Informal Caregivers’ Benefits of Residing in a Neighborhood with High Social Participation: A Multilevel Analysis in Japan

Social participation (SP) has been shown to positively impact the mental health of family caregivers. However, a key concern for local authorities is understanding how and to what extent living in a neighborhood with high SP can moderate the psychological burden of caregivers. This study aimed to address this issue. We conducted a multilevel analysis using 17-wave longitudinal data from 33,813 individuals (16,416 men and 17,397 women) aged 50–59 years residing in 2,446 neighborhoods in 2005. We examined how neighborhood SP (NSP) moderated the impact of caregiving on caregivers’ psychological distress (PD), defined as a Kessler (K6) score ≥5. We also incorporated individual SP (ISP) and its interaction with NSP. The results revealed an asymmetric moderation effects of high NSP and ISP on the impact of caregiving on PD, with sex differences. For men, high NSP moderated 73.3% (95% confidence interval (CI): 21.3–125.2%) of the impact when it interacted with ISP. Conversely, for women, ISP moderated 31.3% (95% CI: 10.8–51.9%) of the impact when it interacted with high NSP. We obtained similar findings using both the K6 score and a more severe threshold for severe mental disorder (K6 ≥13). These results suggest that high NSP and ISP moderate the psychological impact of caregiving differently for men and women, highlighting the importance of considering the interaction between NSP and ISP when developing policies to support caregivers through enhancing NSP.