Prevalence of caregiving and high caregiving strain among late-career medical school faculty members: workforce, policy, and faculty development implications

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Abstract

Background

Nearly one-third of medical school faculty members are age 55 + . As our population ages, the prevalence of family caregiving is increasing, yet we know very little about the caregiving experiences of aging faculty members in academic medicine. Faculty caregiving responsibilities coupled with projected physician shortages will likely impact the future academic medical workforce. We examined the prevalence of caregiving, concomitant caregiving strain, general well-being, and thoughts about retirement for medical school faculty members age 55 and older.

Methods

We analyzed data from a survey of 2,126 full-time medical school faculty 55 + years of age conducted in 2017. Chi-square tests of independence and independent samples t-tests were used to examine statistical differences between subgroups.

Results

Of the 5,204 faculty members invited to complete the parent survey, 40.8% participated ( N = 2126). Most were male (1425; 67.2%), White (1841; 88.3%), and married/partnered (1803; 85.5%). The mean age was 62.3 years. Of this sample, 19.0% ( n = 396) reported providing care on an on-going basis to a family member, friend, or neighbor with a chronic illness or disability, including 22.4% ( n = 154) of the female respondents and 17.3% ( n = 242) of the male respondents. Among the caregiving faculty members, 90.2% reported experiencing some or a lot of mental or emotional strain from caregiving. Caregivers gave lower ratings of health, social and emotional support, and quality of life, but greater comfort in religion or spirituality than non-caregivers. Both caregiving and non-caregiving faculty members estimated retiring from full-time employment at age 67.8, on average.

Conclusion

These data highlight caregiving responsibilities and significant concomitant mental or emotional strain of a significant proportion of U.S. medical schools’ rapidly aging workforce. Human resource and faculty development leaders in academia should strategically invest in policies, programs, and resources to meet these growing workforce needs.

Related collections

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There is strong consensus that caring for an elderly individual with disability is burdensome and stressful to many family members and contributes to psychiatric morbidity. Researchers have also suggested that the combination of loss, prolonged distress, the physical demands of caregiving, and biological vulnerabilities of older caregivers may compromise their physiological functioning and increase their risk for physical health problems, leading to increased mortality. To examine the relationship between caregiving demands among older spousal caregivers and 4-year all-cause mortality, controlling for sociodemographic factors, prevalent clinical disease, and subclinical disease at baseline. Prospective population-based cohort study, from 1993 through 1998 with an average of 4.5 years of follow-up. Four US communities. A total of 392 caregivers and 427 noncaregivers aged 66 to 96 years who were living with their spouses. Four-year mortality, based on level of caregiving: (1) spouse not disabled; (2) spouse disabled and not helping; (3) spouse disabled and helping with no strain reported; or(4) spouse disabled and helping with mental or emotional strain reported. After 4 years of follow-up, 103 participants (12.6%) died. After adjusting for sociodemographic factors, prevalent disease, and subclinical cardiovascular disease, participants who were providing care and experiencing caregiver strain had mortality risks that were 63% higher than noncaregiving controls (relative risk [RR], 1.63; 95% confidence interval [CI], 1.00-2.65). Participants who were providing care but not experiencing strain (RR, 1.08; 95 % CI, 0.61-1.90) and those with a disabled spouse who were not providing care (RR, 1.37; 95% CI, 0.73-2.58) did not have elevated adjusted mortality rates relative to the noncaregiving controls. Our study suggests that being a caregiver who is experiencing mental or emotional strain is an independent risk factor for mortality among elderly spousal caregivers. Caregivers who report strain associated with caregiving are more likely to die than noncaregiving controls.

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Author and article information

Contributors

Kimberly A. Skarupski:

ORCID: http://orcid.org/0000-0002-6722-6181

kskarupski@jhmi.edu

Journal

Journal ID (nlm-ta): Hum Resour Health

Journal ID (iso-abbrev): Hum Resour Health

Title: Human Resources for Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1478-4491

Publication date (Electronic): 19 March 2021

Publication date PMC-release: 19 March 2021

Publication date Collection: 2021

Volume: 19

Electronic Location Identifier: 36

Affiliations

[1 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Division of Geriatric Medicine and Gerontology, School of Medicine, Epidemiology, , Bloomberg School of Public Health, Johns Hopkins University, ; Baltimore, MD USA

[2 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Division of Geriatric Medicine and Gerontology, School of Medicine, Biostatistics, Bloomberg School of Public Health; and Director, Center on Aging and Health, , Johns Hopkins University, ; Baltimore, MD USA

[3 ]GRID grid.411940.9, ISNI 0000 0004 0442 9875, Division of Geriatric Medicine and Gerontology and Executive Vice Chair, Department of Medicine, , Johns Hopkins Bayview Medical Center, ; Baltimore, MD USA

Author information

Kimberly A. Skarupski http://orcid.org/0000-0002-6722-6181

Article

Publisher ID: 582

DOI: 10.1186/s12960-021-00582-3

PMC ID: 7980543

PubMed ID: 33740994

SO-VID: f85f5db4-441b-4463-9bed-2e122019258c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 30 December 2020

Date accepted : 8 March 2021

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: caregiving,faculty development,academia,workforce

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: caregiving, faculty development, academia, workforce

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