Caregiving, marital quality, and physical health: A U.S. national study

Guided by a life course perspective and biopsychosocial model, this study examined the extent to which varying types of family caregiving place married adults at physical health risk. Using data from the 1995-2005 National Survey of Midlife in the U.S. (MIDUS) and estimating multivariate regression models, this study examined whether caregiving for a child, spouse, parent, or parent-in-law (in contrast to no caregiving) is linked to differences in levels of self-reported health (self-reported global health, functional limitations, physical symptoms, chronic conditions) and levels of clinically-assessed biological risk factors (allostatic load and its three subscales -- inflammatory dysfunction, metabolic dysfunction, hypothalamic-pituitary-adrenal/sympathetic nervous system [HPA/SNS] dysfunction). This study also explored how gender and marital quality (spousal support and strain) can moderate the associations between providing caregiving and physical health according to different relationship types. Findings indicated that child caregiving was linked to more physical symptoms, parent caregiving was linked to higher levels of HPA/SNS dysfunction, and parent-in-law caregiving was linked to higher levels of metabolic dysfunction. Evidence for gender differences was most observed in models regarding child caregiving and parent-in-law caregiving. Child caregiving was linked to higher levels of functional limitations and chronic conditions among women; whereas, parent-in-law caregiving was linked to higher levels of reported chronic conditions among men. Although the patterns of marital quality moderation varied according to caregiving relationship types (moderator effects were more prevalent in spouse caregiving) and gender (more marital quality moderator effects among women), the results generally indicated that better marital quality eliminated or reduced problematic caregiving impact (e.g., better marital quality eliminated problematic child caregiving impact on global health and chronic conditions) and poorer marital quality exacerbated the physical health risks of caregiving (e.g., in the presence of poor marital quality women child caregivers evidenced higher allostatic load; spouse caregiving had a problematic effect on functional limitations and inflammatory dysfunction among both women and men; parent caregiving had problematic effects on global health, physical symptoms, and chronic conditions among both women and men, as well as functional limitations among women; and parent-in-law caregiving had a problematic effect on inflammatory dysfunction among both women and men).