Get the full report on today's state of caregiving & family health
Download Cleo’s 2026 Family Health Index Annual Report for the most up-to-date picture of caregiving and family health burden driving healthcare and workforce costs today.
February 25, 2026
Today, Cleo released our 3rd annual Family Health Index™ report, highlighting the state of caregiving and family health in the U.S. and globally in 2026.
In case you don’t already know, the Family Health Index is an evidence-based, multidimensional risk assessment designed to proactively identify working family caregivers and parents who are at elevated risk for burnout and related health strain, enabling earlier, targeted support.
This year’s topline findings from more than 19,200 assessments revealed that 64% of working women in the sandwich generation are at a breaking point with escalating mental health strain, higher healthcare costs, productivity loss and attrition.
This burnout risk is not only disrupting workforce stability, but also accelerating preventable health decline for women in their peak earning and leadership years.
Forty-six percent of women ages 40-54 face the highest burnout risk across all age groups marked not just by exhaustion, but by measurable warning signs of health deterioration. Most report a significant decline in self care and overall health, and more than half screen positive for depression and anxiety on the Patient Health Questionnaire-4 (PHQ-4) alongside increased social isolation.
Women at greatest risk are often those managing the most complex caregiving load such as those in the sandwich generation (64%), taking care of neurodivergent children (59%), parenting a teen (52%), or navigating perimenopause and menopause while caregiving (51%). This heightened risk is not only personal, it is costly.
Caregivers at high risk of burnout incur substantially higher medical spend (~ $1000 PMPM vs $600 PMPM for lower risk members), reinforcing caregiver burnout as a leading indicator for preventable healthcare utilization.
Caregiving isn’t a side hustle, it’s a second full-time job, and for many women it functions as a powerful social determinant of health that quietly compounds risk over time.
“Our research at National Alliance for Caregiving reveals a crisis: nearly two-thirds of family caregivers, many of whom are women, face high emotional stress, losing a full week every month to poor mental health. Crucially, over half of caregivers didn’t choose this role and they suffer the most from isolation. This isn’t a test of individual resilience; it’s a systemic failure to provide the support these emotional realities demand.”
Jason Resendez, CEO of National Alliance for Caregiving
Importantly, women in midlife often represent a highly experienced, high-impact segment of the workforce – yet caregiving strain is showing up as a women’s health issue with downstream consequences for careers and healthcare costs.
When employers invest in caregiving support the result is both human and financial:
- Lower avoidable healthcare utilization and spend
- Stronger health activation and screening adherence
- Fewer unplanned leaves of absence
- Reduced burnout-driven performance disruption
- Higher loyalty among employees carrying the heaviest load (while women remain the majority of family caregivers, these benefits extend to all family caregivers)
