Prevalence and Health Characteristics of Asian American and Pacific Islander Adults Caregivers in the U.S

Background and Purpose. Asian American and Pacific Islanders (AAPIs) are the fastest growing racial group in the U.S., and yet they are still understudied. AAPIs are also a highly diverse, heterogeneous group with more foreign-born older immigrants (50+ years). Regardless of their subethnic groups, AAPIs value filial piety and respect elders. Elder caregiving is expected as many middle-aged AAPIs care their older family members compared to general population of the same age group (42% vs 22%). However, these cultural expectations may not be met by their U.S.-born, acculturated children or grandchildren. The purposes of this study were to assess the prevalence of elder caregiving provided by community-dwelling AAPI adults (18+ years), to compare the health of AAPI caregivers to AAPI non-caregivers, and to evaluate the experiences of AAPI caregivers with other racial/ethnic groups of caregivers in the U.S.

Methods. Data from adults aged 18 years and older from 44 states, the District of Columbia, and Puerto Rico that included the Caregiver Module on the 2015-2017 Behavioral Risk Factor Surveillance System was used (N=248,167). Respondents who had provided care/assistance to a friend/family member with a long-term illness or disability during the past 30 days were classified as caregivers. Frequent mental distress was defined as experiencing 14 days or more of poor mental health in the past 30 days. Four chronic conditions were required to be included in the measure. Chi-square tests were used to compare the prevalence of caregiver experiences across racial/ethnic groups and to compare caregivers and non-caregivers.

Results. Among 7,029 AAPI respondents, 1,136 (10.6%) were caregivers. The majority were employed (64.0%), married (59.0%), college-educated (75%), female (53.0%) and in excellent/very good/good health (87.7%) with their annual household income of $50+K (63.5%). AAPI caregivers assisted with personal care (62.4%) and helped with household tasks (79.0%), but were more likely than non-caregivers to experience frequent mental distress (13.0% vs. 6.2%, p=0.009) and had at least one chronic health condition (39.4% vs. 23.6%, p=0.004). Otherwise, AAPI caregivers and non-caregivers were similar in demographic and health characteristics. Compared to other racial/ethnic groups, contrary to middle-aged AAPIs, overall AAPI adult caregivers were less likely to provide care (AAPI: 11% vs. Black: 23%, American Indian/Alaska Native: 27%, White: 21%, and Hispanic: 16%; all p<0.001). In terms of caregiving hours and lengths, all racial/ethnic groups provided care similarly: 20+ hours in an average week and 2+ years of caregiving length.

Conclusions and Implications. One in ten AAPI adults in 44 states and territories was a caregiver. AAPI caregivers were more likely to experience frequent mental distress and had a chronic health condition compared to non-caregivers. AAPI caregivers tended to spend substantial caregiving time, which might put them at higher risk for negative health outcomes. As baby boomers age, the demand for caregiving is inevitable. Social workers have to be cognizant of the characteristics of AAPI as well as all racial/ethnic groups of caregivers and collaborate among healthcare professionals in support of caregivers so that these caregivers can continue their caregiving duties while managing their own health.