Abstract: Mental Health and Substance Use Among Caregivers in Rural and Non-Metropolitan Areas (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Friday, January 12, 2024

Independence BR A, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

James Eastman, Undergraduate Student, East Tennessee State University, TN

Manik Ahuja, PhD, Assistant Professor, East Tennessee State University, Johnson City, TN

Thiveya Sathiyaseelan, MD, Physician, Ballad Health, TN

Praveen Fernandopulle, MD, Resident physician, East Tennessee State University, TN

Johanna Cimilluca, DPH, Research Assistant, East Tennessee State University, TN

Nils Went, MD, Resident Physician, East Tennessee State University, NY

Ashlee Eastman, BS, Undergraduate Student, East Tennessee State University, TN

Background: Approximately 1 in 5 adults in the U.S. identify as a caregiver. A caregiver is defined as providing care for friends, family members or others on a regular basis, who need medical care. Providing care may be rewarding, it may also be significant burden on the caregiver. Prior research has found that caregiver status has been linked to increase levels of stress. This may be of an increased burden in rural/non-metropolitan areas, where transportation is limited, along with other challenges including access to care, and other factors. The proposed study examines the association of caregiver status and substance use (marijuana, alcohol, and smoking) and depression among rural populations, using a nationally representative sample.

Methods: We used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System a nationally representative U.S. telephone-based survey of adults over the age of 18 years and extracted data for non-metropolitan/rural counties. Logistic regression analyses were conducted separately to test the association between self-identified caregiver status and three outcomes, including depression, current marijuana use, and current alcohol use. We controlled for past month alcohol use, income, race, educational status, and age. Caregiver status was identified based on providing care or assistance to a friend of family member over the last 30 days.

Results: Overall, 21.7% (n=13,653) of our participants self-identified as a caregiver, while 19.5% reported depression, past month alcohol use (48.2%) , past month smoking (13.5%), and past month marijuana use (4.2%). Self-identified caregiver status was associated with higher odds of depression (OR=1.51, 95% CI, 1.44,1.58), past month marijuana use (OR =1.74, 95% CI, 1.51, 2.01), and past month smoking (OR=1.38 95% CI, 1.31, 1.45). Self-identified caregiver status was not associated with past month alcohol use.

Conclusions: The data indicates a need for intervention concerning caregivers in rural areas. These caregivers are working without fiscal compensation for their efforts, as a result, they are more likely to be suffering from depression, and use marijuana and/or tobacco, as a coping mechanism. A few feasible interventions which could be incorporated include professionally led group psycho-social support programs, expanding telehealth services, or developing a standardized protocol for the clinicians of the caregivers. If incorporated in rural areas, these interventions could have a significant impact on the mental/ physical health of caregivers in rural areas. For the areas which do have interventions in place for rural caregivers, expanding awareness and access to the impact of them should be explored.