P137 The mental and physical health effects of transitions into unpaid caregiving: a longitudinal, propensity score analysis in the UK Household Longitudinal Study

Background

Social care provision is increasingly important in the context of population ageing and the UK currently relies on family and friends to provide a majority of this care on an unpaid basis. Evidence regarding the health effects of providing unpaid care is mixed, possibly to a reliance on study designs which do not measure the temporality of events; few studies have examined changes in health around becoming a caregiver. Conflicting evidence may also reflect heterogeneity of effects by care characteristics (such as intensity) or caregiver characteristics (such as gender). Importantly from a life course perspective, when in the lifecourse people become caregivers is likely to influence its health effects. Most studies of caregiving and health have focused on mid-life or older caregivers, but younger adults also provide care, during a life stage which is crucial for establishing employment and family life. This study investigated the mental and physical health effects of becoming a caregiver and whether these associations varied by age of caregiving onset, gender, and caregiving intensity.

Data

UK Household Longitudinal Study, a nationally representative household panel study, using annually-collected longitudinal data between 2009–2020.

Methods

Mental health was measured using the 12-item General Health Questionnaire (GHQ-12) and the mental health component of the 12-item Short Form Survey (SF-12 MCS) while physical health was measured using the SF-12 physical component (PCS), all as continuous measures. We used propensity score matching to match participants who became caregivers to non-caregivers with similar characteristics. Sample sizes were n = 15,699 for GHQ-12 and n = 16,800 for SF-12. We modelled physical and mental health trajectories via piecewise growth curve modelling, centring the trajectories on caregiving transition. Predicted levels of mental and physical health with 95% confidence intervals are shown for every year up to eight years before and up to nine years after becoming a caregiver, comparing caregivers and matched non-caregivers. Models are shown, first pooled, then stratified by gender and weekly caregiving hours.

Results

Mental health deteriorated for both measures in the year of becoming a caregiver, particularly for women under age 50. A deterioration in physical health in response to becoming a caregiver was only seen for those under age 30. Transitioning to intense caregiving (10+ hrs/week) was associated with a deterioration in both mental and physical health across all age groups.

Conclusion

Our findings suggest support should be targeted to those providing intensive care and younger adult caregivers.