Intensity of grandparent caregiving and life satisfaction among rural Chinese older adults: a longitudinal study using latent difference score analysis

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.

Potential factors associated with resilience among older adults in rural China: a multilevel analysis

BACKGROUND

Resilience is crucial for older adults who experience adversities, but research on the issue in rural China remains limited. This study aims to examine factors associated with resilience among older adults in rural China, as related to different types of resilience, and under different levels of adversity.

METHODS

Data were taken from the eight-wave (2001-2021) Longitudinal Study of Older Adults in Anhui Province, China. We used data from the eighth wave (2021) for the outcome variables and lagged predictors (2018) to avoid reverse causal effects. The study sample included individuals 60 years and above, excluding new participants from 2021, those without any adverse events, and any respondents with incomplete analytic data. Resilience was operationalized as residuals of the regressions of life satisfaction (Life Satisfaction Scale) and depressive symptoms (CES-D) on adversity, referred to as Type-1 and Type-2 resilience respectively. These two types of resilience were then treated as the outcome variables in subsequent multilevel regressions, with the predictors focusing on individual, social, and environmental characteristics and resources. This study adheres to STROBE guidelines.

RESULTS

43% of rural older adults exhibited both Type-1 and Type-2 resilience, whereas 18% exhibited only Type-1 resilience and 7% exhibited only Type-2 resilience. Common factors associated with both types of resilience included self-rated health, satisfaction with one's own financial situation, and the prestigiousness of social networks. Predictors for higher levels of Type-1 resilience included higher levels of financial and emotional support and more options for places of leisure. Predictors for higher levels of Type-2 resilience included greater access to medical care. The prestigiousness of social networks, higher levels of emotional support and instrumental support, access to medical care, and more options of places of leisure were positively associated with resilience in the low-adversity group (first tertile of adversity), only satisfaction with financial situation was positively correlated with the resilience of the middle-adversity group (second tertile), while better self-rated health, satisfaction with financial situation, and financial support yielded greater resilience in the high-adversity group (third tertile).

CONCLUSIONS

We examined two types of resilience among older adults in rural China, and found that they have shared and unique associated factors. In addition, the potential factors influencing resilience varied with the level of adversity.

The chain mediation model of social support and life satisfaction among migrant older adults with children: The role of mental health and sleep quality

INTRODUCTION

Few studies have examined the life satisfaction of migrant older adults with children (MOAC), who emerged due to rapid urbanization and population aging in China. This study aimed to explore the chain mediating effect of mental health and sleep quality on the association between social support and life satisfaction among MOAC in Weifang, China.

METHODS

A cross-sectional study was conducted using multi-stage cluster random sampling, and 613 participants were included. The Social Support Rating Scale, Depression Anxiety Stress Scale, Pittsburgh Sleep Quality Index, and Scale with Life Satisfaction were used to measure the social support, mental health, sleep quality, and life satisfaction of MOAC, respectively. Descriptive statistics, t-tests, and ANOVA were used to explore the relationship between sociodemographic variables and life satisfaction. Pearson's correlation analysis and structural equation modeling (SEM) were conducted to investigate the association between social support, mental health, sleep quality, and life satisfaction.

RESULTS

The mean total SWLS score was 27.87±5.58. SEM analysis demonstrated that social support had a positive effect on life satisfaction (β= 0.197). Mental health and sleep quality partially mediated the association between social support and life satisfaction (95% CI: 0.083-0.193), and the mediating effect accounted for 39.198% of the total effect.

CONCLUSION

Life satisfaction was relatively high, and mental health and sleep quality partially mediated the association between social support and life satisfaction. Policy suggestions were provided based on these results.

Impacts of grandparenting on older Chinese adults' mental health: a cross-sectional study

BACKGROUND

The practice of grandparenting has been growing in popularity worldwide, particularly in Asian societies. Nevertheless, there is a lack of thorough studies investigating the mental health effects of grandchild care on grandparents, particularly within the family context. The present study aimed to explore the impact of grandparenting on depressive symptoms in older Chinese adults, taking into account the functional role of intergenerational support.

METHODS

Using the China Longitudinal Aging Social Survey (CLASS, 2014 and 2018, N = 9,486), we employed the Pooled Ordinary Least Square method (POLS) to explore the association between depressive symptoms and grandparenting intensity as well as include the interaction terms to investigate the role of intergenerational support among grandparents aged from 60 to 80.

