The price of care: socioeconomic determinants of mental health among informal caregivers in Europe

Abstract Background Informal caregivers play a vital role in supporting older adults with chronic illnesses and disabilities. However, this care provision often comes at a significant personal cost. This study investigates how individual and contextual factors affect the mental health of informal caregivers in Europe, using a multilevel approach. Methods Data from waves 8 and 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used to estimate multilevel logistic regression models on the probability of reporting depressive symptoms. The model accounted for individual (age, gender, income, self-perceived health, social network satisfaction, caregiving situation) and contextual (country and survey year) characteristics. Results Female caregivers (OR: 1.90), those with lower income (OR: 0.93), and poor self-perceived health (OR: 3.49) showed significantly higher odds of depression (p < 0.001). Lower satisfaction with social support also increased this probability, whereas higher satisfaction levels had a protective effect. Caregiving burden was amplified for those not cohabiting with a partner. Significant cross-national and temporal differences were observed. Conclusions The mental health of informal caregivers is shaped by both socioeconomic inequalities and the availability of social support. This underscores the need for public policies that reduce caregiver burden through financial aid, formal care services, and stronger social support systems. Addressing the care economy's mental health toll is essential for a sustainable and equitable long-term care strategy in Europe. Key messages • Informal caregiving harms mental health, especially in women and low-income groups - supportive policies are essential for equity and sustainability in long-term care. • Stronger social networks reduce depression risk in caregivers - investing in community and emotional support can protect their well-being and improve care quality