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Caring as a social determinant of health: review of evidence

Unpaid carers provide critical support for people with health and social care needs. The majority of recipients of unpaid care are older parents or spouses and partners, and changes in the make-up of our population indicate that the number of dependent older people in the UK will increase by 113% by 2051.

Supporting those who provide unpaid care to older people is therefore hugely important, and evidence is needed on how best to do this. The support provided by carers is often physically and emotionally demanding, with consequences for carers’ own health and wellbeing.

In this work, PHE commissioned Newcastle University to:

  • explore the consequences of being an unpaid carer of older people
  • identify evidence about how best to support this group of carers

To address these aims, a rapid review of existing evidence reviews (an ‘umbrella review’) was conducted, alongside analysis of data on carers (for any population) from the NHS England GP Patient Survey. The main findings are:

  • mounting evidence that unpaid caring should be considered a social determinant of health
  • carers experience poor physical and mental health but also have unmet care needs themselves
  • different groups of carers may have different support needs
  • a lack of clear and robust evidence about how best to support people caring for older populations, and gaps in evidence on key outcomes


This report proposes a logic model as a tool for evaluating the impact of carer interventions.

It also includes ‘access enablers’ as important in ensuring that carers are connected with relevant services and interventions on offer. Social prescribing is one of these enablers.

Key Information

Type of Reference
Type of Work
Research focus
Public Health England
Publication Year