. (2000). Gender differences in psychiatric morbidity among family caregivers: A review and analysis. The Gerontologist, 40(2), 147–164. https://doi.org/10.1093/geront/40.2.147CrossRefPubMed

35.

Swinkels, J., van Tilburg, T., Verbakel, E., & van Groenou, M. B. (2019). Explaining the gender gap in the caregiving burden of partner caregivers. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 74(2), 309–317. https://doi.org/10.1093/geronb/gbx036CrossRefPubMed

36.

Wang, Z., Chen, Y., Pan, T., Liu, X., & Hu, H. (2019). The comparison of healthcare utilization inequity between URRBMI and NCMS in rural China. International journal for equity in health, 18(1), 90. https://doi.org/10.1186/s12939-019-0987-1CrossRefPubMedPubMedCentral

37.

Bijnsdorp, F. M., van der Beek, A. J., van Groenou, M. I. B., Proper, K. I., van den Heuvel, S. G., & Boot, C. R. L. (2022). Associations of combining paid work and family care with gender-specific differences in depressive symptoms among older workers and the role of work characteristics. Scandinavian Journal of Work Environment & Health, 48(3), 190–199. https://doi.org/10.5271/sjweh.4014CrossRef

38.

Zhao, Y., Strauss, J., Chen, X., Wang, Y., Gong, J., Meng, Q., Wang, G., & Wang, H. (2020). China Health and Retirement Longitudinal Study Wave 4 User’s Guide, National School of Development, Peking University. https://charls.charlsdata.com/pages/data/111/en.html.

39.

Stansfeld, S., Smuk, M., Onwumere, J., Clark, C., Pike, C., McManus, S., Harris, J., & Bebbington, P. (2014). Stressors and common mental disorder in informal carers–an analysis of the english adult psychiatric morbidity survey 2007. Social Science & Medicine, 120, 190–198. https://doi.org/10.1016/j.socscimed.2014.09.025CrossRef

40.

Baker, L. A., & Silverstein, M. (2008). Preventive health behaviors among grandmothers raising grandchildren. Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 63(5), S304–S311. https://doi.org/10.1093/geronb/63.5.S304CrossRefPubMed

41.

Minkler, M., Roe, K. M., & Price, M. (1992). The physical and emotional health of grandmothers raising grandchildren in the crack cocaine epidemic. The Gerontologist, 32(6), 752–761. https://doi.org/10.1093/geront/32.6.752CrossRefPubMed

42.

Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving. American Journal of Nursing, 108, 23–27. https://doi.org/10.1097/01.NAJ.0000336406.45248.4cCrossRefPubMed

43.

Goode, W. J. (1960). A theory of role strain. American Sociological Review, 25, 483–496. https://doi.org/10.2307/2092933CrossRef

44.

Barnett, R. C., & Baruch, G. K. (1985). Women’s involvement in multiple roles and psychological distress. Journal of Personality and Social Psychology, 49(1), 135–145. https://doi.org/10.1037//0022-3514.49.1.135CrossRefPubMed

45.

Pearlin, L. I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30(3), 241–256. https://pubmed.ncbi.nlm.nih.gov/2674272.CrossRefPubMed

46.

Lyonette, C., & Yardley, L. (2003). The influence on carer wellbeing of motivations to care for older people and the relationship with the care recipient. Ageing & Society, 23, 487–506. https://doi.org/10.1017/s0144686x03001284CrossRef

47.

Cantor, M. H. (1983). Strain among caregivers - A study of experience in The United-States. The Gerontologist, 23(6), 597–604. https://doi.org/10.1093/geront/23.6.597CrossRefPubMed

48.

Li, L., Wister, A. V., & Mitchell, B. (2021). Social isolation among spousal and adult-child caregivers: Findings from the Canadian longitudinal study on aging. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 76(7), 1415–1429. https://doi.org/10.1093/geronb/gbaa197CrossRefPubMed

49.

Nah, S., Martire, L. M., & Zhaoyang, R. (2022). Perceived gratitude, role overload, and mental health among spousal caregivers of older adults. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 77(2), 295–299. https://doi.org/10.1093/geronb/gbab086CrossRefPubMed

50.

van Groenou, M. I. B., de Boer, A., & Iedema, J. (2013). Positive and negative evaluation of caregiving among three different types of informal care relationships. European Journal of Ageing, 10(4), 301–311. https://doi.org/10.1007/s10433-013-0276-6CrossRef

51.

Comas-d’Argemir, D., & Soronellas, M. (2019). Men as carers in long-term caring: Doing gender and doing kinship. Journal of Family Issues, 40(3), 315–339. https://doi.org/10.1177/0192513x18813185CrossRef

Titel: Impact of caregiving on mental, self-rated, and physical health: evidence from the China health and retirement longitudinal study
Auteurs: Qing Su
Lijun Fan
Publicatiedatum: 21-04-2024
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-024-03659-3

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Abstract

Objectives

Method

Results

Discussion

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