Department of Public Health, University of Rhode Island, Kingston, RI, United States.
Front Public Health. 2024 Aug 19;12:1423457. doi: 10.3389/fpubh.2024.1423457. eCollection 2024.
Informal caregiving is a critical component of the healthcare system despite numerous impacts on informal caregivers' health and well-being. Racial and gender disparities in caregiving duties and health outcomes are well documented. Place-based factors, such as neighborhood conditions and rural-urban status, are increasingly being recognized as promoting and moderating health disparities. However, the potential for place-based factors to interact with racial and gender disparities as they relate to caregiving attributes jointly and differentially is not well established. Therefore, the primary objective of this study was to jointly assess the variability in caregiver health and aspects of the caregiving experience by race/ethnicity, sex, and rural-urban status.
The study is a secondary analysis of data from the 2021 and 2022 Behavioral Risk Factor Surveillance System (BRFSS) from the Centers for Disease Control and Prevention. Multivariable logistic regression or Poisson regression models assessed differences in caregiver attributes and health measures by demographic group categorized by race/ethnicity, sex, and rural-urban status.
Respondents from rural counties were significantly more likely to report poor or fair health (23.2% vs. 18.5%), have obesity (41.5% vs. 37.1%), and have a higher average number of comorbidities than urban caregivers. Overall, rural Black male caregivers were 43% more likely to report poor or fair health than White male caregivers (OR 1.43, 95% CI 1.21, 1.69). Urban female caregivers across all racial groups had a significantly higher likelihood of providing care to someone with Alzheimer's disease than rural White males ( < 0.001). Additionally, there were nuanced patterns of caregiving attributes across race/ethnicitysexrural-urban status subgroups, particularly concerning caregiving intensity and length of caregiving.
Study findings emphasize the need to develop and implement tailored approaches to mitigate caregiver burden and address the nuanced needs of a diverse population of caregivers.
尽管非正式护理对非正式护理人员的健康和福祉有诸多影响，但它仍是医疗体系的重要组成部分。照护职责和健康结果方面的种族和性别差异得到了充分的记录。基于地点的因素，如邻里条件和城乡地位，越来越被认为是促进和调节健康差异的因素。然而，基于地点的因素与护理属性相关的种族和性别差异之间相互作用的潜力，以及它们对护理属性的共同和差异影响，尚未得到充分确立。因此，本研究的主要目的是共同评估护理人员健康和护理经验方面的变异性，这些变异性与种族/族裔、性别和城乡地位有关。
本研究是对疾病控制与预防中心行为风险因素监测系统（BRFSS）2021 年和 2022 年数据的二次分析。多变量逻辑回归或泊松回归模型评估了按种族/族裔、性别和城乡地位分类的护理人员属性和健康指标的差异。
来自农村县的受访者报告健康状况不佳或一般的可能性明显更高（23.2%比 18.5%），肥胖率（41.5%比 37.1%）和平均合并症数量更高。总体而言，农村黑人男性护理人员报告健康状况不佳或一般的可能性比白人男性护理人员高 43%（OR 1.43，95%CI 1.21，1.69）。所有种族群体的城市女性护理人员照顾阿尔茨海默病患者的可能性明显高于农村白人男性（ < 0.001）。此外，在种族/族裔性别城乡地位亚组中，存在护理属性的细致模式，特别是关于护理强度和护理时间。
研究结果强调需要制定和实施有针对性的方法来减轻护理人员的负担，并满足多样化护理人员群体的具体需求。
