Gender, Spousal Caregiving, and Depression: Does Paid Work Matter?
| Date | 01 April 2018 |
| Author | Rebecca Glauber,Melissa D. Day |
| Published date | 01 April 2018 |
| DOI | http://doi.org/10.1111/jomf.12446 |
R G M D. D University of New Hampshire
Gender, Spousal Caregiving, and Depression: Does
Paid Work Matter?
Studies have shown that spousal caregiving
leads to psychological distress, but few have
analyzed the moderating effect of paid work.
Using the 2000 to 2012 Health and Retirement
Study and two-stage least squares regres-
sion models, this study found that caregiving
increased women’s and men’s depressive symp-
toms. Ordinary least squares models showed
that caregiving had more adverse effects on
women’s mental health than on men’s, but
these differences were eliminated in two-stage
least squares models that accounted for the
bidirectional effects of depression and care-
giving. The current study also found that for
women, part-time work attenuated the depres-
sive effect of spousal caregiving, whereas for
men, part-time work exacerbated it. These
gender differences persisted even for intensive
spousal caregivers. The authors suggest that
caregiving women who work part-time may
benet from work-related resources. Caregiving
men who work part-time, however, may feel
distressed, as their work–family experiences
conict with traditional gender norms.
The United States has a rapidly aging popu-
lation and relatively few public programs that
provide long-term care to older individuals
(Kemper, Komisar, & Alecxih, 2005/2006). The
Department of Sociology, Universityof New Hampshire,
15 Academic Way,Durham, NH 03824
(rebecca.glauber@unh.edu).
KeyWords: aging, caregiving,depression, gender, marriage,
work, work–family issues.
vast majority of those who need care turn to
their family and friends. Of married people,
80% provide care to a spouse at some point
during their life (Lima, Allen, Goldscheider, &
Intrator, 2008). Spousal caregivers report more
emotional, physical, and nancial burden when
compared with other caregivers, such as those
who care for their elderly parents. They expe-
rience greater isolation and less help (Pinquart
& Sörenson, 2011). Women are more likely
than men to care for their spouses, and spousal
caregiving also appears to take a larger toll on
women’s mental health (e.g., Lavela & Ather,
2010; Y. Lee & Tang, 2013; Pinquart & Sören-
son, 2006, 2011). Our study explores the gen-
dered tensions among work, family, and mental
health. We pose the following research ques-
tions: Does paid work exacerbate or attenuate the
depression associated with spousal caregiving?
Do the effects differ for men and women?
Some studies have explored the effect of
spousal caregiving on mental health (e.g., Bur-
ton, Zdaniuk, Schulz, Jackson, & Hirsch, 2003;
Dunkel et al., 2014; Jenkins, Kabeto, & Langa,
2009; Marks, Lambert, & Choi, 2002). Other
studies have explored the effect of caregiving
on work (e.g., Barnett, 2013, 2015; Carr & Kail,
2013; Chumbler, Pienta, & Dwyer, 2004; Y. Lee
& Tang, 2013; Marks, Lambert, Jun, & Song,
2008). Still other studies have explored the
effect of work on mental health (e.g., Pavalko
& Smith, 1999). Fewer studies have analyzed
the relationships among all three, including
work, spousal caregiving, and mental health.
This is a signicant omission that prevents us
from fully understanding the complexities of
Journal of Marriage and Family 80 (April 2018): 537–554 537
DOI:10.1111/jomf.12446
538 Journal of Marriage and Family
and constraints on older women’s and men’s
lives. As life expectancy increases and older
workers continue to represent a larger share
of the workforce (Toossi, 2013), there is an
increased likelihood that individuals will com-
bine paid work with spousal caregiving in later
life. Numerous studies have shown that the
mental health effects of caregiving differ for
women and men (Dunkel et al., 2014; Lavela
& Ather, 2010; Pinquart & Sörenson, 2006;
Raschick & Ingersoll-Dayton, 2004).
