Analysis of Correlates and Trends in Caregivers’ Mental Health Pre- and COVID-Onward From the HINTS, 2018-2022

TL;DR

This study finds that caregivers have higher mental distress than non-caregivers, with risk factors changing over time, especially during and after the COVID-19 pandemic.

Contribution

The study identifies how caregiving status and associated mental health risks evolved before and during the pandemic.

Findings

Caregivers had higher mean PHQ-4 scores than non-caregivers (p<.01).

Caregiving status was significantly linked to mental distress both pre-COVID and during the pandemic.

Education level and health status were significant predictors of mental distress at different time points.

Abstract

To compare correlates of mental distress among caregivers versus non-caregivers, and evaluate trends in caregivers’ mental distress pre- versus COVID-onward.

This cross-sectional study used nationally representative data from multiple cycles of the Health Information National Trends Survey (2018 to 2022; n = 15,318). We characterized sociodemographic, health, and caregiving characteristics and estimated logistic regression models evaluating correlates of mental distress among the full sample and pre- and COVID-onward.

Caregivers reported a higher mean PHQ-4 score than non-caregivers overall (|t|=2.88, p<.01). Caregiving status was significantly associated with mental distress pre-COVID (OR = 1.47; 95%CI=1.13-1.92; p<.01) and COVID-onward (OR = 1.51; 95%CI=1.01-2.26; p<.05). Being in fair or poor health status was associated with a higher likelihood of mental distress pre-COVID (OR = 2.58, 95%CI=1.31-5.09, p < 0.01) while having a college education or higher was associated with a lower likelihood of mental distress COVID-onward (OR = 0.46, 95%CI=0.21-0.99, p< .05).

Caregiving status continues to be a significant risk factor for mental distress. Factors significantly associated with mental distress among caregivers change over time. Findings suggest the COVID-19 pandemic may continue to present risks to caregivers’ mental wellbeing, requiring development and implementation of policies and programs to address caregiver mental health.