Session: Leveraging Secondary Data to Answer Complex Social Work Questions: Caregivers in the Behavioral Risk Factor Surveillance System (BRFSS) (Society for Social Work and Research 24th Annual Conference - Reducing Racial and Economic Inequality)

Background and Purpose: Significant resources contribute to the development and collection of large longitudinal public health data sets. Such data is important to understand the prevalence and risk of disease as well as identify risk factors associated with negative health outcomes. As a result, they are largely defined and examined by the fields of public health and medicine. Yet, questions related to social identity, social context, and social policies embedded within these data remain largely overlooked. As social work researchers, we are uniquely qualified and positioned to address complex and unanswered questions using these existing resources. This symposium highlights data from the Behavioral Risk Factor Surveillance System (BRFSS), whose optional questions on caregiving were asked across 46 states between 2015-2017. Using this large population-based dataset, we sought to extend the rich social work evidence base on the experience and impact of family caregiving.

Description of the Problem and Symposium Objectives: Social work researchers on caregiving have underutilized large population-based datasets. Large datasets that include information about caregiving can be leveraged by social workers to address more complex research questions than typically asked in the public health literature. One paper addresses caregivers in Medicaid expansion states compared to non-expansion states to explore a policy relevant question. Another considers how rural and non-rural caregivers fare across these 46 states. Lastly, one paper investigates caregiving for mental illness specifically, an area that has lacked sufficiently large population-based samples. The papers presented in this symposium maximize the geographic range and size of the BRFSS data to address questions of substantial breadth and depth.

Methods: The BRFSS is a nation-wide telephone survey, conducted annually, that collects information about health related behavior, health status, and use of health care services. In addition to a core questionnaire, states have the option of adding additional modules that collect specific information. Between 2015-2017, 46 states included the optional caregiving module, which included 8 caregiving items: prevalence, type, duration, frequency, relationship, care need, unmet service needs, and future caregiving expectations. In total, the data include information on 62,163 caregivers. Each paper in this symposium tested for bivariate differences in demographic, socioeconomic, health, and caregiving behaviors among caregivers in light of their specific research question. Drawing on existing literature and Pearlin's stress and coping model for caregivers, each paper used mental health quality of life (MHQOL) as the dependent variable in multivariable regression models, adjusted for demographic and socioeconomic factors.

Results, Conclusions and Implications: The individual papers presented in this symposium draw conclusions about how the experience of caregiving and caregivers' MHQOL depend on the caregiver's role and their geopolitical context. Public health data sets are useful for examination by social work researchers. By looking at such data with a more complex lens interesting questions related to social identities, contexts and policies can be identified. Social work has a unique and significant contribution to make to the analysis of existing public health data. We can also add to the discussion of best practices for defining and collecting such data.