Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Joan Monin

Second Advisor

Becca Levy



Purpose of the study: To examine gender and caregiving network differences in the care provided to older adults by adult children and the association with care-recipients’ physical and mental health at baseline and longitudinally. To test the hypothesis that poorer health at baseline and better health over time will be observed in care-recipients with multiple caregivers compared to care-recipients with one caregiver.

Design and Method: A secondary analysis of the most recent national cross sectional survey – National Health and Aging Trends Study (NHATS) conducted from 2011 to 2013 with 5616 older adults (65 years of age or older). The relationships between gender and caregiving network of adult child caregivers and the duration of care, type of care provided, care-recipients’ physical and mental health (self-reported health status, total number of chronic diseases, depression and anxiety) were analyzed by bivariate procedures and non-parametric tests. The longitudinal effects of gender and caregiving network of adult child caregivers on the physical and mental health of care-recipients were analyzed through multivariate procedures.

Result: Daughters are more likely to serve as caregivers than sons. Primary caregivers who cooperate with other caregivers providing care to the care-recipients spend more hours of care compared to sole caregivers who are the only caregiver for the care-recipients. Care-recipients with multiple caregivers have poorer health compared to those with one caregiver at baseline and longitudinally.

Implication: Older adults who have poorer health require more hours of care that provided by multiple caregivers. More research is needed to understand the optimal caregiving network to improve or maintain older care recipients’ health.

Key words: adult child caregiver, gender difference, caregiver network, primary caregiver, physical health, psychological health

Acknowledgements: I would like to thank Dr. Joan Monin and Dr. Becca Levy of Yale School of Public Health for their time spent and guidance in this project. Also, I would like to thank research staffs and study participants in NHATS study for their contribution to the data source in this project.


This is an Open Access Thesis.

Open Access

This Article is Open Access