The European Journal of Public Health Advance Access published online on April 16, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp045
Caring, employment and health among adults of working age: evidence from Britain and Belgium
Maria-Isabel Farfan-Portet1, Frank Popham2, Richard Mitchell3, Christian Swine1 and Vincent Lorant1
1 Institut Santé et Société, Université Catholique de Louvain, Brussels, Belgium
2 School of Geography and Geosciences, University of St Andrews, Scotland, UK
3 Public Health and Health Policy, University of Glasgow, Scotland, UK
Correspondence: Maria-Isabel Farfan-Portet, Institut Santé et Société, Université Catholique de Louvain, Clos Chapelle au Champs 30.41, B-1200 Brussels, Belgium, tel: ++32 2 764 3098, fax: ++32 2 764 3021, e-mail: maria.farfan{at}uclouvain.be
Received July 11, 2008 , accepted March 17, 2009
Background: For those of working age, results are inconclusive when exploring the health impact of providing care. Moreover, population data is lacking and the impact of welfare policies on the caregivers’ health has not been yet analysed. Methods: Associations between general health and care giving, adjusting for differences in employment and socio-economic position, were explored for working age adults using logistic regression models. Data came from the 2001 British census (n = 1 361 222, 5% sample) and from the 2001 Belgian census (n = 4 368 637). The final model was stratified by employment status, given the significant interaction between caregiving and employment status. Results: In both countries, when compared with those providing no care, men and women providing 
20 h of care per week had an increased risk of poor health. This increased risk was attenuated after adjustment for socio-economic position and particularly after adjustment for differences in employment status. However after stratifying by employment status, a dose response relationship between time spent caring and poor health was observed for the employed and unemployed, but not for the economically inactive. Conclusions: Despite contrasting welfare systems, employment status plays an important role in the association between caring and health in both countries. For the economically active, providing more care increases the risk of poor health. Whilst formal employment may be good for general health, having to informally care whilst in formal employment may have a detrimental health impact.
Keywords: caregiver, self-reported health, socio-economic factors