Do carers care for themselves? A population-based study

Abstract

Background
Informal caregiving has become an integral part of many societies, however there is increasing concern about the well-being of carers and how they manage their care-related responsibilities in conjunction with their health and mental health. Previous studies have reported mixed results with some proposing that carers are intrinsically healthier.

Aims
To explore the association between different levels of caregiving and health behaviours and mental health status.

Methods
Data were collected through HealthWise Wales (HWW) and linked to healthcare records (N=27,455). These included self-reported data on level of caring responsibilities (0;1-19;20-49;50+ hours per week), whether or not they left employment due to their caring role, mental health using the short Mental Health Inventory (MHI-5) and health behaviour data on smoking status, physical activity and dietary habits. Data on current diagnosis of Anxiety and Depression were drawn from linked healthcare records. Separate logistic regression models adjusted for age, gender and socio-economic status were fitted to assess the association between intensity of caring responsibility and each mental health and health behaviour outcome.

Results
Of the 14,451 HWW participants who had complete records, 3,856 (26.7%) reported being an informal carer. Intense carers (20-49 hours per week) were more likely to be physically inactive (OR:1.27, 95%CI:1.04-1.56), smoke cigarettes (OR:1.49, 95%CI:1.11-2.00) and eat unhealthily (OR:1.48, 95%CI:1.13-1.93). They were more also likely to self-report (OR:1.87, 95%CI:1.51-2.32) or have a diagnosis of depression or anxiety (OR:1.57, 95%CI:1.26-1.97). Other levels of caregiving intensity also demonstrated the above associations. Carers who had given up work to care were more likely to be smokers and have common mental disorders.

Conclusion
Being an informal carer is associated with unhealthy behaviours and common mental disorders, with a gradient effect dependent on the level of caregiving activity. New interventions that can support carers to improve their health and wellbeing are urgently needed.

Background

Informal caregiving has become an integral part of many societies, however there is increasing concern about the well-being of carers and how they manage their care-related responsibilities in conjunction with their health and mental health. Previous studies have reported mixed results with some proposing that carers are intrinsically healthier.

Aims

To explore the association between different levels of caregiving and health behaviours and mental health status.

Methods

Data were collected through HealthWise Wales (HWW) and linked to healthcare records (N=27,455). These included self-reported data on level of caring responsibilities (0;1-19;20-49;50+ hours per week), whether or not they left employment due to their caring role, mental health using the short Mental Health Inventory (MHI-5) and health behaviour data on smoking status, physical activity and dietary habits. Data on current diagnosis of Anxiety and Depression were drawn from linked healthcare records. Separate logistic regression models adjusted for age, gender and socio-economic status were fitted to assess the association between intensity of caring responsibility and each mental health and health behaviour outcome.

Results

Of the 14,451 HWW participants who had complete records, 3,856 (26.7%) reported being an informal carer. Intense carers (20-49 hours per week) were more likely to be physically inactive (OR:1.27, 95%CI:1.04-1.56), smoke cigarettes (OR:1.49, 95%CI:1.11-2.00) and eat unhealthily (OR:1.48, 95%CI:1.13-1.93). They were more also likely to self-report (OR:1.87, 95%CI:1.51-2.32) or have a diagnosis of depression or anxiety (OR:1.57, 95%CI:1.26-1.97). Other levels of caregiving intensity also demonstrated the above associations. Carers who had given up work to care were more likely to be smokers and have common mental disorders.

Conclusions

Being an informal carer is associated with unhealthy behaviours and common mental disorders, with a gradient effect dependent on the level of caregiving activity. New interventions that can support carers to improve their health and wellbeing are urgently needed.