Wells Whitney, Xue Baowen, Lacey Rebecca, McMunn Anne
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
Research Department of Epidemiology & Public Health, University College London, London, UK.
J Epidemiol Community Health. 2025 Jan 13;79(2):94-101. doi: 10.1136/jech-2024-222633.
Unpaid carers deliver critical social care. We aimed to examine differences by ethnicity in (1) profiles of unpaid caring and (2) associations between caring and physical and mental health trajectories.
We used 10 waves of data from 47 015 participants from the UK Household Longitudinal Study (2009-2020). Our outcomes were 12-item Short Form Health Survey physical and mental component scores. We performed bivariate comparison of profiles of caring by ethnicity. We used multilevel linear mixed effects models to estimate associations between caring and health trajectories and assess for heterogeneity by ethnicity.
We found that caring profiles differed by ethnicity. The proportion caring for someone within their household ranged from 39.7% of White carers to 70.1% of Pakistani and 74.8% of Bangladeshi carers. The proportion providing 20+ hours/week of care ranged from 26.9% of White carers to 40.6% of Pakistani and 43.3% of Black African carers. Ethnicity moderated associations between caring and physical but not mental health trajectories (test for interaction: p=0.038, p=0.75). Carers showed worse physical health compared with non-carers among Black African (-1.93; -3.52, -0.34), Bangladeshi (-2.01; -3.25, -0.78), Indian (-1.30; -2.33, -0.27) and Pakistani carers (-1.16; -2.25, -0.08); Bangladeshi carers' trajectories converged with non-carers over time (0.24; -0.02, 0.51). White carers showed better baseline physical health than non-carers (0.35; 0.10, 0.60), followed by worsening trajectories versus non-carers (-0.14; -0.18, -0.10).
There are differences by ethnicity in profiles of caring and associations between caring and physical health trajectories. Future research should account for ethnicity to ensure applicability across groups.
无偿护理者提供着至关重要的社会护理。我们旨在研究种族在以下两方面的差异：（1）无偿护理的概况；（2）护理与身心健康轨迹之间的关联。
我们使用了英国家庭纵向研究（2009 - 2020年）中47015名参与者的10轮数据。我们的结局指标是12项简短健康调查问卷的身体和心理成分得分。我们对不同种族的护理概况进行了双变量比较。我们使用多级线性混合效应模型来估计护理与健康轨迹之间的关联，并评估种族间的异质性。
我们发现护理概况因种族而异。照顾家庭中某人的比例从白人护理者的39.7%到巴基斯坦裔护理者的70.1%以及孟加拉裔护理者的74.8%不等。每周提供20小时及以上护理的比例从白人护理者的26.9%到巴基斯坦裔护理者的40.6%以及非洲裔黑人护理者的43.3%不等。种族调节了护理与身体健康轨迹之间的关联，但未调节与心理健康轨迹之间的关联（交互作用检验：p = 0.038，p = 0.75）。与非护理者相比，非洲裔黑人（-1.93；-3.52，-0.34）、孟加拉裔（-2.01；-3.25，-0.78）、印度裔（-1.30；-2.33，-0.27）和巴基斯坦裔护理者（-1.16；-2.25，-0.08）的身体健康状况较差；随着时间推移，孟加拉裔护理者的轨迹与非护理者趋同（0.24；-0.02，0.51）。白人护理者的基线身体健康状况比非护理者更好（0.35；0.10，0.60），但随后与非护理者相比轨迹变差（-0.14；-0.18，-0.10）。
护理概况以及护理与身体健康轨迹之间的关联存在种族差异。未来的研究应考虑种族因素，以确保研究结果在不同群体中的适用性。
