A university-wide survey of caregiving students in the US: Individual differences and associations with emotional and academic adjustment

University students in the US often balance academic obligations with family caregiving responsibilities for elderly or chronically ill relatives or for minors. Despite evidence that caregiving among young people is increasing, US higher education institutions do not routinely identify or support caregiving students. This study aimed to: (1) estimate the prevalence and intensity of student caregiving (hours per day, days per week) and distinguish caregiving for elderly/ill persons versus minors; (2) examine demographic correlates of caregiving (gender, race/ethnicity, financial aid/low SES, first-generation status, graduate vs. undergraduate status, part-time vs. full-time enrollment); and (3) test associations between caregiving intensity and student adjustment (depression, anxiety, GPA), using linked administrative records. Understanding these patterns can inform policies to support caregiving students’ wellbeing and academic success.

The paper situates student caregiving within socioecological models, emphasizing how home and family obligations intersect with academic life. Prior work indicates a growing population of caregiving youth and young adults in the US, yet they are often unrecognized institutionally compared to the UK and Australia. Caregiving tasks vary widely by care recipient: care for elderly/ill individuals may involve activities of daily living and medical tasks, while caregiving for minors can include supervision and routine parenting responsibilities; the time intensity and flexibility of these tasks vary substantially across households. Identifying caregivers is challenging because many young people do not self-identify with the term “caregiver.” Demographic patterns from broader caregiving research suggest over-representation among historically marginalized racial/ethnic groups, lower SES households, and women, though such patterns are understudied among college-age populations. Evidence from adults and adolescents links caregiving (especially for elderly/ill individuals) with heightened stress and poorer mental health, while limited studies in college populations show higher depression and anxiety among caregivers. Caregiving may also impede academic performance due to time constraints and stress-related impacts on concentration and sleep. The study builds on this literature by quantifying prevalence, demographic disparities, and differential associations of caregiving type and intensity with emotional and academic outcomes in a large US university sample.

Design and setting: A campus-wide survey was administered in fall 2020 at a large public research university in North Carolina, approximately seven months after COVID-19–related campus closure. All undergraduate and graduate students were invited; responses were linked to institutional records. Participants: N = 7,592 students (69.9% women, 30.0% men, <0.1% non-binary). Race/ethnicity: 62.7% White non-Latinx, 14.5% Asian, 8.1% Latinx, 6.2% Black/African American, 8.6% Mixed/Other (small subgroups combined). Enrollment: 67.5% undergraduate, 32.5% graduate (including medical and other professional students). Status: 86.35% full-time, 13.65% part-time. First-generation: 12.59%. Among undergraduates, 20.6% received Pell grants (low SES). Mean GPA = 3.49 (SD = 0.43). Procedures: Students received an email invitation to a ~10-minute online well-being survey. Informed consent was obtained. Survey responses were linked to records for GPA, Pell grant receipt, first-generation status, undergraduate vs. graduate status, and full-time vs. part-time status. IRB approval was obtained (UNC-Chapel Hill). Measures: - Caregiving status and intensity: • Caregiver for elderly/ill person: Binary indicator derived from responses about providing care to someone chronically ill (≥3 months), elderly, or in need of care, whether co-residing or not. • Caregiver for minor: Binary indicator derived from responses about being a caregiver/parent/guardian for one or more minors under age 18. • Hours caregiving per day: Continuous (0–24 hours). • Days caregiving per week: Categorical: 0 = no caregiving/0 days, 1 = 1–2 days/week, 2 = 3–5 days/week, 3 = 6–7 days/week. - Demographics (from records unless noted): gender (woman=1, man=0), race/ethnicity (White non-Latinx [ref], Asian, Latinx, Black/African American, Mixed/Other), part-time vs. full-time, Pell grant receipt (low SES), first-generation student, undergraduate vs. graduate. - Student adjustment outcomes: • Depression: 4-item CES-D short form (Radloff, 1977); 4-point Likert; α = 0.87. • Anxiety: GAD-7 (Löwe et al., 2008); 4-point Likert; α = 0.91. • Academic performance: Most recent institutional GPA (0.5–4.0). Missing data and analysis software: Missingness was <1% for most variables but higher for depression (28.20%), anxiety (28.46%), and GPA (52.05%; largely due to first-year students without GPA). Listwise deletion was used. Analyses were conducted in StataSE 17. Statistical analysis: - Research Question 1 (prevalence/intensity): Descriptive statistics. - Research Question 2 (demographic predictors of caregiving): Logistic regression for binary caregiving indicators (elderly/ill; minor). Negative binomial regression for caregiving hours/day and caregiving days/week due to over-dispersion and many zeros. - Research Question 3 (caregiving intensity and adjustment): Standardized linear regressions predicting depression, anxiety, and GPA from caregiving intensity (hours/day; days/week), first in full sample, then separately for caregivers of elderly/ill and caregivers of minors. All models controlled for gender, race/ethnicity, Pell receipt, enrollment status (part-time), student level (graduate), and first-generation status; men and White non-Latinx were reference groups.

