Chronic Health Cost Burden in Older Caregivers and non-Caregivers in the United States.

BACKGROUND AND OBJECTIVES: Chronic health conditions affect the physical and financial well-being of millions of older adults, including those who themselves provide care to relatives and friends. As well, certain conditions cost more than others to manage, and older caregivers may be especially at risk of experiencing financial burden from an illness. This study investigated the association between caregiving and longitudinal change in health cost burden by measuring condition-specific expenses in a nationally-representative sample of older caregivers and non-caregivers.

RESEARCH DESIGN AND METHODS: Three waves of the Health and Retirement Study (HRS) were used in the analysis. Caregiver socio-demographic and financial status was matched with updated treatment and lost-wage costs for chronic conditions developed by the Milken Institute. Profiles of health cost burden were created for community-dwelling adults 60 years and older who completed the HRS core survey for all three wave years from 2016 through 2020 (N = 10,540). Bivariate and regression analyses were used to examine differences in health cost burden between caregivers and non-caregivers over time.

RESULTS: Compared to non-caregivers, caregivers were healthier and less burdened at baseline. Yet, holding other variables constant, caregivers showed steeper increases in chronic condition prevalence and costs over a four-year period after initiating caregiving activities.

DISCUSSION AND IMPLICATIONS: Findings suggest that whereas older caregivers may appear to select into the caregiving role while healthier, they are more likely to experience increased economic and health burdens over time - both from medical treatment and lost wages - related to chronic conditions.