(see Poster Gallery) Perceived Neighborhood Characteristics and Biological Risk Among Spousal Caregivers

Objectives: Family members are the primary source of care and support for community-dwelling older adults. Previous studies have reported that caregivers often experience poorer health than non-caregivers, including worse cognitive functioning, increased cardiovascular disease risk, and more depressive symptoms. The effect of caregiving on the health and well-being, however, varies. For instance, the negative effect of caregiving decreased significantly among caregivers with more psychosocial resources, such as self-efficacy and social supports, compared to those with less psychosocial resources. On the other hand, ongoing chronic stressors, such as caregivers’ health problems and financial strains, increased caregiving stress and resulted in poor health outcomes. Neighborhoods may also play an important role as resources or a source of stress in caregiver health. However, most prior research on caregivers’ mental health focused on individual or household factors, we know much less about the influence of neighborhood factors on mental health of spousal caregivers. The current study fills the gap in our knowledge by examining the association of neighborhood characteristics and biological risk among spousal caregivers.

Methods: We used data from 2006 to 2016 waves of the Health and Retirement Study, as these were the waves in which respondents’ evaluation of their neighborhoods and biomarkers were collected. Perceived neighborhood characteristics included perceived neighborhood disorder and neighborhood social cohesion. Biological risk was assessed using nine biomarkers: systolic blood pressure, diastolic blood pressure, pulse rate, total cholesterol, high-density lipoprotein (HDL) cholesterol, glycated hemoglobin, cystatin-C, obesity, and C-reactive protein. Poisson and logistic regression models were estimated to examine the association of perceived neighborhood characteristics and biological risk.

Results: Perceived neighborhood characteristics were significantly associated with biological risk. Respondents with low levels of neighborhood disorder and low levels of social cohesion (IRR=1.30, 95% CI: 1.02, 1.66) and those with high levels of neighborhood disorder and low levels of social cohesion (IRR=1.53, 95% CI: 1.26, 1.86) had an increased biological risk compared to those who lived in more cohesive neighborhoods than those with low levels of neighborhood disorder and high levels of neighborhood social cohesion. When we included additional confounding factors (i.e., hours of caregiving, type of care, smoking status), the association between perceived neighborhood characteristics and overall biological risk remained significant.

Conclusion and Implications: This study highlights the importance of neighborhood contexts in understanding caregivers’ health. Findings of this study suggests that spousal caregivers may be less influenced by neighborhood disorder when they feel that they can rely on their neighbors. Therefore, policy makers and practitioners should prioritize strengthening social ties in neighborhoods before directing resources to reduce signs of neighborhood disorder.