TIME USE TRADE-OFFS IN FAMILY CAREGIVING: EVIDENCE FROM THE AMERICAN TIME USE SURVEY
Author(s)
Shihan Jin, MPH, PhD, Boshen Jiao, MPH, PhD;
University of Southern California, Los Angeles, CA, USA
University of Southern California, Los Angeles, CA, USA
OBJECTIVES: To quantify how informal caregiving status and intensity reshape individuals’ 24-hour time allocation in the United States, and to examine whether time-use trade-offs differ between weekdays and weekends.
METHODS: Using pooled 2018-2023 American Time Use Survey (ATUS) data (N = 38,937), this study examines how time is reallocated across market work, non-market work, personal care, sleep, leisure, and other activities as caregiving intensity increases. Fractional multinomial logit (FMLM) models estimate associations between caregiving (status and hours per day) and activity time shares, adjusting for a comprehensive set of demographic, socioeconomic, and household covariates.
RESULTS: Active caregiving is associated with significant reductions in market work (average treatment effect on the treated [ATT]: −46.8 minutes/day), leisure (−24.5 minutes), and sleep (−24.7 minutes). These reallocations emerge even at low caregiving intensities (<0.5 hours/day) and increase progressively with additional caregiving time. Trade-off patterns differ by day type: on weekdays, caregiving primarily displaces market work (ATT: −72.0 minutes), whereas on weekends it mainly replaces leisure (−36.1 minutes) and sleep (−37.9 minutes).
CONCLUSIONS: Informal caregiving substantially reshapes daily time allocation beyond paid labor, with clear intensity gradients and pronounced weekday-weekend contrasts. These findings provide the first contemporary U.S. benchmark of intensity-dependent caregiving time trade-offs, offering an empirical foundation for policy analysis and economic evaluations that explicitly value caregivers’ time.
METHODS: Using pooled 2018-2023 American Time Use Survey (ATUS) data (N = 38,937), this study examines how time is reallocated across market work, non-market work, personal care, sleep, leisure, and other activities as caregiving intensity increases. Fractional multinomial logit (FMLM) models estimate associations between caregiving (status and hours per day) and activity time shares, adjusting for a comprehensive set of demographic, socioeconomic, and household covariates.
RESULTS: Active caregiving is associated with significant reductions in market work (average treatment effect on the treated [ATT]: −46.8 minutes/day), leisure (−24.5 minutes), and sleep (−24.7 minutes). These reallocations emerge even at low caregiving intensities (<0.5 hours/day) and increase progressively with additional caregiving time. Trade-off patterns differ by day type: on weekdays, caregiving primarily displaces market work (ATT: −72.0 minutes), whereas on weekends it mainly replaces leisure (−36.1 minutes) and sleep (−37.9 minutes).
CONCLUSIONS: Informal caregiving substantially reshapes daily time allocation beyond paid labor, with clear intensity gradients and pronounced weekday-weekend contrasts. These findings provide the first contemporary U.S. benchmark of intensity-dependent caregiving time trade-offs, offering an empirical foundation for policy analysis and economic evaluations that explicitly value caregivers’ time.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HPR100
Topic
Health Policy & Regulatory
Topic Subcategory
Public Spending & National Health Expenditures
Disease
No Additional Disease & Conditions/Specialized Treatment Areas