Health Impacts of Intergenerational Caregiving Among Pre-Retirement-Aged Adults in the United States

Abstract

This project investigates the physical health consequences of dual caregiving—simultaneously caring for children and aging parents—among U.S. adults aged 51 to 64. Grounded in the stress process model, this study leverages nationally representative longitudinal data from the RAND Health and Retirement Study (HRS) and RAND Family Files (1998–2018) to assess how dual caregiving status relates to self-rated health and the number of chronic conditions over time. Descriptive analyses tracked changes in health outcomes across 11 waves, highlighting consistent disparities between dual and non-dual caregivers, with the gap widening in recent years. Mixed-effects linear regression models were employed to evaluate these associations while adjusting for key covariates: age, gender, education, household income, employment status, and survey wave. Sensitivity analyses incorporated birth cohort as a substitute for age to account for generational health differences. Findings indicate that dual caregivers experience significantly poorer self-rated health and a higher burden of chronic disease, even after adjusting for socioeconomic and demographic factors. The effects remained robust in cohort-adjusted models, confirming the independent health risks associated with dual caregiving. These results point to a cumulative physiological toll likely driven by overlapping care demands, time scarcity, and financial stress. This research contributes to the public health literature by identifying dual caregivers as a distinct, high-risk population within the broader context of aging and caregiving in the United States. Policy implications include the urgent need for expanded access to paid family leave, workplace flexibility, and caregiver health monitoring—supports currently available in only 13 states. Interventions tailored to the unique pressures of dual caregiving could reduce health disparities and support aging-in-place strategies for both caregivers and care recipients.