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Variation in the Spillover Effects of Illness on Parents, Spouses, and Children of the Chronically Ill

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Abstract

Background

Given the broad scope of the spillover effects of illness, it is important to characterize the variability in these outcomes to identify relationship types in which secondary impacts of illness are particularly important to include in health economic evaluations.

Purpose

To examine heterogeneity in spillover effects of chronic conditions on family members by type of familial relationship with patient.

Methods

Adults (aged ≥18 years) and adolescents (aged 13–17 years) who had a parent, spouse, or child in their household with a chronic condition (Alzheimer’s disease/dementia, arthritis, cancer, or depression) were recruited from a US national panel to participate in an on-line survey. Respondents were asked to rate the spillover effect of their family member’s illness on their own health on a 0–100 scale, with lower scores indicating greater spillover. Regression analysis was used to evaluate the association between rating scale scores and relationship with an ill family member (ill parent, child, or spouse) for each illness separately, controlling for caregiving responsibility and the health status of the ill family member.

Results

1,267 adults and 102 adolescents met inclusion criteria. In adjusted analyses, having a sick child was significantly (p < 0.05) associated with lower rating scale scores compared with having a spouse with the same condition (cancer: −24.2; depression −9.7). Having a non-elderly or elderly adult parent with a condition, compared with a spouse, was significantly associated with lower rating scale scores for arthritis (−3.8) and depression (−5.3), but not for Alzheimer’s disease/dementia or cancer.

Conclusions

The impact of illness on family members, measured with a rating scale, varies by relationship type for certain illnesses. Having a child with cancer, a parent with arthritis, or either with depression, is significantly associated with greater spillover, compared with having a spouse with one of these conditions.

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Acknowledgments

The authors thank Acham Gebremariam for his programming assistance.

Source of financial support

Funding for this study was provided by the National Institute of Nursing Research (7-R01-NR-011880-03).

Author Contributions

Tara A. Lavelle: Dr. Lavelle contributed to the conceptualization and design of the study, carried out all data analyses, drafted the manuscript, and approved the final manuscript as submitted. Dr. Lavelle takes responsibility for the overall content of the manuscript.

Eve Wittenberg: Dr. Wittenberg contributed to the conceptualization and design of the study, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Kara Lamarard: Ms. Lamarand coordinated data collection, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Lisa A. Prosser: Dr. Prosser contributed to the conceptualization and design of the study, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Conflict of interest

Tara A. Lavelle: Dr. Lavelle reports no conflict of interest.

Eve Wittenberg: Dr. Wittenberg reports no conflict of interest.

Kara Lamarard: Ms. Lamarand reports no conflict of interest.

Lisa A. Prosser: Dr. Prosser reports no conflict of interest.

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Authors and Affiliations

  1. University of Michigan Medical School, Ann Arbor, MI, USA

    Tara A. Lavelle, Kara Lamarand & Lisa A. Prosser

  2. Harvard School of Public Health, Boston, MA, 02115, USA

    Eve Wittenberg

  3. The RAND Corporation, 1200 South Hayes St., Arlington, VA, 22202, USA

    Tara A. Lavelle

Authors
  1. Tara A. Lavelle
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  2. Eve Wittenberg
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  3. Kara Lamarand
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  4. Lisa A. Prosser
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Corresponding author

Correspondence to Tara A. Lavelle.

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Lavelle, T.A., Wittenberg, E., Lamarand, K. et al. Variation in the Spillover Effects of Illness on Parents, Spouses, and Children of the Chronically Ill. Appl Health Econ Health Policy 12, 117–124 (2014). https://doi.org/10.1007/s40258-014-0079-8

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  • DOI: https://doi.org/10.1007/s40258-014-0079-8

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