Three-generation households and child mental health in European countries

The impact of family structure on depressive symptoms in secondary school students: The mediating role of emotional neglect

PURPOSE

A growing body of research has identified the influence of family factors on depression. This study aimed to investigate the effects of different family structures on adolescent depressive symptoms and to investigate the mediating role of adverse childhood experiences between family structure and adolescent depressive symptoms.

METHODS

Stratified whole cluster sampling was used. Junior and senior high school students were randomly selected from three schools in one district each in urban and rural areas. Depressive symptoms and traumatic events were investigated through the Patient Health Questionnaire-9 (PHQ-9) questionnaire and the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Adolescent family structure types were classified using latent category analysis (LCA), and mediation models were used to explore the mediating effects of adverse childhood experiences (ACEs) between family structure and depressive symptoms.

RESULTS

After LCA analysis, three family structure types were delineated: Nuclear Family, Paternal Grandparents Family (single father + paternal grandparents as primary caregivers), and Paternal Grandparents Family (single mother + maternal grandparents as primary caregivers). Detection rate of depressive symptoms in non-nuclear families was 27.2 %; adolescent depressive symptoms were higher in Paternal Grandparents Family compared to Nuclear Family (OR = 0.823, 95 % CI:0.037,1.610, p < 0.05); the difference in adolescent depressive symptoms in Maternal Grandparents Family was not significant (OR = -0.504, 95 % CI: -1.570,0.561). The mediating effect of emotional neglect was only present in the association between Paternal Grandparents Family and depressive symptoms in secondary school students [β(95 %CI) = 0.490 (0.153,0.845)], with a mediating effect proportion of 58.40 %.

CONCLUSION

Depressive symptoms are more prominent among secondary school students in non-nuclear families, especially Paternal Grandparents Family. Emotional neglect, which may be triggered by the absence of the mother's role, increases the risk of depressive symptoms among secondary school students.

Intergenerational care and rural childhood obesity in the digital era: Based on screen exposure perspective

Background

Rural Chinese children are experiencing increasing obesity rates, yet studies often neglect the impact of IT and screen media growth on obesity risks in the context of intergenerational care, leading to incomplete strategies for the digital era.

Methods

By comprehensively utilizing the data on rural children aged 6-17 from the China Family Panel Studies (CFPS) and the China Health and Nutrition Survey (CHNS), this study aims to test the logical chain and specific mechanisms regarding "intergenerational care - screen exposure - rural childhood obesity". We employ the Propensity Score Matching (PSM) and Generalized Propensity Score Matching (GPSM) methods to respectively address the self-selection biases associated with inter-generational care and children's screen exposure behaviors.

Results

1) Intergenerational care significantly increases screen exposure among rural children. 2) Gender bias increases the risk of screen exposure for rural boys under intergenerational care. 3) Children with higher screen exposure levels are more affected by intergenerational care, which further undermines parental supervision. 4) Children's screen exposure leads to increased sedentary time and higher probability of purchasing unhealthy foods, thereby exacerbating obesity. This process is facilitated by enhancing preferences for snacks, fast food, and beverages, and weakening preferences for physical activity. 5) GPSM analysis indicates that children's screen exposure has an inverted "U"-shaped impact on unhealthy dietary preferences and a "U"-shaped impact on activity preferences. It results in a nonlinear positive impact of screen exposure on obesity. This study reveals a positive association between screen exposure and obesity, offering new insights into how intergenerational care in the digital era may elevate obesity prevalence through excessive screen time for rural children.

Research Review: Grandparental care and child mental health - a systematic review and meta-analysis

BACKGROUND

The number of children residing in grandfamilies is growing worldwide, leading to more research attention on grandparental care over the past decades. Grandparental care can influence child well-being in various forms and the effects vary across contexts. In this systematic review and meta-analysis, we synthesize the evidence on the relation between grandparental care and children's mental health status.

METHODS

We identified 5,745 records from seven databases, among which 38 articles were included for review. Random effects meta-analyses were used to synthesize evidence from eligible studies. We also examined the variability across study and participant characteristics, including study design, recruitment method, child age, child gender, study region, family type, comparison group, and outcome rater.

RESULTS

The meta-analysis consisted of 344,860 children from the included studies, whose average age was 10.29, and of which 51.39% were female. Compared with their counterparts, children being cared for by their grandparents had worse mental health status, including more internalizing problems (d = -0.20, 95% CI [-0.31, -0.09], p = .001), externalizing problems (d = -0.11, 95% CI [-0.21, -0.01], p = .03), overall mental problems (d = -0.37, 95% CI [-0.70, -0.04], p = .03), and poorer socioemotional well-being (d = -0.26, 95% CI [-0.49, -0.03], p = .03). The effects varied by study design and child gender.

