Differences by ethnicity in the association between unpaid caring and health trajectories over 10 years in the UK Household Longitudinal Study.

Background: Unpaid carers deliver critical social care. We aimed to examine differences by ethnicity in (1) profiles of unpaid caring and (2) associations between caring and physical and mental health trajectories.

Methods: We used 10 waves of data from 47 015 participants from the UK Household Longitudinal Study (2009-2020). Our outcomes were 12-item Short Form Health Survey physical and mental component scores. We performed bivariate comparison of profiles of caring by ethnicity. We used multilevel linear mixed effects models to estimate associations between caring and health trajectories and assess for heterogeneity by ethnicity.

Results: We found that caring profiles differed by ethnicity. The proportion caring for someone within their household ranged from 39.7% of White carers to 70.1% of Pakistani and 74.8% of Bangladeshi carers. The proportion providing 20+ hours/week of care ranged from 26.9% of White carers to 40.6% of Pakistani and 43.3% of Black African carers. Ethnicity moderated associations between caring and physical but not mental health trajectories (test for interaction: p=0.038, p=0.75). Carers showed worse physical health compared with non-carers among Black African (-1.93; -3.52, -0.34), Bangladeshi (-2.01; -3.25, -0.78), Indian (-1.30; -2.33, -0.27) and Pakistani carers (-1.16; -2.25, -0.08); Bangladeshi carers' trajectories converged with non-carers over time (0.24; -0.02, 0.51). White carers showed better baseline physical health than non-carers (0.35; 0.10, 0.60), followed by worsening trajectories versus non-carers (-0.14; -0.18, -0.10).

Conclusions: There are differences by ethnicity in profiles of caring and associations between caring and physical health trajectories. Future research should account for ethnicity to ensure applicability across groups.