Sponsor. Northern California Kaiser Permanente Division of Research, Kaiser Foundation Research Institute.
Purpose. This study examined health-risk behaviors and preventive health care activities among a cross-sectional, stratified random sample of caregivers for older adults.
Description. A stratified sample of caregivers and noncaregivers was randomly selected from a listing of individuals ages 50 and older who were members of the Kaiser Foundation Health Plan in Northern California. An initial screening questionnaire was mailed to approximately 10,000 individuals and 7,391 usable questionnaires were returned (74 percent response rate).
Based on responses to this questionnaire, respondents were classified as caregivers if they met all of the following criteria: (1) they provided assistance to another person(s) with at least one personal ADL or at least two IADL, (2) the assistance was provided at least monthly, (3) persons receiving the assistance were at least age 65 or older, (4) recipients did not pay respondents for providing the services, and (5) respondents had provided this care for at least the past 12 months.
Those who met the criteria received a more detailed health practices questionnaire, which included questions about health behaviors, preventive health care activities, level of caregiving assistance, respondent characteristics, and care recipient characteristics. A sample of noncaregivers matched on age, sex, and race also received the health practices questionnaire. Twelve-hundred thirty-six of 1,574 persons (80 percent) completed the questionnaire. Of these respondents, 272 individuals were determined to be caregivers and 917 were determined to be noncaregivers (i.e., they were not currently providing unpaid assistance to the older person).
Results. After controlling for age, sex, race, education, marital status, and income level, caregivers were more likely than noncaregivers to eat breakfast daily, get influenza shots, and receive pneumonia vaccines. Caregivers and noncaregivers did not differ with regard to any of 10 other health practices (including regular exercise, sleep, smoking, alcohol use, normal weight, receipt of a routine physical, receipt of a mammogram [for women], receipt of a rectal examination, receipt of a pelvic examination [for women], and receipt of a stool blood test); neither did the groups differ with respect to the total number of positive health behaviors. These findings suggest that, at least for caregivers who have access to the extensive health promotion resources of a large health maintenance organization, caregiving responsibility may not always have the deleterious impact on health and health practices that had previously been assumed.32
Next Steps. Although this study has been completed, additional research is needed to examine the processes by which caregiving can affect health and health behaviors and to identify those caregivers who are at greatest risk of deleterious health outcomes.32
Andrew E. Scharlach, Ph.D.
University of California
School of Social Work
329 Haviland Hall
Berkeley, CA 94720-7400
Phone: (510) 642-0126
Fax: (510) 643-6126