The current study broadens this body of
research by showing that the gendered mental
health effects of caregiving cannot be under-
stood without also looking at women’s and
men’s paid work. Coworkers may provide
caregivers with emotional support, comfort,
and sympathy as well as instrumental support,
such as help sifting through information and
resources. Work may also provide a distraction
from the challenges of family life. Many people
nd work less stressful than home (Damaske,
Smyth, & Zawadzki, 2014; Hochschild, 1997),
and some have argued that work has become
“the new neighborhood” (Dahlin, Kelly, &
Moen, 2008). At the same time, numerous
studies have shown that work and family vie
for women’s and men’s time (Blair-Loy, 2003;
Damaske, 2011; Greenhaus & Beutell, 1985;
Hochschild, 1989; J. Williams, 2001; Winslow,
2005). In this way, paid work may deplete care-
givers’ energy and exacerbate psychological
distress (Marks et al., 2008; Moen, Robison, &
Fields, 1994; J. A. Lee, Walker, & Shoup, 2001;
Pavalko & Woodbury, 2000; Utz, Lund, Caserta,
& Wright, 2012). A gendered life course per-
spective would lead us to expect that the cultural
contexts and gendered experiences of caregiving
matter (Chesley & Moen, 2006; Moen, 2001;
Moen et al., 1994; Moen, Dempster-McClain, &
Williams, 1992; Moen, Lam, & Jackson, 2014).
In the contemporary United States, caring for
family members is associated with femininity.
Women who care for their husbands engage in
culturally appropriate behavior. Men who care
for their wives, however, behave in ways that are
partially at odds with traditional gender norms
(Townsend, 2002).
Using data from the Health and Retirement
Study (HRS) and a sample of 28,431, we nd
that for women, part-time work attenuates the
depression associated with spousal caregiving,
whereas for men, part-time work exacer-
bates caregiving-related depression. These
ndings suggest that caregiving women who
work part-time time may benet from various
work-related resources without experiencing
intense work–family conict. Caregiving men
who work part-time, however, may experi-
ence greater distress because both their work
and family experiences are inconsistent with
traditional gender norms.
B
Spousal Caregiving, Gender, and Mental Health
Although spousal caregiving may be a labor of
love, it is also a chronic stressor. Spouses and
partners tend to provide around-the-clock care
that can range from bathing and personal assis-
tance to complex medical procedures such as
administering injections. Individuals who care
for their spouses spend more time caregiving and
receive less help from others when compared
with those who care for their elderly parents.
Lavela and Ather (2010) argued that when com-
pared with noncaregivers, spousal caregivers
experience “worse cognitive functioning, poorer
mental health, have higher levels of emotional
caregiver strain, stress/distress, loneliness, and
depressive/anxious symptoms” (p. 74). Many
other studies have shown that spousal caregiving
has detrimental effects on caregivers’ health and
well-being (e.g., Burton et al., 2003; Cannuscio
et al., 2002; H. Choi & Marks, 2006; Dunkel
et al., 2014; Lavela & Ather, 2010; Marks et al.,
2002; Schulz & Beach, 1999).
Women receive less caref romt heir husbands
than husbands do from their wives (Allen, Gold-
scheider, & Ciambrone, 1999; Katz, Kabeto,
& Langa, 2000; Spitze & Ward, 2000). In the
United States, this gender disparity may par-
tially stem from deep-seeded cultural norms
that assign caregiving and family responsibil-
ities to women and nancial breadwinning to
men. In recent decades, women have increased
their labor force participation, and men have
increased their share of housework, but gender
disparities in families persist (England, 2010;
Gerstel & Gallagher, 2001; Hochschild, 1989;
Sarkisian & Gerstel, 2004; Sayer, 2005).
Most studies have found that when com-
pared with men, women experience more
adverse effects from spousal caregiving, includ-
ing depression, anxiety, stress, and loneliness
(Dunkel et al., 2014; Lavela & Ather, 2010;
Pinquart & Sörenson, 2006; Raschick &
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