The relationship between work and health in unpaid carers: part II of a scoping review and new model

Background
Unpaid carers can struggle to manage caring duties alongside paid employment, often consequently changing their work role, reducing hours or leaving employment. However, less is known about how working whilst delivering unpaid care is linked to physical and/or mental health outcomes. Thus, the aim of this scoping review was to explore and compare the existing published evidence on the relationship between paid work and health in unpaid carers for dependants aged 18 + .

Methods
Four online databases were searched in October 2025 for published research on the relationship between paid work and health in unpaid carers, in English or German, and published between 2000 and 2025. Papers were not restricted by methodological approach. Three researchers reviewed titles and abstracts, then two research team members screened full texts. Any disagreements were discussed and settled within the wider research team.

Results
Fifty-eight papers from 21 countries met inclusion criteria for this review. Evidence was categorised into three levels, informing a new model on the relationship between paid work and health in unpaid carers – the Carers’ Work and Health Support Model: Personal; workplace; and system and society factors. The relationship between paid work and health in unpaid carers is complex, with some carers benefitting from working longer hours and others being negatively affected. The majority of evidence reported negative impacts on mental health when having unpaid caring duties whilst in employment, with supportive management and colleagues critical for wellbeing.

Conclusions
This novel scoping review is the first to present a co-produced and systematically evidence-derived model on the relationship between paid work and health in unpaid carers. Work-place based interventions need to be designed and tested to improve employee well-being and maintain unpaid carers in the paid workforce.