Unseen Impact: How Unpaid Caregiving Shapes Health and Lives

Caregiving can be a rich and complex experience that is both rewarding and challenging. Enrico Pfeifer (@EnricoPfeifer1), a PhD Candidate at University College London, knows this first-hand. Today, he explores his doctoral research on the impact that caregiving can have on people’s health, and how we can support caregivers to stay healthy.

Imagine someone very dear to you: your spouse, parent, child, or a close friend. Now, imagine that this loved one suddenly falls ill due to an accident, stroke, cancer diagnosis, or perhaps you give birth to a disabled child. Without a second thought, you step into the role of their caregiver. You’re not trained for this, you won’t be paid, and you do it all while balancing the rest of your life.

While this might seem like an overwhelming challenge, it’s the reality for over 4.3 million people in the UK who become unpaid carers every year. And while caregiving can be deeply rewarding, the emotional and physical toll can be heavy. In fact, studies show unpaid caregivers tend to have shorter lives and are more likely to become ill themselves.

The question is: why?

As someone who was a young unpaid caregiver myself, I can tell you first-hand that caregiving may change everything—from your daily routine to how you prioritise your health. But how exactly does caregiving impact health behaviours, and do those effects persist once caregiving ends? These are the questions driving my PhD research, which investigates how caregiving alters lifestyles over time, using large-scale UK data.

A Personal Connection to My Research

I know the strain of caregiving because I’ve lived it. Becoming a carer at a young age meant making difficult trade-offs - school, social activities, and personal time often took a backseat. But it was the effect on my own health behaviours that intrigued me the most. I started noticing patterns in myself and others: some carers turned to smoking or alcohol as coping mechanisms, while others adopted healthier habits, perhaps motivated by a desire to stay strong for their loved one.

It was this lived experience that inspired me to study the intersection of caregiving and health. As I transitioned into academia, I realised that, despite advancements in health research, we still don’t fully understand how caregiving affects a person’s health behaviours over time.

In a world where we’ve flown to the moon, why don’t we know how caregiving impacts people’s lifestyle choices?

The Complexity of Studying Caregivers

Caregivers, by their very nature, are difficult to study. Their lives are busy and complex, and their caregiving responsibilities fluctuate over time. Most research on caregivers focuses on a single point in time, making it hard to capture how behaviours might shift before, during, and after caregiving.

That’s where my research steps in. I’m analysing longitudinal data from “Understanding Society,” the UK’s largest household study, which follows 40,000 households over time. This rich dataset allows me to explore the long-term effects of caregiving on health behaviours like smoking, drinking, diet and physical activity.

It’s not without challenges - real-life data isn’t as neat and tidy as a controlled lab study. But by using ‘fancy’ statistical methods, like propensity score matching and piecewise growth curve models, I can track these behaviour changes over time and compare caregivers with similar non-caregivers.

What I’ve Discovered So Far

My research has already yielded some surprising and important findings. For example, it shows that when people became unpaid carers, they were more likely to start or continue smoking. Unfortunately, even when caregiving ended, they weren’t any more likely to quit. On the flip side, those providing high-intensity care—20 or more hours per week—were less likely to engage in problematic drinking than other carers.

And then there’s physical activity: people who became caregivers in my study became more physically active and the question is now whether this is because caregiving involves physical tasks, or whether caregivers use physical activity as respite from caring? It seems that while caregiving may introduce certain health risks, it also has the potential to encourage healthier behaviours, at least in some respects.

Why This Matters

These findings bring us closer to understanding how caregiving impacts health behaviours across different stages of life. But this is more than just an academic exercise - it’s about developing real-world solutions that can support caregivers’ health, as well as the wellbeing of those they care for.

The fact that high-intensity caregivers are less likely to be problematic drinkers, for instance, suggests that caregiving might act as a protective factor in some cases. However, the increase in smoking during caregiving highlights the need for targeted interventions to help caregivers manage stress in healthier ways.

Care for the Carers

At the end of the day, unpaid caregivers are the backbone of health and social care systems across the world. They provide essential support to loved ones, often at great personal cost. My hope is that my research will help shine a light on the challenges they face - especially when it comes to their own health- and inform policies that better support caregivers.

We must ensure that while they care for others, caregivers also receive the support they need to stay healthy. After all, their wellbeing is crucial not only for their own lives but for the lives of the people they care for.

Unpaid caregivers do more than provide physical and emotional support. They shape the health of our communities. It’s time we recognise the full impact of caregiving and invest in the health of those who give so much of themselves for others.

Moderator: Molly Saunders (@mollyess22)