PARENTS OF CHILDREN WITH HEALTH PROBLEMS: HOW DOES THEIR HEALTH CHANGE OVER TIME?

Purpose:  The literature on the health of parents of children with health problems is mixed as to how their health should change over time, with hypotheses suggesting that it should a) decline faster over time, or b) actually improve over time compared to caregivers of healthy children. Canadian population-based data were used to examine changes over a 10-year time period in the health of caregivers of children with increasingly complex health problems compared to caregivers of healthy children.

Method:  The Canadian National Longitudinal Study of Children and Youth provided data collected biennially from 9401 children and their caregivers over six data cycles between 1994/5 and 2004/5. Linear and logistic growth curve analyses were used to model two outcomes: self-reported general health, based a single item reported on a 5-point scale ranging from 1 (poor) to 5 (excellent), and number of depressive symptoms, based on a shortened version of the Center for Epidemiological Studies Depression Scale (CES-D). The sample was divided into four groups of caregivers: caregivers of Healthy children, and caregivers of children with 1, 2, or 3 or more of four conceptually distinct indicators of child health problems. Modeled covariates included child (age, gender and only child status) and caregiver variables (age, gender, education, income, marital status).

Result:  Models showed that after controlling for covariates, caregivers of children with more severe health problems were less likely than caregivers of healthy children to report good general health (Healthy child group: 76.9%; 3+ indicators group 60.7%, p < .001) and reported more depressive symptoms (Healthy: 4.2/36; 3+ indicators: 7.1/36, p < .001). The size of this caregiver health effect varied according to complexity of child health problems (overall =100.20, df=3, p<.0001). Over the 10-year time period, there was a consistent 25% reduction in the percentage of respondents self-reporting good health for all four groups.

Conclusion:  The caregiver health decrement associated with having a child with a health problem is relatively stable over time, can persist for many years, and is greater with more complex child health problems. Increased awareness of these patterns should inform providers and policy-makers in their decisions about how to serve these families.