RESULTS

After adjusting for control variables, both non-intensive (-0.17; 95% CI: -0.30, -0.03) and intensive (-0.69; 95% CI: -0.95, -0.43) childcare, as well as giving financial support to adult children (-0.06; 95% CI: -0.08, -0.04) and emotional closeness with them (-0.94; 95% CI: -1.15, -0.72), were found to have a positive impact on the mental health of grandparents. Giving financial support (non-intensive: -0.04, 95% CI: -0.07, -0.01; intensive: -0.06, 95% CI: -0.13, -0.01) and providing instrumental support to adult children (non-intensive: -0.12, 95% CI: -0.24, -0.01; intensive: -0.19, 95% CI: -0.37, -0.02) moderated the association between grandparenting and the mental health of older adults, regardless of care intensity. However, the moderating role of receiving financial support (-0.07; 95% CI: -0.12, -0.02) only existed when non-intensive childcare was provided.

CONCLUSION

Grandchild care predicted better mental health in grandparents, mainly when they engaged in intensive grandparenting. Emotional closeness and providing financial support to adult children brought mental health benefits to grandparents involved in childcare. Giving financial support and providing instrumental support to adult children moderated the association between grandparenting and the mental health of older adults. However, the moderating role of receiving financial support from adult children only existed when non-intensive childcare was provided.

How is caring for grandchildren associated with grandparents' health: the mediating effect of internet use

Objective

Prior studies showed mixed results of the association between grandchild care and grandparents' health. This research focused on the mechanisms behind the above link by studying how internet use served as a mediator through which grandchild care has impacted grandparents' health. The study aimed to draw implications to improve health of grandparents who offer care to grandchildren.

Methods

Using a sample of 16,829 grandparents aged 50 through 80 from the 2018 wave of China Health and Retirement Longitudinal Study (CHARLS), the study relied on the KHB method to conduct the analysis. Grandparental health was measured by self-rated health (SRH), instrumental activity of daily living (IADL), life satisfaction and depression.

Results

Overall, grandchild care had a positive effect on grandparental health. Those who engaged in grandchild care were more likely to use internet. In addition, internet use mediated the ways in which grandchild care impacted grandparents' health. Interne use generally promoted the positive influence of grandparental caregiving on grandparents' health. Specifically, the mediating effects of watching videos and chatting through the internet were most pronounced among urban grandmothers. The mediating effects of watching news were most noticeable among both urban grandmothers and grandfathers.

Conclusion

Internet use served as a mediator in the association between grandchild child care and grandparental health. Promoting internet usage may be an effective way reducing the negative impact of grandchild care on grandparents' mental health. It could also increase the positive effect of caregiving on grandparents' SRH and functional independence. The study also underscored the importance of taking rural-urban context and gender role into consideration when studying intergenerational caregiving and Chinese grandparents' health.

Social support and subjective well-being of noncustodial grandparent caregivers in urban China: The mediating roles of generative acts

While social support is generally beneficial, it remains unclear how it directly and indirectly affects subjective well-being among grandparents via generative acts. Multi-stage cluster random sampling was employed in a city in Eastern China, reaching 1013 noncustodial grandparent caregivers of kindergarten children (mean age = 58.3, range: 40-93, female = 71.9%, non-local = 508). Data were analyzed using structural equation modeling (SEM). The results reveal that social support positively affected three indicators of subjective well-being among noncustodial grandparent caregivers. Also, social support worked through agentic generative acts to positively affect life satisfaction and positive affect, while not through domestic generative acts. The present study contributes to grandparent caregiving research in urban China by advancing an integrated framework that considers the mechanism of generative acts. Policy and practice implications are also discussed.

Association between caring for grandchildren based on living arrangements and cognitive function among Chinese middle-aged and older adults: The mediating roles of social activities and depressive symptoms

Introduction

In the context of an aging population and age-related conditions increasing, the increasing number of middle-aged and older adults are involved in grandchildren care. This study aimed to 1) explore the association between caring for grandchildren based on living arrangements and cognitive function among Chinese middle-aged and older adults; and 2) investigate the mediating roles of social activities and depressive symptoms in the aforementioned association.

Methods

This study selected 5490 Chinese people (≥45 years old) from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Participants answered questions related to socio-demographics, the Mini-mental State Examination, the intensity of grandchildren care, the Center for Epidemiological Studies Depression Scale, and social activity.

