Location, Location, Location: Caregivers in Disadvantaged Neighborhoods Show Surprising Outcomes

A new study utilized a mapping tool to uncover differences in caregiver outcomes based on neighborhood characteristics.

The researchers conducted telephone surveys with 792 caregivers living in an urban setting who provide unpaid care for a friend or relative age 50 or better. The survey included questions about demographic characteristics, caregiving intensity, caregiver burden and depression, and unmet needs of the care recipient. The researchers also used Geographic Information System, a tool that maps a variety of location characteristics, to match caregivers with their neighborhood characteristics such as disadvantaged or medically underserved areas. Disadvantaged areas were defined as locations that have a high poverty or minority population, while underserved areas were defined as locations that have a shortage of available health care. These areas could overlap.

The researchers had speculated that living in disadvantaged or underserved areas could be a source of added stress for caregivers, resulting in negative outcomes. Unexpectedly, however, this was not the case. In fact, caregivers living in these areas reported significantly less burden and lower depression, compared to caregivers outside these areas. There was even a trend for caregivers in disadvantaged and underserved areas to report more positive aspects of caregiving. When accounting for individual-level characteristics, these associations were not as strong, but were still present. Even unmet needs of the care recipient did not differ among neighborhood types.

One explanation proposed by the researchers was that caregivers in these areas are able to utilize strategies to cope with stress that they have developed through living in disadvantaged areas. Alternatively, providing care for a loved one in these areas may be a more common expectation, rather than an additional source of stress.

While these findings may be contrary to expectations, one important takeaway is that neighborhood characteristics can have an important impact on caregivers’ well-being. Future research may need to investigate how neighborhood characteristics relate to other aspects of caregiving, or how environmental features beyond disadvantaged areas relate to this topic. Needless to say, caregivers in disadvantaged areas still need support, but this type of research will help to inform the types of resources to offer caregivers living in diverse areas.


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Beach SR, Kinnee E, & Schulz R. Caregiving and place: Combining Geographic Information System (GIS) and survey methods to examine neighborhood context and caregiver outcomes. Innovation in Aging (2019); 3(3): 1-15.


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