Likelihood of African American Primary Caregivers and Care Recipients Receiving Assistance From Secondary Caregivers: A Rural-Urban Comparison

Abstract

We examine rural-urban differences in reliance on secondary caregivers for African American female primary caregivers (250 rural, 242 urban) and their care recipients. Logistic regression was used to identify caregiver and care recipient characteristics significantly associated with the likelihood of having a secondary caregiver within rural and urban samples. Post hoc Wald chi-square tests were used to identify significant between-sample differences in regression coefficients. Secondary caregivers were more common in urban than rural contexts. Having a secondary caregiver was more strongly related to primary caregivers' poorer physical health and nonresidence with care recipients in rural than urban contexts. Findings suggest that policy initiatives, such as the National Family Caregivers Support Act and the cash and counseling model, may benefit rural and urban residents, particularly rural residents as the majority of them lacked secondary caregiver assistance.

Figure 1

A schematic model for receipt of secondary caregivers’ assistance by African American older adults and primary caregivers Note: A focus on the likelihood of secondary caregivers reflects caregiving systems model. Arrow a depicts proposed linkages between care recipient/caregiver characteristics and reliance on secondary caregivers, based on contextual caregiving approaches. A critical human ecology perspective was the basis for Arrows b–d describing possible influences of rural and urban residence on care recipient/caregiver characteristics, reliance on secondary caregivers, and the linkages between care recipient/caregiver characteristics and reliance on secondary caregivers.