Results

The results showed that caring for grandchildren and cohabiting with a spouse was positively associated with cognitive function among Chinese middle-aged and older adults (B = 0.829, p < 0.001). Furthermore, there was a positive association between providing intensive or no-intensive grandchildren care and cognitive function. In contrast, caring for grandchildren but not cohabiting with a spouse was negatively associated with cognitive function (B = -0.545, p < 0.05). Moreover, directly and indirectly, caring for grandchildren was significantly associated with cognitive function among Chinese middle-aged and older adults, as mediated by social activities and depressive symptoms.

Discussion

The findings emphasize that living arrangements, social engagement, and psychological health could be considered when encouraging grandparent care as formal care.

How is grandparenting linked to life satisfaction among community-dwelling older migrants in Nanjing, China: The mediating role of loneliness and self-esteem

Grandparenting is a crucial part of family child care. This study aims to examine the effect of grandparenting on the life satisfaction of community-dwelling older migrants, and attempts to explore the psychological mechanisms linking them. A total of 723 participants were recruited. The PROCESS Model 6 was used to complete the mediation analysis. The mediating effect was significant if the 95%CI did not contain zero. Results indicated that grandparenting was positively associated with migrants' life satisfaction (r=0.223, p<0.001). Loneliness and self-esteem significantly mediated this relationship, with mediating effects of 0.287 (95%CI: 0.072, 0.563) and 1.127 (95%CI: 0.648, 1.622), respectively. Grandparenting affects life satisfaction either directly, or indirectly by reducing loneliness and enhancing self-esteem.

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.

The effect of childhood socioeconomic status on depressive symptoms in middle-old age: the mediating role of life satisfaction

BACKGROUND

Some studies have shown that childhood socioeconomic status (SES) can influence the development and progression of depression in adulthood. This study aimed to analyze the effects of childhood SES on depressive symptoms in individuals of middle-old age and examine the potential mediating role of life satisfaction based on national data in China.

METHODS

Data were derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS) data. A total of 17,129 individuals who were aged 45 years and older were included. The dependent variable was depressive symptoms in middle-old age. Childhood SES was the independent variable, and life satisfaction was the mediator. This study controlled four factors: general demographic characteristics, adult SES, childhood adversity and health and living status. Pearson correlations and hierarchical multiple regression analysis were performed, and the Baron and Kenny method was used to test the mediating role.

RESULTS

The score of depressive symptoms among all participants was 7.88 ± 6.65. Gender, age, adult SES, childhood adversity and health and living status all affected the development of depression symptom in middle-aged and elderly individuals in China. After adjusting for all covariates, the higher the childhood SES, the lower the depressive symptom score (β = - 0.422, P < 0.001). Life satisfaction had a partial mediating effect between childhood SES and depressive symptoms. Low childhood SES may improve life satisfaction (β = 0.051, P < 0.001) and life satisfaction indirectly decreases depressive symptom scores (β = - 0.403, P < 0.001).

CONCLUSIONS

Life satisfaction was a partial mediator between childhood SES and depressive symptoms in middle and old age. Improving life satisfaction may serve as an intervention to reduce the incidence of depression symptoms in the future.

Grandparenting, health, and well-being: a systematic literature review

Whether grandparenting is associated with improved health or well-being among older adults is a salient question in present-day aging societies. This systematic review compiles studies that consider the health or well-being outcomes of grandparenting, concerning (1) custodial grandparent families, where grandparents are raising grandchildren without parental presence; (2) three-generation households, where grandparents are living with adult children and grandchildren; and (3) non-coresiding grandparents, who are involved in the lives of their grandchildren. Review was based on literature searches conducted in September 2019 via Web of Science, PubMed, PsycINFO, and Ebsco. We screened 3868 abstracts across four databases, and by following the PRISMA guidelines, we identified 92 relevant articles (117 studies) that were published between 1978 and 2019. In 68% of cases, custodial grandparenting was associated with decreased health or well-being of grandparents. The few studies considering the health or well-being of grandparents living in three-generation households provided mixed findings (39% positive; 39% negative). Finally, in 69% of cases, involvement of non-coresiding grandparents was associated with improved grandparental outcomes; however, there was only limited support for the prediction that involved grandparenting being causally associated with grandparental health or well-being. Despite this, after different robustness checks (counting all nonsignificant results, taking into account the representativeness of the data and causal methodology), the main finding remains the same: the most negative results are found among custodial grandparents and three-generation households and most positive results among non-coresiding grandparents.

