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Informal caregiving and mortality―Who is protected and who is not? A prospective cohort study from Japan

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  • Miyawaki, Atsushi
  • Tanaka, Hirokazu
  • Kobayashi, Yasuki
  • Kawachi, Ichiro

Abstract

Informal caregiving is linked to psychological stress. However, recent studies have suggested a protective association between informal caregiving and mortality among caregivers. We sought to test the association between caregiving and survival in the Komo-Ise study, a prospective cohort of community-dwelling residents aged 44–77 years living in two areas in Gunma prefecture, Japan. Caregiving status was assessed in 2000, and 8084 individuals were followed for ten years. All-cause mortality was ascertained from official registers. Using multivariate Cox proportional hazards models, we found no statistically significant overall association between informal caregiving and all-cause mortality for either combined sexes, (HR 0.97, 95% CI 0.79, 1.19), men (HR 0.98, 95% CI 0.76, 1.27), or women (HR 0.95, 95% CI 0.68, 1.34). The propensity score matched model also showed no increased risk of all-cause mortality across all caregivers, male caregivers, and female caregivers. The association with all-cause mortality was not observed regardless of the presence of support for activities of daily living (ADLs)/instrumental activities of daily living (IADLs) or the relationships to the care recipients. In subgroup analyses, informal caregiving was not associated with increased risk of all-cause death across subgroups for combined sexes, men, or women, except for increased mortality among female caregivers in the lowest-income group (HR 1.75, 95% CI 1.03, 3.00). An increase in the risk of mortality was not observed among male caregivers. In conclusion, informal caregiving did not increase mortality as a whole, nor for most subgroups, while some sub-groups such as women in the lower socioeconomic status groups may be vulnerable to the adverse health effects of caregiving.

Suggested Citation

  • Miyawaki, Atsushi & Tanaka, Hirokazu & Kobayashi, Yasuki & Kawachi, Ichiro, 2019. "Informal caregiving and mortality―Who is protected and who is not? A prospective cohort study from Japan," Social Science & Medicine, Elsevier, vol. 223(C), pages 24-30.
    • Handle: RePEc:eee:socmed:v:223:y:2019:i:c:p:24-30
    DOI: 10.1016/j.socscimed.2019.01.034
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    References listed on IDEAS

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    1. Yoshihama, Mieko, 2021. "Visualizing drivers of gender health disparities: Ongoing participatory action research following the 2011 disaster in Japan," Social Science & Medicine, Elsevier, vol. 283(C).
    2. Gen Nakayama & Shoichi Masumoto & Junji Haruta & Tetsuhiro Maeno, 2020. "The Influence of Family Caregivers’ Experience of Interprofessional Care on Their Participation in Health Checkups as Preventive Health Behavior in Japan—A Cross-Sectional Analysis," IJERPH, MDPI, vol. 18(1), pages 1-12, December.
    3. Bria Willert & Krista Lynn Minnotte, 2021. "Informal Caregiving and Strains: Exploring the Impacts of Gender, Race, and Income," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 16(3), pages 943-964, June.
    4. Uccheddu, Damiano & Gauthier, Anne H. & Steverink, Nardi & Emery, Tom, 2019. "The pains and reliefs of the transitions into and out of spousal caregiving. A cross-national comparison of the health consequences of caregiving by gender," Social Science & Medicine, Elsevier, vol. 240(C).

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