Sandwich 'carers' suffer long mental health toll, study finds

A new study has found that ‘sandwich carers’ - those who care for both their children and elderly relatives - experience a significant decline in both mental and physical health over time.

The study by UCL researchers analysed data from around 2,000 sandwich carers and 2,000 non-sandwich carers collected from the UK Household Longitudinal Study between 2009 and 2020, shedding light on the health challenges faced by people juggling the dual responsibilities of raising children under 16 and caring for ageing parents or relatives.

The researchers who wanted to understand how the transition to sandwich caring affected health over time tracked the participants’ health over nine years using questionnaires that assessed mental and physical well-being before, during and after taking on caring responsibilities. Statistical models were used to compare changes in health between sandwich carers and non-sandwich carers.

Mental health was measured using scores from the General Health Questionnaire (GHQ), which assesses issues such as concentration, sleep, and feelings of strain. Physical health was assessed using a Physical Component Summary (PCS), which covers aspects such as mobility, pain and limitations in daily tasks.

The findings, published in Public Health showed that sandwich carers, especially those providing more than 20 hours of care per week, experienced a significant decline in mental health compared to non-sandwich carers. This decline was sustained over several years. Intensive carers also showed a decline in physical health during their transition into this role.

The number of sandwich carers is increasing due to factors such as increased life expectancy and women having children later in life. In the UK alone, an estimated 1.3 million people are in this situation, with the average age of a sandwich carer being 36.8 years. People aged 30-49 are most likely to take on this role.

In Kenya, although not always formally identified as sandwich carers, similar care dynamics exist. In Kenyan society, care responsibilities are deeply rooted in cultural and social norms, with individuals often expected to care for both their children and ageing parents or relatives. This dual role is compounded by economic pressures, limited access to formal elderly care services and the prevalence of intergenerational living arrangements.

Many Kenyan families live in extended households, with middle-aged adults supporting both younger and older generations simultaneously. As health care improves and life expectancy increases, more older people require long-term care, increasing the burden of caregiving. At the same time, elderly parents are often financially dependent on their adult children, adding to the dual responsibility of raising children and supporting ageing relatives.

“Our study highlights the significant mental and physical health challenges faced by sandwich carers. These individuals, who balance the demands of caring for both their children and ageing parents, often experience a decline in their well-being. It’s crucial that we recognize and support the unique needs of this growing group to ensure their health and resilience,” said Dr Baowen Xue, lead author of the study.