Intergenerational Caregiving Patterns, Living Arrangements, and Life Satisfaction of Adults in Mid and Later Life in China

While the health implications of intergenerational caregiving have been broadly investigated in the aging literature, less is known about caregivers in four-generation families and their living arrangements. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study (N = 12,914 obs.), we document enhanced life satisfaction of grandchild caregivers and sandwich caregivers caring for both grandchildren and parents than non-caregivers. When further taking living arrangements into consideration, we find that parent caregivers also benefit from care provision when not living with their parents and sandwich caregivers only have an advantage when co-residing with care recipients with adult children present in households. By contrast, grandchild caregivers living with grandchildren show substantially higher life satisfaction no matter adult children are present or not. The subgroup comparison suggests that females and rural residents enjoy psychological advantages over their male counterparts and urban counterparts in grandparenting within skipped-generation households and sandwich caregiving.

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.

Caring as curing: Grandparenting and depressive symptoms in China

Research on grandparenting (i.e., caring for grandchildren) and mental health in Asian contexts has been limited, despite the rapid growth of older adults who take care of grandchildren. This study aims to investigate how grandparenting influences depressive symptoms in China. Using the China Health and Retirement Longitudinal Study (2011-2015, N = 4354), we conducted fixed effects regression models to examine the association between various types of grandparenting and depressive symptoms among older adults between the ages of 45 and 80. The results show that for grandparents, providing care to their grandchildren in skipped-generation households (i.e., grandparent-grandchildren families without adult children) is associated with a lower level of depressive symptoms compared to providing no care, after controlling for socioeconomic status, health behaviors, social support, and basic demographic characteristics. Other types of care (i.e., multigenerational household grandparenting, and part-time and full-time noncoresident grandparenting) are not significantly linked to caregiving grandparents' depressive symptoms. Overall, our findings suggest that sociocultural contexts need to be considered in explaining the different mental health implications of grandparenting.

Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren

BACKGROUND

Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement.

METHODS

A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms.

RESULTS

Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = - 0.087, 95%CI: - 0.163, - 0.010; Coef. = - 0.291, 95%CI: - 0.435, - 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = - 0.171, 95% CI: - 0.313, - 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers.

CONCLUSIONS

Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.

Benefits of Grandparental Caregiving in Chinese Older Adults: Reduced Lonely Dissatisfaction as a Mediator

Objective

The purpose of the present study is twofold: (1) to investigate the differences in terms of physical and mental health between those who provide grandparental care and those who do not and (2) to explore the mechanism that connects grandparental caregiving and health-related outcomes.

Methods

Two studies (a cross-sectional and a short-term longitudinal follow-up) were conducted. The cross-sectional study (Study 1) examined 148 older adults who provided grandparental care and another 150 older adults who did not. A small longitudinal follow-up study (Study 2) was conducted among 102 older adults randomly selected from Study 1, of which 52 were older adults who provided grandparental care, and another 50 older adults were those who did not. Health status (measured by SF-36), lonely dissatisfaction (measured by Lonely Dissatisfaction Subscale of PGC-MS), and cognitive functions (measured by subscales of WAIS) as well as demographics were measured in both studies.

Results

Results of both the cross-sectional and longitudinal studies showed that, compared with older adults who did not provide grandparental care, those providing grandparental care had significantly better physical and mental health as well as reduced lonely dissatisfaction. Further path analysis showed that lonely dissatisfaction mediated the association between providing grandparental care and enhancement in functions such that providing grandparental care could reduce lonely dissatisfaction, which, in turn, could improve their physical and mental health even after controlling for their cognitive functions.

Discussion

These results suggest that providing grandparental care can improve older adults’ physical and mental health through reduced lonely dissatisfaction.

Emerging themes in food security: environmental justice, extended families and the multiple roles of grandmothers

BACKGROUND

Pre- and perinatal nutritional status defines the development of adult metabolism and energy balance in humans. Young children in poor households are disproportionately more vulnerable to food insecurity given the cumulative impact of chronic stress on susceptibility to chronic diseases as an adult. Qualitative studies focusing on the experience of food insecurity in Latin America are scarce. In Argentina, although socioeconomic indicators improved in the aftermath of the 2001ecomomic crisis, the disadvantaged provinces in the north continue to bear the burden of historical inequities. The study was conducted among Primary Health Care patients in the city of San Salvador de Jujuy, Argentina. It analyzes environmental and household level stressors through the narratives of mothers with young children living with food insecurity, from the perspectives of eco-developmental conceptual frameworks.

