Caregiving transition trajectories and health behaviours: a latent class analysis of the UK Household Longitudinal Study
- 1University College London
Abstract
BackgroundUnpaid caregiving is a recognised social determinant of health, yet most research treats it as a fixed exposure measured at a single time point, and little is known about how patterns of caregiving transitions relate to health behaviours.
MethodsSecondary analysis of the UK Household Longitudinal Study (waves 2-13, approximately 2010-2023; n=25,049). Latent class analysis was applied to binary caregiving status across 12 waves to identify caregiving trajectories. Associations between trajectories and four health behaviours (physical inactivity, fruit and vegetable consumption, problematic drinking, current smoking) at waves 7 to 13 were estimated using logistic and linear regression, adjusting for sociodemographic, health and baseline behavioural confounders.
ResultsAn eight-class solution identified a non-caregiving class comprising 62.9% (n=15,760) of the sample. Among caregivers (n=9,289), trajectories were Temporary (20.0%), Former-short (20.2%), Former-long (10.9%), Emerging-short (15.4%), Emerging- long (11.6%), Long-term (15.7%) and Recurrent (6.3%). In fully adjusted models, Recurrent caregivers had higher odds of smoking (OR=1.67, 95%CI: 1.17 to 2.40) compared with non- caregivers but lower odds of physical inactivity (OR=0.65, 95%CI: 0.53 to 0.81) and problematic drinking (OR=0.75, 95%CI: 0.59 to 0.94). Associations for other trajectory classes were largely attenuated after adjustment.
ConclusionThe pattern and timing of caregiving transitions are an under-explored dimension of the caregiving experience. Recurrent caregivers had a distinctive profile, with elevated smoking but lower physical inactivity and problematic drinking. Recurrent caregiving should be recognised alongside intensity and duration, and support systems better equipped for people who move into and out of care repeatedly.
What is already known on this topicO_LIUnpaid caregiving has been linked to adverse health outcomes, but most studies treat caregiving as a fixed, single-time-point exposure and rely on researcher-defined categories. C_LIO_LIEvidence on the association between caregiving and health behaviours is inconsistent and largely cross-sectional. The dynamic nature of caregiving, including recurrent episodes, has not been examined in relation to health behaviours. C_LI
What this study addsO_LILatent class analysis of 12 waves of panel data identified eight distinct caregiving trajectories, capturing variation in the timing, duration, and recurrence of caregiving episodes. C_LIO_LIRecurrent caregivers had higher odds of smoking but lower odds of physical inactivity and problematic drinking, a profile not identifiable through conventional classification approaches. C_LI
How this study might affect research, practice or policyO_LIRecurrent caregiving should be recognised as a distinct dimension of the caregiving experience, and support systems should prioritise reducing the burden of care for people who move into and out of caregiving repeatedly. C_LIO_LITargeted smoking cessation support may complement upstream support measures but should not replace them. C_LI
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BibTeX
@misc{pfeifer2026caregiving,
title = {{Caregiving transition trajectories and health behaviours: a latent class analysis of the UK Household Longitudinal Study}},
author = {E. Pfeifer and R. E. Lacey and B. Xue and H. Pikhart and A. McMunn},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.26.26364079},
url = {https://www.medrxiv.org/content/10.64898/2026.09.26.26364079v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Caregiving transition trajectories and health behaviours: a latent class analysis of the UK Household Longitudinal Study
AU - E. Pfeifer
AU - R. E. Lacey
AU - B. Xue
AU - H. Pikhart
AU - A. McMunn
PY - 2026
DA - 2026/09/26
PB - medRxiv
DO - 10.64898/2026.09.26.26364079
UR - https://www.medrxiv.org/content/10.64898/2026.09.26.26364079v1
AB - BackgroundUnpaid caregiving is a recognised social determinant of health, yet most research treats it as a fixed exposure measured at a single time point, and little is known about how patterns of caregiving transitions relate to health behaviours. MethodsSecondary analysis of the UK Household Longitudinal Study (waves 2-13, approximately 2010-2023; n=25,049). Latent class analysis was applied to binary caregiving status across 12 waves to identify caregiving trajectories. Associations between trajectories and four health behaviours (physical inactivity, fruit and vegetable consumption, problematic drinking, current smoking) at waves 7 to 13 were estimated using logistic and linear regression, adjusting for sociodemographic, health and baseline behavioural confounders. ResultsAn eight-class solution identified a non-caregiving class comprising 62.9% (n=15,760) of the sample. Among caregivers (n=9,289), trajectories were Temporary (20.0%), Former-short (20.2%), Former-long (10.9%), Emerging-short (15.4%), Emerging- long (11.6%), Long-term (15.7%) and Recurrent (6.3%). In fully adjusted models, Recurrent caregivers had higher odds of smoking (OR=1.67, 95%CI: 1.17 to 2.40) compared with non- caregivers but lower odds of physical inactivity (OR=0.65, 95%CI: 0.53 to 0.81) and problematic drinking (OR=0.75, 95%CI: 0.59 to 0.94). Associations for other trajectory classes were largely attenuated after adjustment. ConclusionThe pattern and timing of caregiving transitions are an under-explored dimension of the caregiving experience. Recurrent caregivers had a distinctive profile, with elevated smoking but lower physical inactivity and problematic drinking. Recurrent caregiving should be recognised alongside intensity and duration, and support systems better equipped for people who move into and out of care repeatedly. What is already known on this topicO_LIUnpaid caregiving has been linked to adverse health outcomes, but most studies treat caregiving as a fixed, single-time-point exposure and rely on researcher-defined categories. C_LIO_LIEvidence on the association between caregiving and health behaviours is inconsistent and largely cross-sectional. The dynamic nature of caregiving, including recurrent episodes, has not been examined in relation to health behaviours. C_LI What this study addsO_LILatent class analysis of 12 waves of panel data identified eight distinct caregiving trajectories, capturing variation in the timing, duration, and recurrence of caregiving episodes. C_LIO_LIRecurrent caregivers had higher odds of smoking but lower odds of physical inactivity and problematic drinking, a profile not identifiable through conventional classification approaches. C_LI How this study might affect research, practice or policyO_LIRecurrent caregiving should be recognised as a distinct dimension of the caregiving experience, and support systems should prioritise reducing the burden of care for people who move into and out of caregiving repeatedly. C_LIO_LITargeted smoking cessation support may complement upstream support measures but should not replace them. C_LI
ER -