CONCLUSIONS

The findings highlight that grandparental care is negatively associated with child mental health outcomes with trivial-to-small effect sizes. More supportive programs and interventions should be delivered to grandfamilies, especially in disadvantaged communities.

The consequences of household composition and household change for Indigenous health: evidence from eight waves of the Longitudinal Study of Indigenous Children (LSIC)

Households are important health contexts, providing social, emotional, financial and material support, but little is known about the role of household composition in the social etiology of Indigenous health. Our research is framed by an Indigenous standpoint, using eight waves of data from the Longitudinal Study of Indigenous Children. We investigated whether household composition and change in household composition were associated with the self-reported general health of Indigenous children and their mothers, adjusting for socioeconomic, household structure and social support factors. Our measure of household composition comprised eight groups differentiating lone and couple parents, living with and without other children and adults. Study children in couple households with other children and adults were 16% less likely to have excellent health and mothers in these same households were 7% less likely to report excellent health than children and mothers in couple households. We find little evidence that mothers in lone parent households have poorer health than mothers in couple households, after adjustment for covariates. Change in household composition was positively associated with health for both children and mothers. The results caution against presuming a direct translatability of research findings from non-Indigenous to Indigenous Peoples.

Using the intergenerational solidarity framework to understand the grandparent-grandchild relationship: a scoping review

Intergenerational interactions and exchange are major components of grandparenting, and the present study sought to examine how the intergenerational solidarity framework has been used to investigate grandparenting practices across the lifespan and in different cultures. This framework is widely used across cultures and provides a basis to discuss the future of grandparenting research, considering cultural intermingling and changes in society. Following PRISMA-ScR guidelines, we searched three databases (PsycInfo, PubMed, and Web of Science). Finally, 42 empirical studies that met the inclusion criteria were included in this scoping review. They were published between 1991 and 2020 and assessed intergenerational solidarity between grandparents and their grandchildren. Our findings show that research on grandparenting based on the intergenerational solidarity framework has increased in the last 30 years, and that this model provides a comprehensive approach to studying grandparenting across the lifespan in different cultures. The present study identified cross-cultural differences in the prevalence of the types of intergenerational solidarity. Affectual solidarity was shown to be the most studied dimension of intergenerational solidarity in North America, Europe and Israel, while normative solidarity was the most represented in Asian studies. The only Australian study investigated affectual and functional solidarity. This model is thus suitable for studying grandparenting, but further studies are needed to investigate changes in intergenerational solidarity between grandparents and their grandchildren at different stages of development and account for cultural specificities.

Grandparental care and childhood obesity in China

Ongoing increases in childhood obesity have become a serious public health concern. Meanwhile, caregiving by grandparents becomes a worldwide social phenomenon. This study estimates the effect of grandparental care on childhood obesity and explores its pathways. Utilizing five waves of panel data from the China Family Panel Studies, we found that grandparental care significantly increases the probability of childhood obesity, adding 3.6 percentage points. The effect is heterogeneous between boys and girls and between grandparents with different education attainments. The channels through which grandparents contribute to childhood obesity include inappropriate dietary patterns and insufficient physical activities. Additionally, we found that grandparents' famine experience generates a long-term fear of hunger, which translates into overfeeding their grandchildren, thus aggravating childhood obesity in China.

How do grandparents influence child health and development? A systematic review

Grandparents are often a key source of care provision for their grandchildren, yet they are sidelined in caregiving research and policy decisions. We conducted a global, systematic review of the literature to examine the scope and quality of studies to date (PROSPERO database CRD42019133894). We screened 12,699 abstracts across 7 databases, and identified 206 studies that examined how grandparents influence child health and development. Indicators of grandparent involvement were contact, caregiving behaviors, and financial support. Our review focused on two research questions: how do grandparents influence child health and development outcomes, and what range of child outcomes is reported globally? We examined study design, sample characteristics, key findings, and outcomes pertaining to grandchildren's physical health, socio-emotional and behavioral health, and cognitive and educational development.  Our search captured studies featuring grandparent custodial care (n = 35), multigenerational care (n = 154), and both types of care (n = 17). We found substantial heterogeneity in the data provided on co-residence, caregiving roles, resources invested, outcomes, and mechanisms through which "grandparent effects" are manifested. We identified two important issues, related to operationalizing indicators of grandparent involvement and conceptualizing potential mechanisms, leading to gaps in the evidence base. Currently, our understanding of the pathways through which grandparents exert their influence is constrained by limited data on what grandparents actually do and insufficient attention given to interpersonal and structural contexts. We present a conceptual framework to explicitly measure and theorize pathways of care, with a view to inform research design and policy implementation. We underscore the need for more robust data on three indicators of caregiver involvement-contact, behavior, and support-and for careful description of structural and interpersonal contexts in caregiving research.