Research has shown that geographic location and individual circumstances can impact a caregiver’s health

About a quarter of adults in the U.S. care for elderly family members or children who are sick or disabled, or sometimes both. According to a team led by Penn State researchers, although family caregiving consumes the time and resources of both individuals and governments, social scientists do not fully understand how it affects those providing care. In collaboration with colleagues from Purdue University and the University of Minnesota, researchers conducted a large-scale study of caregiver well-being and found that geographic location and individual circumstances can impact a caregiver’s health, comfort and happiness even more than state policies regarding family care.

Findings recently published in a scientific journal found that, compared to urban caregivers, caregivers in rural and suburban areas were more likely to have low or medium well-being and less likely to have high well-being. However, the personal characteristics of caregivers – such as age, income and education – had a stronger impact on their well-being than the family care policies in the country where they live. However, the researchers concluded that family care policies can have an impact on well-being if they take into account differences between rural, suburban and urban areas – particularly in terms of available support and infrastructure.

Although caregiving can be an emotionally fulfilling and fulfilling experience, caregivers often face significant stress and challenges in their roles, and researchers and policymakers often overlook the impact of caregiving on well-being.”

Elena Maria Pojman, first author of the article and a doctoral student in sociology and demography in the Department of Sociology and Criminology at Penn State

To better understand caregiver well-being, including differences between rural, suburban and urban caregivers, researchers used two publicly available datasets. One was a care study conducted by the North Central Regional Development Center and a collaboration with the Penn State-based Northeast Regional Center for Rural Development. The survey includes responses from 4,620 caregivers about their realities caring for children and adults in the North Central and Northeast regions of the United States. The second dataset comes from a group of researchers at the University of North Carolina at Chapel Hill and contains information on state-level programs and policies related to the availability of services such as respite care, day care, special transportation, and state-paid leave from work for caregiving purposes.

By combining these two data sets for the current study, researchers assessed how caregivers were faring and whether state-level policies – laws and programs related to family care – played a role in caregiver well-being. First, the team’s analysis revealed that caregivers could be grouped according to their well-being score: high, medium or low, based on how they responded to several aspects of their well-being: happiness, self-rated health, and the impact of caregiving on their physical, mental/emotional health and social life. The researchers then used a statistical technique that predicts the probability of an outcome in more than two categories to analyze the likelihood of people from rural, suburban or urban areas belonging to each category.

The researchers concluded that rural and suburban caregivers were more likely to have poorer well-being than urban caregivers, but the overall differences between them were small. However, Pojman noted, the analysis found that suburban caregivers were more like rural than urban caregivers, contradicting previous research by other researchers that grouped suburban and urban caregivers together.

“Suburban caregivers often face unique challenges based on their geographic and social location that differ from those experienced in urban or rural settings,” Pojman said, explaining that the study highlighted the need for better-targeted policies and resources. “Balancing caregiving with work, parenting and personal needs is often complicated by factors specific to suburban areas, such as limited public transport and the isolation that comes from living in more dispersed communities.”

The researchers also concluded that support systems were key – caregivers who had access to paid assistance and community support specific to caregiving tended to enjoy higher well-being. Less specific supports, such as broad federal programs, were less strongly associated with high well-being. This suggests that policy should focus on increasing the availability of care-specific supports, explained team leader and senior author Florence Becot, professor of early career national insurance and director of the agricultural safety and health program in the College of Agricultural Sciences at Penn State

“While caregiving can be an emotionally fulfilling and fulfilling experience, caregivers often face significant stress and challenges in their roles, and researchers and policymakers often overlook the impact of caregiving on well-being,” she said. “Caregivers often report a complex range of feelings about the care they provide and the impact it has on their lives, ranging from enormous financial and emotional burdens to joy and personal growth. There is a clear need to develop better family care policies that reflect the real differences in support needs across rural, suburban and urban areas – particularly to help caregivers struggling with difficulties.”

Because caregiving experiences vary so much, it is important to consider the caregiver’s well-being in a differentiated and individualized way, Becot added.

“Understanding the challenges caregivers face in different social, demographic and geographic contexts and circumstances helps researchers, health care providers and policymakers better support caregivers – especially those at risk of burnout or emotional distress,” she said.

Zuzana Bednarik from the North Central Regional Center for Rural Development at Purdue University and Carrie Henning-Smith from the University of Minnesota School of Public Health participated in the research.

Funding for this research was provided by the Nationwide Insurance Endowment in the College of Agricultural Sciences at Penn State; North Center for Rural Development; North-Eastern Regional Centers for Rural Development; U.S. Department of Agriculture National Institute of Food and Agriculture; North Central Regional Association of Directors of State Agricultural Experiment Stations; and the North Central Cooperatives of Extension Association.