Supplementary grandchild care, social integration, and depressive symptoms: longitudinal findings from Korea

Longitudinal Correlates of Grandparenting with Depressive Symptoms and Poor Sleep Quality Among Middle-Aged and Older Women and Men in South Africa

OBJECTIVES

The study aimed to assess the impact of grandparenting on incident depressive symptoms and incident poor sleep quality among aging women and men in rural South Africa.

METHODS

This longitudinal community study enrolled 3,237 adults (≥40 years) from the "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)."

MEASUREMENTS

Grandparenting was assessed by self-report at wave 1, and depressive symptoms and poor sleep quality at waves 1 and 2. Outcomes were incident depressive symptoms and incident poor sleep quality at wave 2. Logistic regression was utilized to estimate the associations between grandparenting and incident depressive symptoms and incident poor sleep quality.

RESULTS

Almost half of the grandfathers (44.6%) and 68.4% of the grandmothers were parenting 7/days/week. In the final adjusted models, among grandmothers, compared to 0 days/week grandparenting, 7 days/week grandparenting reduced the odds of incident depressive symptoms (AOR: 0.71, 95% CI: 0.55 to 0.91) and reduced the odds of incident poor sleep quality (AOR: 0.58, 95% CI: 0.40 to 0.82).

CONCLUSION

Grandparenting significantly reduced poor mental health among grandmothers but not among grandfathers.

CLINICAL IMPLICATIONS

Practitioners may encourage grandparent caregiving, among grandmothers, to reduce poor mental health in South Africa.

Revisiting the association between grandparenting and mental health in China: New evidence from the harmonized CHARLS

BACKGROUND

In the context of the global aging challenge, an increasing number of middle-aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena.

METHODS

The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference-in-differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting.

RESULTS

The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = -0.172, T = 0.65, p = 0.517 in the PSM-DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, T = 0.26, p = 0.795 in the PSM-DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves.

CONCLUSIONS

In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies.

Association between the location of social medical insurance and social integration among China's elderly rural migrants: a nationwide cross-sectional study

BACKGROUND

Universal social medical insurance coverage is viewed as a major factor in promoting social integration, but insufficient evidence exists on the integration of elderly rural migrants (ERM), generally aged 60 years and above, in low- and middle-income countries. To address this problem, we explore the relationship between the location of social medical insurance (SMI), such as a host city, and social integration in the context of Chinese ERM.

METHODS

This study is based on data from the 2017 National Internal Migrant Dynamic Monitoring Survey in China. The study participants were Chinese ERM. An integration index was constructed to measure the degree of social integration in a multi-dimensional manner using a factor analysis method. This study used descriptive statistics and one-way analysis of variance to explore the differences in social integration between ERM with SMI from host cities and hometowns. Stepwise multiple linear regression analysis was used to test the correlation between SMI location and social integration level in the overall sample. Finally, the results were verified by propensity score matching.

RESULTS

It was found that 606 (18.2%) of the insured ERM chose host city SMI, while 2727 (81.8%) chose hometown SMI. The level of social integration was lower among ERM with hometown SMI (-1.438 ± 32.795, F = 28.311, p ≤ 0.01) than those with host city SMI (6.649 ± 34.383). Among the dimensions of social integration, social participation contributed more than other factors, with a contribution rate of 45.42%. Host city SMI increased the probability of the social integration index by 647% among ERM (k-nearest neighbor caliper matched (n = 4, caliper = 0.02), with a full sample ATT value of 6.47 (T = 5.32, SE = 1.48, p < 0.05)).

CONCLUSIONS

ERM with host city SMI have a higher social integration level than those with hometowns SMI. That is, host city SMI positively affects social integration. Policymakers should focus on the access of host city SMI for ERM. Removing the threshold of host city SMI coverage for ERM can promote social integration.

Continuity and changes in grandchild care and the risk of depression for Chinese grandparents: new evidence from CHARLS

Objectives

Although studies have researched the mental effects of intergenerational care, little is known about the impact of transformations in caregiving intensity on depression. This study explores grand-parents' depressive symptom outcomes in terms of changes over time in grandparental childcare, with considerations for subgroup differences.

