title: The relationship between informal caregiving and mortality: an analysis using the ONS Longitudinal Study of England and Wales.
abstract: BACKGROUND
  Many studies have suggested that caregiving has a detrimental impact on health. However, these conclusions are challenged by research which finds evidence of a comparative survivorship advantage, as well as work which controls for group differences in the demand for care.
  
  
  METHODS
  We use a large record linkage study of England and Wales to investigate the mortality risks of carers identified in the 2001 Census. The analysis focuses on individuals aged 35-74 living with others in private households and a distinction is made between those providing 1-19 and 20 or more hours of care per week. Logit models identify differences in carers' health at baseline and postcensal survival is analysed using Cox proportional hazards models.
  
  
  RESULTS
  12.2% of study members reported providing 1-19 h of care and 5.4% reported providing 20 or more hours. While carers were significantly more likely to report poorer health at baseline, survival analyses suggested that they were at a significantly lower risk of dying. This comparative advantage also held when the analyses were restricted to individuals living with at least one person with poor health.
  
  
  CONCLUSIONS
  The comparative mortality advantage revealed in this analysis challenges common characterisations of carers' health and draws attention to important differences in the way carers are defined in existing analyses. The survival results are consistent with work using similar data for Northern Ireland. However, the study also affords more uniform conclusions about carers' baseline health and this provides grounds for questioning existing hypotheses about the reasons for this advantage.
authors.affiliation: Department for Epidemiology and Public Health, University College London, London, UK. susanramsay@gmx.co.uk
authors.forename: Susan
authors.initials: S
authors.lastname: Ramsay
authors.forename: Emily
authors.initials: E
authors.lastname: Grundy
authors.forename: Dermot
authors.initials: D
authors.lastname: O'Reilly
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D004739:England / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology; D016019:Survival Analysis; D014852:Wales / Q000453:epidemiology
keywords: Ageing; Mortality; Record Linkage