Prevalence and intensity: - 5.7% (N=427) of students were caregivers; 3.2% (N=239) cared for an elderly/ill person; 3.0% (N=227) cared for a minor; 0.5% (N=39) did both. - Among elderly/ill caregivers: caregiving days/week—6–7 days (31.38%), 3–5 days (27.62%), 1–2 days (20.50%), <1 day (20.50%). Mean hours/day = 4.89 (SD = 5.47; range 0–24). - Among minor caregivers: caregiving days/week—<1 day (78.0%), 6–7 days (12.8%), 1–2 days (5.73%), 3–5 days (3.5%). Mean hours/day = 7.53 (SD = 6.72; range 0–24). Demographic associations (Table 3; adjusted): - Elderly/ill caregiving (vs. none): higher odds for women (OR=1.75, SE=0.29, p<0.001), part-time students (OR=1.66, SE=0.29, p<0.01), Pell recipients (OR=2.08, SE=0.41, p<0.001), graduate students (OR=1.42, SE=0.23, p<0.05). - Minor caregiving (vs. none): higher odds for part-time (OR=1.83, SE=0.28, p<0.001), Pell recipients (OR=3.88, SE=1.17, p<0.001), graduate students (OR=10.49, SE=2.33, p<0.001); lower odds for Asian vs. White (OR=0.59, SE=0.15, p<0.05). - Caregiving intensity: More hours/day among graduate students (B=1.52, SE=0.21, p<0.001), part-time students (B=0.54, SE=0.27, p<0.05), Pell recipients (B=1.05, SE=0.32, p<0.01). Demographics were not significantly associated with days/week. Caregiving and adjustment (Table 4; adjusted): - Full sample: 3–5 caregiving days/week associated with lower GPA (β = -0.63, SE = 0.20, p<0.01). Other caregiving intensity variables not significantly associated with depression/anxiety. - Elderly/ill caregivers: 3–5 days/week associated with lower GPA (β = -0.71, SE = 0.34, p<0.05). More hours/day associated with higher depression (β = 0.07, SE = 0.03, p<0.05) and higher anxiety (β = 0.07, SE = 0.03, p<0.01). - Minor caregivers: Caregiving intensity not significantly associated with depression, anxiety, or GPA (all p>0.05).

The study demonstrates that a measurable minority of university students provide caregiving, with distinct patterns by care recipient type. Caregivers are disproportionately graduate, part-time, and low-SES students; women are more likely to care for elderly/ill individuals. Caregiving for elderly/ill persons—particularly at moderate weekly frequency (3–5 days/week) and higher daily hours—is associated with lower academic performance and greater symptoms of depression and anxiety, even after accounting for demographic and enrollment differences. In contrast, caregiving for minors showed no significant associations with academic or emotional outcomes, suggesting differential strain by caregiving context and task demands. These findings address the study’s aims by establishing prevalence, identifying demographic disparities, and documenting specific academic and emotional risks tied to elderly/ill caregiving. The results underscore the need for universities to identify caregiving students (e.g., via routine surveys) and to design supports (flexible scheduling, academic accommodations, mental health services, financial aid considerations) to mitigate risk. Interpretation should consider the COVID-19 context, which may have elevated stress and possibly led to underreporting among caregivers, indicating the importance of follow-up research in post-pandemic conditions.

This study provides one of the first university-wide estimates of caregiving among US students, showing that approximately 6% provide care, with clear demographic disparities. Importantly, caregiving for elderly/ill individuals is linked to elevated emotional distress and lower GPA, identifying a subgroup at heightened academic and mental health risk. Key contributions include demonstrating the feasibility of identifying caregivers via campus surveys and clarifying how caregiving type and intensity relate to student outcomes. Future work should: conduct longitudinal and quasi-experimental studies to assess causal impacts; replicate in more diverse institutions and larger samples of minor caregivers; examine moderators (e.g., SES, resources, living arrangements); assess impacts on retention and time-to-degree; and extend research beyond university populations and across international contexts. Institutions should incorporate caregiving measures into student assessments and implement targeted supports to reduce disparities and promote academic success for caregiving students.

The study is cross-sectional and correlational, limiting causal inference. GPA was missing for many first-year students, and the subgroup of minor caregivers with GPA data was small, reducing power to detect associations. Findings come from a single university and may not generalize to more diverse settings; additional racial/ethnic differences could emerge elsewhere. The timing during the COVID-19 pandemic may have influenced both caregiving demands and mental health, and time pressures may have led to underreporting. Future research should use longitudinal or quasi-experimental designs, larger and more diverse samples, test moderators, examine institutional outcomes such as attrition, and include non-university young adults and international/LMIC contexts.