METHODS

We conducted 11 semi-structured interviews with mothers of children < 1 to 6 years of age who participated in maternal-child health programs in Primary Health Care clinics and lived in food insecure households. Interviews focused on the environmental context and the resources and processes for obtaining and preparing daily meals.

RESULTS

The Eco-bio-developmental (EBD) framework and the vulnerability-assets approach, provided a basis for conceptualizing the significance of findings. Our results indicated the need to understand pathways in the association of stressors, vulnerability and ill health, as well as the mitigating role of social relationships. For example, understanding the link between the stress of being exposed to environmental contaminants and the capacity to overcome food insecurity, or developing strategies to integrate the support provided by kinship networks like extended families into food security programs. The results also indicate the importance of developing support mechanisms for vulnerable family members like grandmothers in food insecure households who play instrumental roles as providers and caretakers of younger relatives.

CONCLUSION

The empirical evidence generated by this study may inform community based strategies and public health policies to address food insecurity in vulnerable population groups who face health effects from multiple stressors.

Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents

The increasing worldwide prevalence and intensity of grandparenting has attracted an attention to its health implications for caregivers against the backdrop of population aging. Thanks to prolonged life expectancy and reduced infant mortality, extended families that comprise four generations, co-residential or not, are no longer rare in China. The current study examines health consequences when Chinese grandparents provide care to not only grandchildren but also their own elderly parents or parents-in-law (i.e., great-grandparents). Drawing on data from the 2011-2013 China Health and Retirement Longitudinal Study (CHARLS), mental health was captured by levels of life satisfaction and depressive symptoms, and physical health was measured by levels of high sensitivity C-reactive protein (CRP), hypertension, high-risk pulse rate, and diabetes. Overall grandparents who cared for grandchildren only had better mental and physical health, compared with non-caregivers. There was some evidence that the 'sandwich' grandparents who cared for both grandchildren and great-grandparents reported greater life satisfaction, fewer depressive symptoms, and reduced hypertension compared with non-caregivers. The health advantage of caregiving was most pronounced in urban grandfathers whose caregiving conformed to the norm of filial piety and who did so most likely to seek emotional reward instead of an intergenerational time-for-money exchange. In contrast, rural grandmothers were the most vulnerable group and their health disadvantage seemed to arise from caring for great-grandparents. These findings highlight the importance of rural-urban context and gender role in studying the health effects of intergenerational caregiving on Chinese grandparents.

Sources and directions of social support and life satisfaction among solitary Chinese older adults in Hong Kong: the mediating role of sense of loneliness

Based on survey data collected from 151 community-dwelling solitary Chinese older adults in Hong Kong, the present study used path analysis to examine the mediating role of sense of loneliness in the relationship between different sources and directions of social support and life satisfaction. The results showed that sense of loneliness mediated the effects of support from families, friends, and support for others on life satisfaction. In addition, a formal source of social support was not associated with life satisfaction among solitary older adults, although those with a more secure financial status had greater overall life satisfaction. These findings highlight the importance of enhancing awareness among social and health care service providers about the negative effects of insufficient social support on older adults' sense of loneliness and life satisfaction. Family and friendship networks should be expanded for solitary older adults.

The impact of intensive grandchild care on depressive symptoms among older Koreans

OBJECTIVE

The aim of this study was to investigate the impact of intensive grandchild care on depressive symptoms among grandparents.

METHODS

We used data from 2008 to 2012 of the Korea Longitudinal Study of Aging. Using the data from 2008 at baseline, data included 5129 individuals aged 50 years and more without depression with at least one grandchild. A generalized estimating equation was used to investigate the impact of intensive grandchild care on depressive symptoms. Investigated factors included the intensity of grandchild care, measured by hours spent caring for a grandchild per week: (i) none (0 h); (ii) non-intensive grandchild care (1-39 h); and intensive grandchild care (≥40 h). Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression scale.

RESULTS

Among 5128 participants from 2008 to 2012, 3.0% were providing non-intensive grandchildren care, and 1.9% were providing intensive grandchild care. Compared with grandparents providing no grandchild care, those who provided intensive grandchild care experienced reduced depressive symptoms (β = -0.51 [p = 0.007] vs. no childcare). Men (β = -1.22 [p = 0.012] vs. no childcare) providing intensive grandchild care experienced a greater reduction in depressive symptoms compared with women (β = -0.44 [p = 0.029] vs. no childcare) providing grandchild care. Grandparents who were receiving financial support from adult children were more likely to experience reduced depressive symptoms than those not receiving such support.

