Race, Social Context, and Caregiving Intensity: Impact on Depressive Symptoms Among Spousal Caregivers.

Abstract

Understanding the factors that influence the mental health of family caregivers is essential. This study examines the impact of caregiving intensity, operationalized as caregiving hours, on depressive symptoms, with a focus on racial differences and gender effects. We analyzed data from n = 2112 unique spousal caregivers across 6622 person-years of observations from the Health and Retirement Study (HRS) longitudinal data (2008-2014). We estimated the impact of caregiving hours on depressive symptoms, controlling for race, gender, and education. Random intercepts accounted for household-level variance. We assessed interaction terms to evaluate differential effects across racial groups. Depressive symptoms were positively associated with caregiving hours β = 1.74, SE = 0.24, suggesting that increasing caregiving hours is likely to lead to emotional distress. We observed a significant negative interaction effect among African American caregivers (β = -1.25, p = 0.013), indicating that increased caregiving hours led to a reduction in depressive symptoms. Gender was not significantly associated with caregiving hours (β = -0.36, p = 0.715). The random effects model demonstrated substantial household-level variation (var(_cons) = 266.07, p < 0.0001). Findings highlight racial differences in the effects of caregiving hours on depressive symptoms and point to the importance of culturally responsive interventions designed to mitigate depressive symptoms among caregivers. Future research should explore protective factors that mitigate psychological distress and promote resilience.