Healthcare coverage and utilization among caregivers in the United States: Findings from the 2015 Behavioral Risk Factor Surveillance System.

Purpose/Objective: Caregivers are vital to our health care system and its sustainability, yet extensive literature has recognized caregivers’ vulnerabilities for experiencing financial, physical, and emotional difficulties—compromising the sustainability of their services. The risks associated with being a caregiver are not well-defined and warrant further exploration to guide national health initiatives underway. This brief report sought to identify risks that may be associated with the wide-ranging secondary effects of being a caregiver. Specifically, health care coverage and utilization were compared between caregivers and noncaregivers in a large national sample. Method: A cross-sectional study design was used with data from the 2015 Behavioral Risk Factor Surveillance System. Risk ratio analyses were conducted to assess how many times more likely unpaid adult caregivers were for experiencing specific risks related to health care access, relative to noncaregivers. Results: Caregivers (n = 24,034; 64.5% female; 69.6% preretirement age) were more at risk for lacking health care coverage and underutilizing needed health care service due to cost, when compared to noncaregivers (n = 84,412; 57.3% female; 61.8% preretirement age). Caregivers were also at an increased risk for lifetime diagnosis of a depressive disorder and activity limitations due to a health challenge. Conclusions: Our findings highlight the need for the development of low-cost and accessible clinical services available to caregivers. Rehabilitation psychology can offer unique and instrumental contributions for addressing this growing population’s health care needs by informing disability-focused public health agendas and incorporating caregivers into rehabilitation programs for care recipients. (PsycINFO Database Record (c) 2020 APA, all rights reserved) Impact and Implications: Caregivers provide valuable services that benefit individuals with disabilities and society as a whole; however, despite identification as a population of interest in current public health initiatives in the United States, few studies have examined factors that influence health care access and utilization among caregivers at the population level. This study contributes to the literature by providing preliminary analysis of epidemiological data, specifically examining for potential differences between caregivers and noncaregivers with regard to health care coverage and financial barriers to health service utilization. The findings indicate that caregivers may be at a greater risk for lacking health care coverage and not accessing needed health care services due to costs—both of which have been shown to be determinants of adverse health outcomes. (PsycINFO Database Record (c) 2020 APA, all rights reserved)