CONCLUSION

The results of this study reveal that intensive grandchild care is associated with lower depressive symptoms among older adults, particularly men. The findings emphasize the importance of encouraging older adults to participate in grandchild care, regardless of gender. Copyright © 2016 John Wiley & Sons, Ltd.

Individual educational attainment, neighborhood-socioeconomic contexts, and self-rated health of middle-aged and elderly Chinese: Exploring the mediating role of social engagement

Analyzing the 2011-2013 China Health and Retirement Longitudinal Study with 14,507 respondents from 393 neighborhoods, and applying generalized linear mixed-effects model, this study examines how individual-level education and neighborhood-socioeconomic contexts affect health through social engagement. Findings reveal that measures of social engagement-social activity and productive activity-are significantly related to self-rated health and partially mediate the effects of individual-level education. Neighborhood-socioeconomic contexts have independent effects on self-rated health beyond individual socio-demographics, and social activity mediates the effects of neighborhood recreational facilities. This study is among the first to simultaneously explore the health effects of individual and neighborhood-level socioeconomic conditions.

Social Engagement and Health

What are the social factors that matter most to the health of elderly Chinese? Are there any gender and age differences? Using a representative sample of elderly Chinese in Shanghai, the most developed city in China with the nation’s largest proportion of elderly residents, this study found that economic conditions, chronic health status, living arrangements, social activity participation, and caring for grandchildren are factors that are most important to the health of elderly Chinese. This is true for both self-rated health and psychological well-being. The beneficial effects of participation in social activities are particularly salient for elderly women and for the old–old, whereas the salutary effects of caring for grandchildren are more substantial for elderly men and for the young–old. Our findings suggest the importance of social engagement in promoting health and successful aging of elderly Chinese and disclose the moderating roles of gender and age in this focal relationship.

Does productive role occupancy prevent depression among older rural Chinese adults? A latent difference score analysis

OBJECTIVES

Depression has been reported as common among older rural Chinese adults, who often face limited access to healthcare services and resources. Empirical studies conducted in the West have shown beneficial effects of productive engagement on psychological well-being. However, the mechanisms by which engagement in productive activities leads to and results from improved mental health remain unclear.

METHOD

Utilizing role enhancement and social resource theories, the present study investigated the relationship between productive role occupancy and depression among older Chinese adults in rural areas over 8 years. Using four waves of data from the Well-Being of Elderly in Anhui Province of China study, we employed bivariate latent different score analysis to examine the temporal sequence of productive role occupancy and depression among 1696 older adults.

RESULTS

Findings indicated that trajectories of productive role occupancy and depression rose across the four waves. There is evidence for self-feedback effects in productive role occupancy and depression. Depression had a significant effect on subsequent changes in productive role occupancy (β = -0.042, p = 0.000), whereas productive role occupancy had no significant effect on subsequent changes in depression.

CONCLUSION

The mental well-being of participants worsened over time. Engaging in productive activities had no effect on mental health status, and rural older adults with poor mental health were less likely to engage in productive activities over time. Findings suggest that psychological well-being as a personal resource significantly affects how productively Chinese adults age in late life.

Parent–child relationships among older Chinese immigrants: the influence of co-residence, frequent contact, intergenerational support and sense of children's deference

Immigration disrupts the bonding process in families. Maintaining close relationships with adult children can be an important protective factor for older immigrants' health and wellbeing. Quantitative research explaining such close relationships is rare. This study examined factors associated with close parent–child relationships in a purposive sample of 236 older Chinese immigrants in Los Angeles who provided information regarding 365 children. Two-level regression models were estimated to investigate factors contributing to cohesive parent–child relationships among these older adults. The findings showed that co-residence, a characteristic that distinguishes immigrant families from most non-immigrant families, was associated with lower parent–child relationship quality. Frequent contact was associated with closer relationships. While receiving instrumental and monetary support from children was associated with favourable ratings of relationships with children, providing such support to children was not related to parents' assessment of relationship quality. Parental perceptions of children being respectful was also associated with better relationship quality ratings. Overall, the findings demonstrate how family-related changes in the immigration context shape parent–child relationships in later life. Implications for future research and practice are provided.