The toll of caregiving: life-course family care and disparities in physical functioning

While gender and racial patterns in caregiving and adverse health impacts of caregiving are well documented, few studies have examined how different domains of family care over the life course are linked to later-life physical health or how various caregiving exposures contribute to health disparities across gender and racial groups.

Data come from the Midlife in the U.S. study, including Non-Hispanic White and Black adults (N = 8,778; 18% Black; 53% women). Family caregiving was assessed across two domains: Caregiving for minors and providing care for family members with chronic illness or disability. We examined gender and racial disparities in caregiving exposure, the associations between each domain of family care and physical functioning, and estimated the extent to which family care-individually and jointly-explains physical functioning disparities.

Intensive and expanded caregiving were more prevalent among women-particularly Black women-who were more likely to report early parenthood, major grandparenting, and repeated care for family members with chronic illness and disability. These experiences were significantly associated with greater functional limitations, with some variation by race. Family caregiving-especially caregiving for minors-partially explained both gender disparities in physical functioning and Black-White disparities among women.

Findings highlight that the convergence of multiple caregiving roles across the life course may contribute to disparities in physical functioning in later life. These results underscore the importance of policy interventions and support systems aimed at alleviating the compounded demands of unpaid caregiving and addressing their unequal distribution across social groups.