Researchers: Adi Vitman Schorr¹, Violetta Rozani²

Background: Family members caring for individuals with dementia often experience high levels of caregiver burden, which can negatively impact their health behaviors, access to preventive medicine, and ability to realize their rights. In the Israeli context, disparities based on ethnicity and geography (center vs. periphery) may further complicate caregiving experiences and access to formal support systems.

Objectives: This study aimed to examine the relationship between caregiver burden and three outcomes: engagement in health behaviors, use of preventive medical services, and realization of social rights. It also explored ethnic and geographic differences in these domains and investigated the mediating role of formal support, informal support, and loneliness, as well as the moderating effects of region and ethnicity.

Method: A cross-sectional mixed-methods study was conducted with a stratified random sample of 360 informal caregivers (veteran Jewish Israelis, immigrants from the former USSR, and Arab citizens), residing in both central and peripheral regions of Israel. Data were collected through structured face-to-face interviews using validated and culturally adapted questionnaires in Hebrew, Arabic, and Russian.

Findings: Caregiver burden was positively associated with engagement in health behaviors, mainly through a significant indirect effect via reduced use of formal services. No significant association was found between caregiver burden and use of preventive medicine. Rights realization was negatively associated with formal service use: higher burden led to greater reliance on formal services, which in turn was linked to lower rights realization. Ethnic and geographic disparities were significant, particularly among immigrants and Arab caregivers in peripheral regions.

Conclusions: The relationship between caregiver burden and outcomes is multifaceted and mediated by systemic and social factors that are not uniformly accessible across populations.

Recommendations: Policy-makers should develop culturally and regionally adapted support services, enhance outreach and accessibility in peripheral areas, and establish proactive guidance mechanisms to empower family caregivers and reduce structural inequities.

Research end date: 09/2025