Method

Using data from the 2015-2018 China Health and Retirement Longitudinal Study on grandparents aged 45 and older, we adopted generalized estimating equations to estimate the effects of seven category changes [(1) continued to provide high-intensity or (2) low-intensity care at both waves; (3) never provided care; (4) started caregiving; (5) ended caregiving; (6) provided less intensive care; and (7) provided more intensive care] over time in grandparental childcare on depressive symptoms among 17,701 grandparents with at least one grandchild, as well as how the impact varies by gender and urban/rural areas.

Results

Grandparents who decreased the intensity of care, stopped childcare, or offered continuous low-intensity care were associated with a lower level of depression compared with those providing no childcare. In addition, the benefit of continuous caregiving on mental health was especially noticeable in urban grandmothers.

Conclusion

Providing continuous low-intensity, decreased-intensity grandparenting and the cessation of caregiving were associated with a decreased level of depression for Chinese grandparents; however, there were complex interactions at play. Policies aimed at supporting grandparenting should consider caregiving intensity transitions relevant to gender and urban/rural residence.

Childcare burden and psychological distress among elderly people involved in grandparenting: A study on local and migrant grandparents in Hangzhou, China

Grandparenting is known to impact psychological health in older people. However, the extent to which the effect is altered by migration-related and sociodemographic determinants is less clear. Therefore, we conducted this cross-sectional study to investigate whether the association between grandparenting and psychological distress differs between rural-urban migrants and local older adults from May to September 2019. A total of 373 rural-urban migrants and 602 local older adults involved in grandparenting in Hangzhou completed measurements assessing sociodemographic characteristics, childcare burden and psychological distress. In total, 22.2% of the grandparents reported psychological distress. Rural-urban migrant grandparents had a lower socioeconomic status (SES), a higher childcare burden (23.6 ± 9.2 vs. 20.7 ± 9.5, p < 0.001) and higher levels of psychological distress (29.8% vs. 17.4%, p < 0.001) than local grandparents. Childcare burden and pressure from adult children were the most significant predictors for psychological distress in both groups (ps < 0.05). Psychological distress was also significantly associated with self-rated health status (β = -0.276, p = 0.033) and willingness to participate in grandparenting (β = -0.659, p = 0.024) in migrant grandparents but associated with female gender (β = 0.346, p = 0.022), caring for children at night (β = 0.424, p = 0.011), conflict with adult children (β = 0.432, p < 0.001) and annual income (β = -0.237, p < 0.001) in local grandparents. Migrant status showed a statistically significant moderating effect between childcare burden and psychological distress. These results may be of assistance in comprehensively understanding the social determinants of mental health of grandparents involved in grandparenting.

Attitudes toward Grandparental Involvement in Hong Kong: A Trend Analysis

This article examines individuals' attitudes toward the involvement of grandparents in family issues in Hong Kong. While existing studies have largely focused on the nature and types of grandparents' involvement in childcare, it is worth conducting a quantitative investigation of the attitudes in the general population about grandparental involvement. Drawing on the 2011, 2013, 2015, and 2017 waves of the Family Surveys, the study examined the trend in attitudes toward grandparental involvement with 8932 HK residents. Multivariate linear regression analyses were performed to assess individual and family relationship factors associated with the attitudes toward grandparental involvement. Results show that although most people held positive attitudes toward grandparental involvement, there was a significant drop in the agreement with grandparental involvement in 2017 across all age groups. The findings imply that intergenerational support tends to be weakened in HK in recent years. Involving grandparents in family issues in HK was more likely to be need-driven rather than value-driven, as parent respondents had relatively more positive attitudes toward grandparental involvement compared with non-parents. Positive family and intergenerational relationships were significantly associated with the positive attitudes toward grandparental involvement. Policymakers and service providers should recognize the changes in people's attitudes toward family lives and provide appropriate support such as family counselling, (grand)parenting programs and childcare support to promote the wellbeing of families and older adults.

The Role of Contact Care by Adult Children in Relieving Depression in Older Adult Individuals

The purpose of this study is to investigate how contact care by adult children influences the effect of caring for grandchildren on depression in older adult individuals. Studies have shown that caring for grandchildren either increases or decreases the symptoms of depression in older adult individuals, while other studies have shown no effect. The reason for these inconsistent results is that the key control variable, contact care by adult children, has been omitted from these previous studies. An analysis of panel data consisting of observations from 162 older adult respondents in the Korean Longitudinal Study of Aging over the 2008-2016 period confirms that the positive effect of caring for grandchildren on depression in older adults increased as the number of adult children who visited their older adult parents after entrusting their children to them increased. As more of their adult children visited the older adult individuals, the latter were more likely to feel that caring for their grandchildren was healing rather than stressful.

