Behavioral Health, Mental Health, and Overall Well-Being of Informal Caregivers Before and After the Covid-19 Pandemic

Informal caregivers, such as relatives or close friends, are vital for maintaining the welfare of the individuals they provide care for. However, caregiving can be difficult and stressful that adversely impacts caregivers’ health. The extra stress brought on by the COVID-19 pandemic can potentially aggravate health problems, particularly mental health. The current research aimed to nationally analyze whether the COVID-19 pandemic was significantly associated with behavioral health (physical activity and smoking), mental health (worrying, nervousness, hopelessness, little interest, and psychological distress score), and the perception of overall well-being among informal caregivers in the United States. Whether behavioral health could mediate mental health and overall well-being was also investigated. The Health Information and National Trends Survey (HINTS), spanning the pre-pandemic period (2017–2019) and the post-pandemic era (2020, 2022), was the data source. Weighted multivariable survey logistic regression models were employed for all outcomes. Predictors for mental health and overall well-being were behaviors, including smoking and physical activity. All models were additionally adjusted to account for sociodemographic factors. Post-pandemic, caregivers exhibited significantly higher odds of reporting “worrying” (OR = 1.43, 95% CI: 1.10-1.87, p = 0.0081) and overall unwell-being (OR = 1.33, 95% CI: 1.05-1.69, p = 0.0159). Caregivers who had insufficient physical activity compared to their physically active counterparts had higher odds of perceiving their overall well-being as diminished (OR=2.16, 95% CI: 1.65-2.82, p<0.0001). Compared to non-smokers, current smokers also had higher odds of perceiving their overall well-being as diminished (OR=1.80, 95% CI: 1.17-2.79, p=0.0077). Smoking and insufficient physical activity had significant association with all mental health issues studied here, except for insufficient physical activity for “nervous”. This research revealed that informal caregivers experienced a decline in the mental health and overall well-being in the United States following the COVID-19 pandemic. Behavioral health, including smoking and insufficient physical activity, were significantly associated with mental health and overall well-being. This research provides updated insights for policymakers on the importance of addressing the mental health and overall well-being of informal caregivers during a crisis. Tailored interventions are required to address these health issues among informal caregivers. Targeted policies are also recommended, prioritizing the behavioral health of informal caregivers to enhance their mental health and overall well-being.