Methods: We used data from the Health and Retirement Study, a longitudinal study of a nationally representative sample of adults over age 50. We defined a respondent as a caregiver if care recipients reported their spouses as a person who provided help in completing ADLs and IADLs. The 2006-2016 HRS includes 2,230 caregiving spouses. We linked the HRS with the National Neighborhood Data Archive, which contains nationwide measures of the physical and social environment. As supportive services and amenities, we included organizations providing home health care and services for older adults (e.g., senior daycare) as well as pharmacies, supercenters, grocery stores, convenience stores, and dollar stores, which can help caregivers complete daily tasks. We estimated negative binomial regression models to examine whether greater availability of supportive services and amenities (per square mile) is associated with fewer depressive symptoms. We also estimated stratified models to urban-rural differences in the relationship.
Results: More availability of supportive services and amenities was associated with fewer depressive symptoms. For one additional service/amenity, depressive symptoms decreased by 0.001 (95% CI: -0.002, 0.00; p<.01). In the stratified model, one additional services and amenities was associated with 0.0007 (95% CI: -0.002, 0.00; p<.05) and 0.0014 (95% CI: -0.003, 0.00; 0<.05) decrease in depressive symptoms in urban and rural, respectively.
Conclusion and Implications: We found that caregiving spouses living in neighborhoods with greater availability of supportive services and amenities had fewer depressive symptoms. We also found urban-rural differences in the association; rural residents were more benefitted from the resources available in their neighborhood. Based on this finding, increasing access to services and amenities may promote the mental health of caregiving spouses.