Published: 25 November 2021
On Carers Rights Day (25 November 2021), new research by Public Health Wales’ Research and Evaluation Division and Swansea University, has found that unpaid carers have markedly poorer health than the general population in Wales; but that being in paid, secure employment and/or education whilst caring for others is associated with higher wellbeing amongst unpaid carers.
At the peak of the COVID-19 pandemic, it was estimated that there were over 700,000 unpaid carers in Wales, an increase from approximately 400,000 in 2019. However, due to the lack of a systematic data collection on unpaid carers, it is difficult to know the true number of unpaid carers in Wales, and to have a full understanding of their health needs.
The research carried out by Public Health Wales and Swansea University addressed this challenge by bringing together anonymous primary care data and the National Survey for Wales. The team were able to identify over 62,000 unpaid carers in Wales over the period 2011 to 2020, and describe the health of this group
Key findings include;
The proportion of individuals diagnosed with a long-term condition was higher amongst unpaid carers compared to non-carers, across 36 different conditions studied.
Anxiety and/or depression was the most commonly diagnosed long-term condition in both unpaid carers and non-carers, but was 1.8 times higher in unpaid carers.
Others conditions with a higher rate among unpaid carers than non-carers included, musculoskeletal disorders, cancer, constipation and irritable bowel syndrome.
Amongst unpaid carers, higher rates of anxiety and/or depression, epilepsy, irritable bowel syndrome and musculoskeletal disorders were amongst young carers.
Over three in 10 unpaid carers in Wales were living with multiple long-term conditions. Unpaid carers were also more likely to be managing multiple conditions at a younger age.
The association between caring and poor health was evident irrespective of deprivation. Within the least deprived communities, carers were 1.8 times more likely to be living with multiple long-term conditions compared to non-carers. Within the most deprived communities, this was similar, at 1.6 times higher amongst carers.
Unpaid carers can include those who care full or part time for others. In the second study, we sought to further understand the impact of hours of caring on self-reported mental wellbeing and the impact of employment and/or education whilst caring for others. Key findings were:
Overall, mental wellbeing decreased as the number of hours caring (caring intensity) increased.
Female carers were likely to provide higher intensity care than males, and were more likely to experience negative impacts of caring on self-reported mental wellbeing.
In the oldest age group (65+ years), those who provided high intensity care reported poorer mental wellbeing compared to those providing low intensity care.
Whereas, amongst the youngest unpaid carers (16 - 44 years) the impact on mental wellbeing was worse for those providing moderate intensity care, compared to low intensity care.
Unpaid carers who were not in employment and those with low level of education reported significantly lower mental wellbeing compared to unpaid carers in employment or with a high level of education.
Jiao Song, Principle Statistician at Public Health Wales, said: “Our findings provide in depth understanding of health amongst unpaid carers in Wales, particularity how different groups may be disproportionately affected by poor mental wellbeing, and how that differs by level of caring intensity, educational attainment and employment status. These findings can be used to help inform actions across sectors to improve unpaid carers’ wellbeing. This includes the importance of understanding and supporting carers health needs, and addressing barriers to entry and retention into education and good, fair employment.”
Alisha Davies, Head of Research and Development at Public Health Wales, said:
“These studies provide valuable information on the health of unpaid carers in Wales, but a key challenge remains the lack of routinely collected data on caring status over time. This limits our ability to fully understand the positive and negative impact of caring, on unpaid carers’ health and wellbeing, alongside the effects of socioeconomic factors including education and employment, across a life course. Approaches on how to best capture routine data on unpaid carers are needed to help ensure the generation of insights at the right time to support local and national action”.
The Deputy Minister for Social Services, Julie Morgan said: “The physical and emotional impact of caring can be overwhelming and it is vital we support unpaid carers in looking after their own health and wellbeing. These studies by PHW will help us all to improve outcomes for unpaid carers and increase wellbeing, educational attainment and employment opportunities.”
Claire Morgan, Director of Carers Wales, said:
“The use of an e-cohort of carers in this research, which we were pleased to support, has added an important new dimension to our understanding of the negative health and wellbeing impacts on this group. There is a clear association between being an unpaid carer and poor health, irrespective of deprivation levels, while being able to access employment or education alongside caring improves wellbeing. The social care system in Wales could not function without unpaid carers, so their health and wellbeing must be a national priority. We need to see investment to restore community services that carers rely on, wider adoption of flexible working practices that support carers to remain in employment and better systematic data collection so the needs of carers can be understood and addressed sooner.”