The Protective Effect of Caring for Grandchildren on the Mental Health of the Elderly: A Structural Equation Modeling Analysis

Population aging has become a common problem all over the world, and the process of China’s population aging is developing rapidly. China has made active aging a national development strategy, giving full attention to the physical and mental health of the elderly. Bloodline and family continuity make the Chinese elderly attach great importance to the responsibility of caring for grandchildren. This study takes the elderly as the research center, and aims to investigate the relationship between caring for grandchildren and the mental health of the elderly in China, and whether participation in social activities mediates such an association. Adopting the data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), a Chi-squared test and multiple regression results showed that caring for grandchildren significantly improved the mental health level of the elderly in China, and the results were still valid after the use of the Propensity Score Matching (PSM) to solve the endogenous problems. Analysis of the mediating effects using the Structural Equation Model (SEM) showed that caring for grandchildren indirectly contributed to the reduction of depression by increasing the diversity and frequency of participation in social activities. The constant adjustment of China’s fertility policy increases the possibility of the elderly caring for multiple grandchildren, and prolongs their time of caring for grandchildren. The elderly caring for grandchildren is a proactive choice, which continuously relieves the child-rearing stress, and highlights the family value and social value of the elderly. At the same time, raising and accompanying grandchildren makes the elderly’s lives more fulfilling and positive, which in turn promotes participation in social activities, and the mental health of the elderly.

Longitudinal impacts of grandparent caregiving on cognitive, mental, and physical health in China

OBJECTIVES

Although studies have documented the effects of grandparenting, little is known about grandparents' long-term health outcomes in terms of optimal engagement with grandchildren, and whether age, gender, or location make a difference. This study explores the longitudinal impacts of grandparenting on health, with considerations for subgroup differences.

METHODS

Using three waves of China Health and Retirement Longitudinal Study, we used propensity score analysis combined with multilevel analysis to examine the longitudinal effect of grandparenting (no, low-, moderate-, and high-intensity) on health (self-rated health, mobility limitations, depressive symptoms, and cognition) among 4,925 grandparents with at least one grandchild, and how impact varies by age, gender, and urban/rural areas.

RESULTS

A nonlinear relationship between grandparenting and health was observed. Compared to those not providing care, grandparents who provided care at a low-to-moderate level were more likely to have fewer mobility limitations and depressive symptoms and better cognition. High intensity had no positive impacts on health. The effects of grandparenting on health operated differently across subgroups. Older grandparents showed better physical, mental, and cognitive health compared to their younger counterparts. Both genders had fewer mobility limitations if they provided care at a low-to-moderate level, although females reported better self-rated health. Rural grandparents reported better physical health; whereas urban grandparents reported better cognition.

CONCLUSION

Grandparenting could improve health in later life; however, there are complex interactions at play. Policies aimed at supporting grandparenting should consider optimal hours of care relevant to age, gender, and urban/rural contexts.

Is Raising Your Grandchild Bad for Your Health? The Association Between Custodial Grandparent Status and Health Biomarkers in Taiwanese Grandparents

Data from two waves of the Social Environment and Biomarkers of Aging Study in Taiwan were analyzed to determine the effects of custodial grandparenting on health in a longitudinal sample. Self-reported measures on respondents' perception of their health, six health biomarkers, the presence of twelve diseases, and a measure of stress were included. Custodial Grandparents (CGPs) were significantly more likely to report worse health than their peers. However, there were no significant differences in biomarkers, and CGPs were only significantly different from non-custodial grandparents (nCGPs) regarding lower respiratory disease. Results suggest that CGPs do not have significantly worse health than nCGPs, but report feeling less healthy. This disparity is suspected to be due to energy levels or stress sources not assessed by the variables in the original study. These results and their implications based upon the stress-coping model elucidate the need to design interventions that incorporate the East Asian cultural values and practices in order to promote better health outcomes for CGP populations overall.