Informal Caregiving, Chronic Physical Conditions, and Physical Multimorbidity in 48 Low- and Middle-Income Countries

Abstract

Background The health of the caregivers is crucial to sustain informal care provision, while multimorbidity is an important health risk concept. However, studies on the association between informal caregiving and physical multimorbidity are currently lacking. Therefore, we investigated this association in adults from 48 low- and middle-income countries (LMICs). Method Cross-sectional data from 242,952 adults (mean age 38.4 years) participating in the World Health Survey 2002–2004 were analyzed. Informal caregivers were considered those who provided help in the past year to a relative or friend (adult or child) who has a long-term physical or mental illness or disability, or is getting old and weak. Nine physical conditions were assessed. Multivariable logistic regression analyses were conducted to assess associations between informal caregiving and physical multimorbidity, while the between-country heterogeneity in this relationship was studied with country-wise analyses. Results The overall prevalence of informal caregiving and physical multimorbidity (ie, two or more physical conditions) was 19.2% and 13.2%, respectively. Overall, caregivers had 1.40 (95% confidence interval = 1.29–1.52) times higher odds for physical multimorbidity. This association was particularly pronounced in younger caregivers (eg, 18–44 years: odds ratio = 1.54; 95% confidence interval = 1.37–1.72), whereas this association was not statistically significant among those aged ≥65 and older (odds ratio = 1.19; 95% confidence interval = 0.98–1.44). Country-wise analyses corroborated these findings, and there was a negligible level of between-country heterogeneity (I2 = 24.0%). Conclusions In LMICs, informal caregivers (especially young caregivers) were more likely to have physical multimorbidity. This should be taken into account in policies that address the health and well-being of informal caregivers.

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

“…Our results suggest that male sex, lower levels of wealth and education, smoking, prevalence of NCDs and associated multimorbidity were significantly higher among people with TB than those without a TB diagnosis. Our results are consistent with previous findings: male sex [ 26 , 59 ] and smoking [ 6 , 7 , 60 ] are two important risk factors for the elevated incidence of TB, and it has also been suggested that people with low educational attainment and poor income are at a higher risk of developing TB [ 61 , 62 ]. The cost of healthcare is a particularly relevant factor in LMICs, where the high healthcare cost relating to NCDs may lead to increased financial restraints and financial burden for accessing preventive health programs and treatment in low-income households [ 63 , 64 , 65 ].…”

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

“…Our results suggest that male sex, lower levels of wealth and education, smoking, prevalence of NCDs and associated multimorbidity were significantly higher among people with TB than those without a TB diagnosis. Our results are consistent with previous findings: male sex [26,59] and smoking [6,7,60] are two important risk factors for the elevated incidence of TB, and it has also been suggested that people with low educational attainment and poor income are at a higher risk of developing TB [61,62]. The cost of healthcare is a particularly relevant factor in LMICs, where the high healthcare cost relating to NCDs may lead to increased financial restraints and financial burden for accessing preventive health programs and treatment in low-income households [63][64][65].…”

Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury

“…Consistent with previous studies, this study found that caregivers had a high level of demand and difficulty in their role [ 8 , 9 ]. The patterns of informal caregiving highlighted in this study demonstrated that people with a moderate to severe TBI are supported by both family and paid support, noting that 12 of the 29 people with TBI had some financial assistance through no-fault insurance or compensation systems.…”

“…The considerable burden experienced by caregivers has been long acknowledged [ 8 , 9 , 10 ] and has been shown to increase with time [ 11 , 12 ]. In addition, the perceived burden for caregivers of adults with TBI has been suggested to be higher when compared to caregivers for adults with other conditions such as dementia [ 13 ].…”