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Race Differences in Characteristics and Experiences of Black and White Caregivers of Older Americans
Open accessAbstract
Background and Objectives: Racial disparities in health and socioeconomic characteristics of older adults have implications for the experiences of their family and unpaid caregivers, but knowledge to date has primarily drawn from convenience samples. Using a population-based sample, we examine associations between caregiver race and caregiving-related effects. Research Design and Methods: Study participants include white (n = 992) and black (n = 556) respondents to the 2015 National Study of Caregiving who assisted community-dwelling older adults with disabilities who participated in the National Health and Aging Trends Study. Guided by Pearlin’s Stress Process Model, hierarchical logistic regression models were constructed to examine race differences in caregiving-related effects after adjusting for caregiving context, stressors, and resources. Results: Relative to white caregivers, blacks more often provided in excess of 40 hr of care per week (54.3% vs 38.6%) and more often cared for an older adult with dementia (27.1% vs 20.7%) who was living below the federal poverty line (31.7% vs 11.9%) or was Medicaid-eligible (42.2% vs 11.8%). Black caregivers more often used supportive services (32.9% vs 24.8%). In fully adjusted regression models, black caregivers were more likely to report gains and less likely to report emotional difficulty than whites. Service utilization did not attenuate caregiving-related emotional difficulty or participation restrictions, regardless of race. Discussion and Implications: Findings highlight caregiving disparities and counterintuitive differences in experiences and indicate the importance of identifying supports such as paid family leave and faith and community-based programming to better support community-dwelling low-income older adults and their family and unpaid caregivers.
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“Black dementia caregivers are also more likely to provide help with ADLs than White dementia, White non-dementia, and Black non-dementia caregivers.420,421”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [420]
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“Black dementia caregivers are also more likely to provide help with ADLs than White dementia, White non‐dementia and Black non‐dementia caregivers.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [454]
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“For example, Black caregivers are more likely than White caregivers to report positive aspects of caregiving.420”
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“Our findings are novel, as few studies have examined racial differences in paid help as well as subsequent health outcomes (Fabius et al., 2018, 2020).”
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Patterson, S., Tate, A. M., Hu, Y., Wang, J., Schoeni, R. F., & Choi, H. (2022) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbac146 · Cited by 19
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“Previous studies have found that minority informal caregivers tend to spend more hours caregiving than their White counterparts (Cohen et al., 2019; Fabius et al., 2020), which in turn may impact both health status and fi nancial strain (Whitney et al., 2023).”
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The positive impact of informal spousal caregiving on the physical activity of older adults
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“This is supported by the data showing that a higher percentage of non-white caregivers are adult children compared to white caregivers (75, 76).”
ResultPerceived loss of support to community caregivers during the COVID‐19 pandemic in the United States
Kennedy, D. P., Friedman, E. M., Kirkegaard, A., Edgington, S. E., & Shih, R. A. (2024) · Journal of Community Psychology · doi:10.1002/jcop.23107 · Cited by 5
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“We followed the steps recommended in prior research (Fabius et al., 2020; Wolff et al., 2016) to create four separate variables that represent restriction in each of the four social activities (0 = no restriction, 1 = participation restriction).”
Lampe, N. M., Desai, N., Norton‐Brown, T., Nowakowski, A. C. H., & Glueckauf, R. L. (2022) · The Qualitative Report · doi:10.46743/2160-3715/2022.4917 · Cited by 5
Tele-Savvy Outcomes of Non-Hispanic Black American and White Caregivers
Johnson, K. B., Higgins, M. K., Epps, F. R., Brewster, G. S., Alexander, K. L., & Hepburn, K. W. (2023) · The Gerontologist · doi:10.1093/geront/gnad044 · Cited by 5
Home‐ and Community‐Based Service Use Among Veterans: The National Landscape
Miller, K. E. M., Price, M., O'Malley, K., Song, S., & Garrido, M. M. (2025) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19492 · Cited by 4
Robinson, A., Wayoe, T., Deakin, R. L., & Richardson, C. L. (2025) · Health Expectations · doi:10.1111/hex.70426 · Cited by 4
Stokes, J. E., Kindratt, T. B., Antonucci, T. C., Cox, C. G., & Choi, H. (2023) · Journal of Aging and Health · doi:10.1177/08982643231201547 · Cited by 4
“However, members of racial and ethnic minority groups often have substantially fewer fi nancial resources compared to non-Hispanic White caregivers (Fabius et al., 2020; Kelley et al., 2015; S¨orensen & Pinquart, 2005), as a result of structural inequity on the basis of race and ethnicity…”
Lai, W., Nemmers, N. L., Tsuker, S., & Leggett, A. N. (2025) · The Gerontologist · doi:10.1093/geront/gnaf110 · Cited by 4
Disparities in Health Care Task Participation and Provider Communication by Family Caregiver Race
Leggett, A. N., Strominger, J., Robinson‐Lane, S. G., & Maust, D. T. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-06766-w · Cited by 4
Ramos, M. D., Spearman, J., Heath, J., Lee, D. L., & Adewuyi, M. F. (2023) · Journal of Gerontological Nursing · doi:10.3928/00989134-20230512-03 · Cited by 3
Silent Suffering: Understanding the Experiences of Black Women Caregivers of Violently Injured Men
Aguilar, N. J., Wical, W., Orozco, J., Chaudhary, M. J., Bullock, C., & Richardson, J. (2023) · Journal of the Society for Social Work and Research · doi:10.1086/725432 · Cited by 3
Vu, T. H., Quinn, M., Womack, J. A., & Monin, J. K. (2024) · Aging & Mental Health · doi:10.1080/13607863.2024.2313729 · Cited by 3
“…caregivers report receiving greater support from family and friends, more positive gains from caregiving, lower levels of depression, and lower levels of caregiver burden compared to White caregivers (American Psychological Association, 2011; Dilworth-Anderson et al., 2005; Fabius et al., 2020).”
