African Americans, Caregiving, and Physical Health Ratings: Does Culture, Religion and Spirituality Provide Support?

Background and Purpose: As the number of older Americans living longer with debilitating mental health and physical health conditions increases, so will the need for increased numbers of caregivers.  Caregiving can be both distressing and physically demanding, especially among African Americans. The literature also treats all caregivers without attention to race. Little research has focused on how to maximize quality of life of African American caregivers who juggle several roles and multiple demands that affect physical health. This study fills the gap in knowledge about how to improve the physical health of African American caregivers using religion and spirituality as important factors.   

Methods: Weighted secondary data analyses were performed on the National Survey of American Life (NSAL) data which included 4,461valid responses to examine the relationship between religion and spirituality experiences on health ratings among African American caregivers using STATA 14. Self-rated health (SRH) represented the dependent variable (DV) and was measured by using the question “How would you rate your overall physical health at the present time?  The responses were coded as 1 if excellent, very good and good and 0 if fair and poor. The main independent variables were defined as: Religiosity as measured by asking “How religious would you say you are?” and spirituality as measured using the question “How spiritual would you say you are?”  Each question offered a 4-point Likert scale which were then dichotomized into 1 if religious or spiritual and 0 if not religious or not spiritual.  Control variables included age; marital status; gender; race; employment status; growing up in a religious home; religion; and placed family member in a nursing home. Descriptive and bivariate statistics were performed to summarize sample characteristics and examine relationships between variables.  Two multivariate logistic regression models were performed to examine religion and spirituality experiences on health ratings controlling for demographic variables.  

Results: The results showed respondents who held strong religious and spiritual beliefs rated their physical health much higher than persons who did not hold such beliefs. African American participants who endorsed religiosity (OR = 1.44, 95% confidence interval [CI]: 1.06, 1.97) and White participants who endorsed religiosity (OR = 2.40, CI: 1.07, 5.40) recorded higher ratings of physical health than those who did not endorse being religious. Maintaining family closeness for African Americans is significantly associated with higher ratings of physical health (OR = 2.02, CI: 1.39, 2.94).  

Conclusions and Implications: All told, African American caregivers who attempt to balance caregiving with their other activities, such as work, family, and leisure, may find it difficult to focus on the positive aspects of caregiving and often experience more negative reactions, such as an increased sense of burden. Social Workers can capitalize on integrating religion and spirituality in service provision and can reduce the distress of caregivers so that better health outcomes can occur.  The findings underscore how maintaining a religious or spiritual lens can enhance health outcomes among African Americans caregivers who need support.