Public health crises like Covid-19 profoundly influence informal care-givers of older adults with functional health limitations. This study deepens existing understanding of care-giving processes during the pandemic to uncover insights useful for developing effective care-giving interventions for the post-pandemic era and future public health crises. Specifically, it examined (1) how care-giving activities during the pandemic impacted care-giver psychological wellbeing by affecting caregiving burden and the positive aspects of caregiving and (2) the moderating effect of pandemic-specific factors (i.e., care recipients’ unmet health-care needs due to the pandemic). Multiple-group analyses were conducted on data on 906 informal care-givers of older adults with functional health limitations, obtained from the Covid-19 Supplement and Round 10 Survey of the National Health and Aging Trends Study conducted in the United States. The mean age of participants was approximately 60 years, and most were white women. Positive aspects of care-giving significantly mediated the relationships between providing assistance in activities of daily living (ADL), instrumental ADL, and emotional support and positive affect. Care-giving burden significantly mediated the relationship between assistance in ADL and positive and negative affect. Care recipients’ unmet health-care needs moderated the relationships between assistance in ADL and burden, assistance in ADL and negative affect, and emotional support and positive affect. In sum, this study underscores the positive aspects of care-giving as well as care-giving burden and demonstrates that greater attention should be paid to care-givers caring for individuals with unmet health-care needs during public health crises. The results suggest that more-effective responses to public health crises must be developed, especially within health-care systems.

Health insurance schemes are important for bridging gaps in health-care needs between the rich and poor, especially in contexts where poverty is higher among seniors (persons aged 65 years and above). In this study we examined (a) gender-based predictors of unmet health-care need among seniors and (b) whether access was influenced by wealth status (measured by income quintiles). Gender-specific negative log–log regression models were fitted to data from the Study on Global Ageing and Health to examine associations between unmet health-care need and health insurance status controlling for theoretically relevant covariates. Insurance status was an important determinant of men and women's unmet health-care need but the relationship was moderated by income quintile for women and not men. While occupation was important for men, religion, marital status and income quintile were significantly associated with women's unmet health-care need. Based on the observed gender differences, we recommend the implementation of programmes aimed at improving the economic situation of older people, particularly women.