摘要：Caregiving has only recently been acknowledged by the nation as an important topic for millions of Americans. A psychological or sociological approach to care-giving services has been most often applied, with little attention to the population-based public health outcomes of caregivers. We conceptualize caregiving as an emerging public health issue involving complex and fluctuating roles. We contend that caregiving must be considered in the context of life span needs that vary according to the ages, developmental levels, mental health needs, and physical health demands of both caregivers and care recipients. THE GOAL OF PUBLIC HEALTH in the United States is to promote healthy individuals living in healthy communities, pursuing quality of life rather than simply absence of disease. The Institute of Medicine 1 designates the general functions of public health as assessment, policy, and assurance. Quality research is an integral part of each of these endeavors. Typically, whereas the funding and authority for public health initiatives come from the federal government or state governments, communities deal with most of the burdens and practicalities of public health issues. Caregiving has become an issue that affects the quality of life for millions of individuals and demands attention from every community. 2 Historically, scientists and practitioners alike rarely thought of caregiving as a public health matter. Studies on caregiving often focused on social and psychological dimensions, primarily on the stress associated with caregiving. However, over the past 25 years, considerable scholarship has addressed multiple dimensions of caregiving. Pioneering work by Shanas, 3 , 4 Sussman, 5 and Brody 6 – 8 helped map an understanding of those who provide care and the richness and paucity of caregiving relationships. More recent investigations have addressed coping strategies 9 and the demands of caring for people with dementia, 10 and a growing body of literature has focused on health concerns associated with caregiving 11 such as illness and caregiver burden. 12 However, even with this abundance of relatively new research, surprisingly little attention has been focused on framing caregiving from a public health standpoint. Therefore, we sought to conceptualize caregiving as an emerging public health issue, with the contention that there is considerable overlap in the individual needs of caregivers—the foundation of an enormous system of care in the United States and around the world—and the public health needs of many communities and their members.
