Analysis of Correlates and Trends in Caregivers’ Mental Health Pre- and COVID-Onward From the HINTS, 2018-2022

Abstract Objectives To compare correlates of mental distress among caregivers versus non-caregivers, and evaluate trends in caregivers’ mental distress pre- versus COVID-onward. Methods This cross-sectional study used nationally representative data from multiple cycles of the Health Information National Trends Survey (2018 to 2022; n = 15,318). We characterized sociodemographic, health, and caregiving characteristics and estimated logistic regression models evaluating correlates of mental distress among the full sample and pre- and COVID-onward. Results Caregivers reported a higher mean PHQ-4 score than non-caregivers overall (|t|=2.88, p<.01). Caregiving status was significantly associated with mental distress pre-COVID (OR = 1.47; 95%CI=1.13-1.92; p<.01) and COVID-onward (OR = 1.51; 95%CI=1.01-2.26; p<.05). Being in fair or poor health status was associated with a higher likelihood of mental distress pre-COVID (OR = 2.58, 95%CI=1.31-5.09, p < 0.01) while having a college education or higher was associated with a lower likelihood of mental distress COVID-onward (OR = 0.46, 95%CI=0.21-0.99, p< .05). Conclusions Caregiving status continues to be a significant risk factor for mental distress. Factors significantly associated with mental distress among caregivers change over time. Findings suggest the COVID-19 pandemic may continue to present risks to caregivers’ mental wellbeing, requiring development and implementation of policies and programs to address caregiver mental health.