Health inequalities and informal care: end of project report

This report describes research that set out to measure, monitor and evaluate health inequalities associated with the provision of unpaid care. It outlines the scope and design of the project and presents the key findings. The adverse health effects of caring are primarily psychological and often manifest themselves as symptoms of anxiety, depression and social dysfunction. Caringrelated inequalities in psychological well-being are quantifiable and significant; they are most pronounced at key turning points in the caring trajectory and in the more demanding care situations. Caregiving is associated with an increased risk of both onset and recurrent distress, and legacies of poor health persist beyond the end of caregiving. An increased risk of mental and psychological distress attributable to caring activities affects a substantial minority of carers who provide long hours of care over extended spells. Carers who provide at least 20 hours care per week are often at greatest risk of poor health and adverse health changes because of their caring responsibilities. Overall, women face greater risk of psychological distress because of their caring responsibilities than men in comparable care situations. Caring for a spouse or partner is particularly associated with additional health problems beyond those that might be attributable to other determinants of health. Caring-related inequalities in psychological distress did not diminish during the 1990s indicating that the evidence for addressing carers’ health needs is as compelling as it ever was. Taken together, the findings begin to validate caregiving as an underlying social determinant in the creation of health inequalities, and help to identify the circumstances in which caregiving might be an important variable in epidemiological analysis. A final section considers implications for policy and practice towards carers and concludes by suggesting that caregiving should be recognised by policy makers, service planners and practitioners as a public health issue and become part of the health inequalities agenda.