Abstract

Background: Poor physical health status is more likely in informal caregivers given the roles of living conditions. One of the major problems stemming from the caregiving role was lifestyle change. Caregivers feeling the strain of the role of caregiving responsibility may not participate in health promotion activities to maintain their own health. When looking at caregivers’ health outcomes, it may be important the intensity of care provided because caregivers face varying levels of intensity of caregiving stressors.

Objectives: Drawing on Grossman’s model of healthcare demand, this study explores the determinants of health checkup attendance among informal caregivers in Japan and analyzed the effect of health checkup attendance on caregivers’ physical health.

Data and methods: Six waves of the Longitudinal Survey of Middle-aged and Elderly Persons (2005–2010) conducted by the Japanese Ministry of Health, Labor and Welfare were used. Taking into account the heterogeneity in the intensity of care provided, I estimated random-effects models of the health checkup functions and physical health functions. Caregivers with regular work were classified as reference category. The Kessler 6 non-specific distress scale was used as mental health measures. Having difficulty in daily life activities was used as physical health measures.

Results: This study uncovered three major findings. Firstly, there was not moderate persistence in health checkup attendance of non-working informal caregivers. The effect of initial conditions of most female caregivers were moderate persistent. Second, almost 40% of the probability of health checkups attendance was reduced by co-residential caregiving in females and males. Co-residential caregiving led to the change in health checkup attendance more than non-residential caregiving. Third, health promotion behaviors such as health checkup attendance and exercise habits reduce the risk of poor physical health of inactive female caregivers. In contrast, male caregivers having diabetes or stroke did not attend health checkup and tended to have future poor physical health.

Policy implications: Because of the potential negative effects of informal caregiving on caregivers’ health, the support of informal caregivers combined with regular health checks is an important public health issue. The estimation results suggested that co-residential inactive female caregivers may benefit from attending health checkups. However, the positive effect of health promotion behaviors on physical health did not exceed the negative effect of caregiving. Much attention should be paid to lifestyle of non-working informal caregivers. In addition to health checkup attendance, cessation of risky health behaviors such as smoking is strongly recommended.

Slides