Background Increasing life expectancy is leading to an increasing number of older people in need of some form of care and the UK relies on adult children to provide much of this care. The simultaneous provision of care to both children and adults, ‘sandwich care’ occurs in mid-life, often alongside employment commitments. This form of care may be particularly stressful, yet little is known about it. This study investigates the impact on physical and mental health of taking up adult care amongst parents of children under age 16, as well as whether these associations vary by gender of sandwich carer or caregiving intensity.

Data This study uses ten waves of the UK Household Longitudinal Study, a large, nationally representative panel study in the United Kingdom. Data were collected annually between 2009–2020.

Methods Mental health was measured using the 12-item General Health Questionnaire (GHQ-12) and the mental health component of the 12-item Short Form Survey (SF-12 MCS) while physical health was measured using the SF-12 physical component (PCS), all as continuous measures. We use propensity score matching to match each caregiver with one non-caregiver with similar characteristics and then employ linear piecewise growth curve modelling to model the trajectories in physical and mental health before and after becoming a caregiver. Predicted levels of mental and physical health with 95% confidence intervals are shown for every year up to eight years before and up to nine years after becoming a caregiver, comparing caregivers and matched non-caregivers. Models are shown, first pooled, then stratified by gender and weekly caregiving hours. N = 2,976

Results We find that uptake of adult care is associated with a deterioration in mental health for mothers on both mental health indicators. This was a dose-response association with levels of distress increasing with increasing number of weekly care hours. For mothers, physical health worsened with uptake of adult care, but only for those caring 10+ house/week. For fathers symptoms of psychological distress on the GHQ increased with uptake of adult care, but only for those caring for 10+ hours/week. Physical health of fathers declined in the lead up to caregiving as well as with the uptake of care, particularly for those caring 10+ hours/week. There was no association between care and the SF-12 MCS for fathers.

Conclusion Targeted support is required for the portion of parents who are also providing adult care for at least ten hours per week.