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A new study by researchers from University College London (UCL) reveals that individuals who care for both their children and aging family members—commonly referred to as “sandwich carers”—experience significant deterioration in both their mental and physical health over time. The research, published in Public Health, examined data collected from approximately 2,000 sandwich carers and 2,000 non-sandwich carers as part of the UK Household Longitudinal Study between 2009 and 2020.
Sandwich carers are those who balance the responsibility of looking after dependent children under the age of 16, while also providing care for elderly parents or relatives. As life expectancy increases and people are having children later in life, the number of individuals in this situation is on the rise. In the UK alone, it is estimated that 1.3 million people are sandwich carers.
The researchers aimed to fill a gap in understanding how this dual caregiving role affects mental and physical health over time. By tracking the health of both sandwich carers and non-sandwich carers over a span of nine years, they assessed changes in health before, during, and after taking on the sandwich caregiving role. Their analysis used statistical models to predict these health changes and compare both groups.
The average age of sandwich carers in the study was 36.8 years, with individuals aged 30 to 49 being the most likely to fall into this caregiving category.
The researchers focused on understanding how health changed during the transition into sandwich care, as well as whether factors such as caregiving hours and gender had any impact on these changes. Mental health was evaluated using the General Health Questionnaire (GHQ), which measures emotional well-being through questions related to issues such as concentration, sleep, and general feelings of strain. Physical health was assessed using a Physical Component Summary (PCS), which evaluates overall physical health, including mobility, body pain, and limitations in daily activities due to physical health problems.
The study found that parents who transitioned into sandwich caregiving experienced a notable decline in mental health, particularly those dedicating more than 20 hours per week to caregiving. This mental health decline was found to persist for several years. Furthermore, caregivers who spent more than 20 hours per week caring for their relatives also showed a deterioration in their physical health as they took on this additional responsibility.
Lead author Dr. Baowen Xue, from UCL’s Department of Epidemiology & Health Care, emphasized the significance of the findings: “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 aging 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.”
In response to these findings, the researchers are advocating for better support systems for those in the sandwich caregiving role. Dr. Xue added, “The study underscores the need for society to recognize and support the unique challenges faced by sandwich carers. Providing targeted support and resources, such as access to respite care and workplace flexibility, is crucial to help maintain their health and well-being, particularly for those offering intensive care.”
This study brings attention to the pressing need for society to better understand and address the mental and physical health challenges of sandwich carers, advocating for more comprehensive support and resources to ensure their well-being.
For more information, see: “Do mental and physical health trajectories change around transitions into sandwich care? Results from the UK Household Longitudinal Study,” published in Public Health (2025).
Journal Information: Public Health