Brady, S., Patskanick, T. R., & Coughlin, J. F. (2024) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbae042 · Cited by 3
Poteat, T., Hall, P., Adams, M. A., Gautam, D. S., Ashenden, R., & Horn, J. L. (2023) · The Gerontologist · doi:10.1093/geront/gnad103 · Cited by 4
“…and psychological benefits in relation to their caregiver role (Roth et al., 2015), Black women consistently perceive caregiving more positively than their White counterparts (Fabius et al., 2020), despite typically experiencing lower household incomes and higher burdens of care (AARP & NAC, 2020).”
BackgroundPiedra, L. M., Zhong, S., Howe, M. J. K., Compernolle, E. L., & Iveniuk, J. (2024) · Research Square · doi:10.21203/rs.3.rs-4178612/v1 · Cited by 3
“For example, Black caregivers face signi�cant disparities in caregiving intensity, economic hardship, and service accessibility (21, 22).”
Caregiving Considerations in Understanding Loneliness and Isolation
Qian, Y. (2025) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2025.04.002 · Cited by 3
Extended family relationships among older African American, Black Caribbean, and White Adults
Taylor, R. J., Xiang, X., Nguyen, A. W., & Qin, W. (2025) · Family Relations · doi:10.1111/fare.70006 · Cited by 2
Alexander, K. L., Epps, F. R., Thornton, J., Chester, M., & Miles, T. P. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1676590 · Cited by 2
From banking to bathing: the mix and shift of caregiving
Zhang, Y., Fabius, C. D., & Miller, K. E. M. (2025) · The Gerontologist · doi:10.1093/geront/gnaf273 · Cited by 2
Self-citationEmotion Work and Spousal Dementia Caregiving: Influences of Gender and Sexual Orientation
Calasanti, T., de Vries, B., Snow, S., & Geng, J. (2026) · Journal of Health and Social Behavior · doi:10.1177/00221465251398808 · Cited by 2
Howard, C. (2022) · doi:10.1093/oso/9780190074456.001.0001 · Cited by 2
Weil, J., & Karlin, N. J. (2023) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2023.07.017 · Cited by 2
Mindfulness-Based Mobile Application for African American Caregivers
Carswell, S. B., Alexander, K., Gryczynski, J., Knowlton, A. R., Abatemarco, D. J., Horodyski, A. M., & Mitchell, M. M. (2023) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-023-00366-7 · Cited by 2
“Compared to White or Asian Americans, African Americans on average spend more time and provide more informal care to family and friends in need, which likely reflects the greater burden of disease in the African American community (Fabius et al., 2020).”
Pereira-Osorio, C., Brickell, E. E., Lee, B. G., Arredondo, B. C., & Sawyer, R. J. (2024) · The Gerontologist · doi:10.1093/geront/gnae052 · Cited by 2
Lassell, R., Tamayo, V., Pena, T., Kishi, M., Zwerling, J. L., Gitlin, L. N., & Brody, A. A. (2024) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2024.1401255 · Cited by 4
Examining mental and physical distress among male informal caregivers in the US
Cooper, D. L., Simkus, A., Holtz, K. D., Wanty, N., Easter, B., & Wright, E. R. (2024) · Discover Health Systems · doi:10.1007/s44250-024-00150-1 · Cited by 2
Gelmon, S. B., Reed, J., & Dawson, W. D. (2024) · Journal of Applied Gerontology · doi:10.1177/07334648241297130 · Cited by 2
Lin, Z. (2025) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbaf038 · Cited by 2
Csillag, B., Campbell, E. M., & Zhou, L. (2025) · Academy of Management Review · doi:10.5465/amr.2023.0242 · Cited by 2
Support for Care Partners and Caregivers: 2023 Summit Session 5
Hepburn, K. W., Gaugler, J. E., Roberto, K. A., Houtven, C. H. V., Chula, R., Resendez, J., & Thomas, C. (2025) · Alzheimer s & Dementia · doi:10.1002/alz.70389 · Cited by 2
Metadata
- Authors
- Fabius, C. D., Wolff, J. L., & Kasper, J. D.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Fabius, Chanee D
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-05-13
- Volume
- 60
- Issue
- 7
- Pages
- 1244-1253
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- PMC
- PMC7491434
- OpenAlex
- W3024212446
- Cited by
- 178
- References
- 41
- Citations by year
- 2026: 20 · 2025: 42 · 2024: 34 · 2023: 22 · 2022: 43 · 2021: 16 · 2020: 1
- FWCI
- 27.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Gerontologist (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01AG047859, R01AG054004, U01AG032947)
- Topics
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Social Sciences › Life-span and Life-course Studies › Aging, Elder Care, and Social Issues
- Keywords
- racial disparities, informal caregivers, family caregiving, Black caregivers, older adults with disabilities, dementia caregiving, participation restrictions, support services, low-income elderly, Medicaid eligibility, poverty, paid family leave, community-based support programs
- MeSH terms
- Race Factors, Aged, Disabled Persons, Persons with Disabilities, Humans, United States, Caregivers, Independent Living
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