Caregiving in a Pandemic: Health-Related Socioeconomic Vulnerabilities Among Women Caregivers Early in the COVID-19 Pandemic

Abstract

PURPOSE Family and friends who provide regular care for a sick or dependent individual ("caregivers") are at increased risk of health-related socioeconomic vulnerabilities (HRSVs). This study examined pre-pandemic prevalence of and early pandemic changes in HRSVs among women caregivers compared with non-caregivers.METHODS A cross-sectional survey was conducted in April 2020 (early pandemic) with 3,200 English-speaking US women aged 18 years or older, 30% of whom identified as caregivers. We modeled adjusted odds of self-reported HRSVs (financial strain, food/ housing insecurity, interpersonal violence, transportation/utilities difficulties) before and changes during the early pandemic by caregiving status. Models were adjusted for age, race/ethnicity, marital status, education, income, number of people in household, number of children in household, physical and mental health, and number of comorbidities. RESULTSPre-pandemic, 63% of caregivers and 47% of non-caregivers reported 1 or more vulnerability (P <.01); food insecurity was most prevalent (48% of caregivers vs 33% of non-caregivers, P <.01). In the early pandemic, caregivers had higher odds than non-caregivers of financial strain, both incident (adjusted odds ratio [AOR] = 2.1; 95% CI, 1.6-2.7) and worsening (AOR = 2.0; 95% CI, 1.4-2.8); incident interpersonal violence (AOR = 2.0; 95% CI, 1.5 -2.7); incident food insecurity (AOR = 1.6; 95% CI, 1.2-2.1); incident transportation difficulties (AOR = 1.9; 95% CI, 1.3-2.6); and incident housing insecurity (AOR = 1.6; 95% CI, 1.1-2.3). CONCLUSIONThe coronavirus disease 2019 (COVID-19) pandemic increased risk of incident and worsening HRSVs for caregivers more than for non-caregivers. COVID-19 response and recovery efforts should target caregivers to reduce modifiable HRSVs and promote the health of caregivers and those who depend on them.

Birth setting decisions during COVID-19: A comparative qualitative study

“…Caregiver burden increased during the COVID-19 pandemic, which had a direct impact on physical and mental health. 30 – 33 While it is well established that access to childcare can be limiting for parents returning to the workplace, it is notable that a similar pattern was seen in our study before family leave even began for participants. Therefore, effective change that supports birthing people also requires addressing childcare and family leave policies.…”

Two concurrent randomized controlled trials of CommunityRx, a social care intervention for family and friend caregivers delivered at the point of care

“…(1-3) Clinical trials enrolling caregivers face particular recruitment and retention challenges including caregiver burden,(4-6) lack of caregiver identi cation in medical records, (5,7) and intermittent caregiver presence at care recipients' clinical visits. (8) The COVID-19 pandemic exacerbated HRSRs among caregivers (9) and, due to restrictions to caregiver attendance at visits, imperiled caregiver clinical trial enrollment. (10) CommunityRx is an evidence-based social care intervention, informed by self-and family management theory, (11) that systematically matches people at the point of healthcare to nearby resources for basic or health-related social needs, wellness, disease self-management and caregiving needs.…”

Experiences of relatives caring for psychiatric patients in the Greater Accra Region of Ghana

“…Thus, it is understandable that caregivers experience a range of emotions such as guilt, grief, exhaustion, depression, anxiety, and anger (Lynch & Lobo, 2012; Tan et al., 2012). Each year, the demand for care giving affects millions of families from all socioeconomic, ethnic, and educational backgrounds (Boyd et al., 2022). The contribution of family caregivers to our health care delivery system cannot be overemphasized.…”