Millions of people combine work with caring responsibilities – looking after an older relative, a disabled child or a partner, for example. But what are the effects on the health of those who do this? Using data from the UK Household Longitudinal Study (UKHLS) also known as Understanding Society, Rebecca Lacey and colleagues from the ESRC International Centre for Lifecourse Studies at UCL have found that younger women and those who juggle working and caring are at higher risk of being obese.
The number of people who care for others without pay is huge – and it’s growing. In the United Kingdom there are more than seven million such carers – around one in five adults. About six in 10 of them are women.
We know from existing studies that becoming a carer can mean having to stop work – but an ageing society, extended working lives and cuts in social care funding mean those doing this unpaid caring are also increasingly often juggling their caring responsibilities and paid work.
Caring is linked to behaviour which leads to health risks, as well as to poorer health. Carers can suffer from the deterioration of their relationships with those they care for – particularly when the person needing to be cared for has dementia. They have to juggle caring and other responsibilities, resulting in little time for themselves: this means they may have less time to exercise and to eat healthily. They can also suffer additional financial burdens. All this can lead to measurably higher levels of stress – for example, research has shown that carers have higher levels of cortisol, which can cause the body to lay down fat. We wanted to know more about whether particular groups of carers were at increased risk of being obese.
We used a major study, Understanding Society, which has followed a representative sample of 40,000 UK households since 2009 and which is also linked to another study, the British Household Panel Survey, which first started in 1991
This enabled us, for the first time, to look at obesity amongst UK carers from the age of 16 onwards: previous studies had only looked at older carers or carers of those with specific conditions such as dementia.
We had information on 9,421 participants who had also been visited by nurses for health checks between 2009 and 2012, of whom 1,282 were carers. We were able to look at factors such as Body Mass Index (BMI) alongside whether participants had an illness or disability, their education, occupation, household income, socioeconomic position, partnership status and whether they were parents. We looked at how many people they cared for, and for how many hours in the week. And we also looked at whether they were also doing paid work, and if this was full or part-time.
Nurse visits were used to measure participants’ weight, percentage of body fat and BMI.
Women as carers
Roughly in line with national figures, we found women were more likely to be carers and to put in more hours of care each week. Female carers were more likely than their male counterparts to have children at home and also to be working outside the home – this may be because male carers tend to be older.
When we looked at whether men’s caring was linked to obesity, we did find an association – men who were carers had higher BMIs and larger waists. However, once we had taken differences in age into account we didn’t find this statistically significant.
But when we looked at women, the story was rather different. In contrast to men, women who were carers were significantly more likely to have larger waists or a higher percentage of body fat. And there was a particularly strong effect when it came to women who combined caring with full-time work: amongst young women aged 16-44 who were in full time work, those who were carers had waists 4cm larger, on average, than those who were not carers. Those who were caring and working beyond the age of 65 were also larger, with higher proportions of body fat and bigger waists.
Why is this? Why would women’s health potentially suffer a greater adverse effect than men’s from being a carer? It seems the strains on them may be greater – younger women may be working outside the home and may also be caring for children, for instance. They may lose touch with friends who have more freedom to enjoy leisure time. Carers are likely to have less time to spend exercising or to prepare healthy and nutritious meals – and those combining several caring roles with working life are likely to be particularly hard-hit
This matters, not least because the scale of the issue is so great – and because the UK relies so heavily on its citizens to look after their own – carers have been estimated to save the UK economy £132 billion per year. We need to make this largely hidden army of unpaid carers a public health priority.
Informal caregiving and markers of adiposity in the UK Household Longitudinal Study is research by Rebecca Lacey, Anne McMunn and Elizabeth Webb of the ESRC International Centre for Lifecourse Studies, University College London published recently in PLOS One
An earlier version of this blog was published on the WorkLife blog.
Rebecca Lacey is a Senior Research Fellow in social epidemiology at UCL. Her research interests include how social factors, such as caregiving and adverse childhood experiences, affect health over the life course. Her work involves the use of longitudinal UK datasets, such as the UK Household Longitudinal Study and the British birth cohort studies.