The health and wellbeing of grandparents caring for their grandchildren

G L A S E R K , D I G ES SA G , A N D T I N K E R A

S O C I A L C A R E WO R K FORC E R ES EARCH U N I T

ES R C ES / K 0 0 3 3 4 8/ 1

Research Study– funding, partnerships and timescaleFunded by ESRC in partnership with Grandparents Plus (Gplus), CalousteGulbenkian Foundation, and the Beth Johnson Foundation

Phase 3: To examine effects of caring for grandchildren on the health of European grandparents.

Project webpage: https://www.grandparentsplus.org.uk/grandparenting-in-europe-the-health-and-wellbeing-of-grandparents-caring-for-grandchildren

Phase 4: Grandparental childcare, its relationship with SES inequalities and health from a life course perspective

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OutlinePrevious work (Phases 1-2)

Background

Key research questions

Findings

Proposed Work

Summary

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Previous Work: Grandparenting in Europe –Phases 1 & 2

To investigate variations across Europe in diversity of grandparents, how grandparents contribute to childcare, and how policies are related to patterns of grandparenting.

http://www.grandparentsplus.org.uk/grandparenting-in-europe-project

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SHARE & ELSA

Nationally representative samples of individuals aged 50+ living in households

✓Survey of Health, Aging & Retirement in Europe (SHARE)

✓[11 countries, ~30,000 individuals]✓Austria, Germany, Sweden, the Netherlands,

Spain, Italy, France, Denmark, Greece, Switzerland and Belgium

✓ English Longitudinal Study of Ageing

✓ (ELSA) [~12,000 individuals]✓ Household response rate: 62% (SHARE);

70% (ELSA) with individual response rates higher than 85%

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% of older adults who are grandparents: 12 European Countries

45

50

55

60

65

70

EN FR DK SE DE NL BE AT CH ES IT GR

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Source: SHARE, 2004/05; ELSA, 2002/03; own calculations. Weighted data.

Mean number of grandchildren

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•French grandparents also have more grandchildren than most of their European counterparts, with an average of nearly five (4.8) compared with an average across the other 11 countries of 4.2.

Source: SHARE, 2004/05; ELSA, 2002/03; own calculations. Weighted data.

% grandparents with at least one grandchild aged 0-2

34 32 34

20

41

25

19

2530 28

23

0

5

10

15

20

25

30

35

40

45

FR DK SE DE NL BE AT CH ES IT GR

8

•Dutch grandparents most likely have grandchild < 3 followed by French, Danish and Swedish.

Source: SHARE, 2004/05; own calculations. Weighted data.

% grandparents in paid work

23

18

2930

1716

15 14

23

119 9

0

8

16

24

32

EN FR DK SE DE NL BE AT CH ES IT GR

9

Source: SHARE, 2004/05; ELSA, 2002/03; own calculations. Weighted data.

Policy & grandparent childcare

❖To what extent are cross-national patterns of grandparental childcare influenced by family policy at country level?

❖Testing model empirically including country and individual-level indicators.

❖Indicators from more than one generation.

❖Focus on intensive grandparent childcare.

❖Multilevel logistic regression (3 levels: parents, grandparent households and countries)

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Di Gessa G, Glaser K, Price D, Ribe E, Tinker A. What Drives National Differences in Intensive Grandparental Childcare in Europe? The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. March 16, 2015 2015.

Policies & Other Indicators

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GRANDPARENTAL CHILDCARE

Policies

• Maternity, Paternity and Parental Rights

• Leave to care for a sick child

• “Family Friendly” Labour Market Policies

• Child benefits

• Childcare and education entitlements and services

• Retirement policies

• Long-term care policies

Family and Gender Cultures and Structures

• Attitudes to child care

• Gender role attitudes

• Satisfaction with public support for families

• Use of child care services

• Use of elder care services

Labour Market Cultures and Structures

• Working patterns of women and mothers by:

• age of children

• number of working hours

• marital status

• Couples in breadwinner-carer/part-time carer and dual-full- time-worker arrangements

• Gender pay gap

2008 data, various sources: Eurostat, OECD, GGS, SHARE, EVS, Eurobarometer, National and International web sources

Country

% pre-school children suffer with working

mother

% mothers aged 25-49 not in paid

work

% children <3 in formal care

% women 50-64 in

paid work

England 5 31 35 58Denmark 2 15 73 62Sweden 4 17 49 72

The Netherlands 7 21 47 53Germany 17 29 19 56

France 13 25 40 50Austria 26 25 29 47Belgium 11 25 35 39

Spain 11 37 39 40Italy 13 44 27 35

Greece 27 40 25 36

Source: OECD 2011, Eurostat (EU-SILC) 2011, European Values Survey Wave 4.

Country-level factors to be included in multivariable analysis

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SHARE

«During the last 12 months,

have you looked after your grandchild[ren]

without the presence of the parents?»

If so i) «how often?» [daily, weekly, monthly, less often]

ii) «about how many hours?»

Intensive grandparental childcare if grandchildren were looked after by

grandparents on a daily basis or at least 15 hours per week

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Intensive childcare

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% Mean England (ELSA) 6 30.0

Denmark 3 29.6Sweden 4 31.2

The Netherlands 8 29.4Germany 11 24.7

France 10 31.1Austria 12 28.3Belgium 16 29.4

Spain 18 30.4Italy 24 26.6

Greece 24 33.7Tot SHARE 13 29.3

The outcome is provision of intensive childcare by grandparents

Findings – Level 3 Country ‘cultural-structural’ level associations

Odds ratios SE

% mothers 25-49 not in paid employment

1.02** 0.00

% women aged 50-64 in paid work 0.94*** 0.01

% children under the age of 3 in formal care

0.97*** 0.01

% pre-school children suffer with working mom

1.01 0.01

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After taking into account parent and grandparent characteristics

Findings – Country ‘cultural-structural’ level associations

Model I: Parent

Model II: Grandparent

Model 3: Country

Indicators

Country level variance1.49

(0.69)1.43

(0.66)0.16

(0.07)

Country level variance as % total variance 13.7% 13.6% 1.7%

Note: the first-level variance is estimated using a threshold model at 3.29.

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Summary –Grandchildcare

•You need an understanding of demographic, policy, and cultural-structural factors to explain cross-national variations in patterns of grandparental childcare.• e.g. More women aged 50-64 in paid work, less

intensive grandparent childcare• e.g. More children 0-2 in formal care, less intensive

grandparent care.

•In Southern European countries (e.g. Italy, Spain) women working full-time rely heavily on family care and on grandparent childcare in particular (as there is little formal childcare)

Di Gessa G, Glaser K, Price D, Ribe E, Tinker A. What Drives National Differences in Intensive Grandparental Childcare in Europe? The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. March 16, 2015 2015.

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Glaser, K. and Hank, K., 2018. Grandparenthood in Europe.

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1

Grandparental childcare (‘take care or look after’)

•Frequency & amount (e.g. how often and for how many hours)

2

Custodial care (US) (vs. coresidence)

•Primary caregiver

Grandparental Households❖Most evidence to date from US shows increase in multigenerational households. ❖Grandparent households important

contributor to this.

❖U.S. especially significant rise in ‘skipped-generation households’ – grandparents living with grandchildren but without the child’s parents.

❖In US grandparent households associated with socio-economic disadvantage (e.g. poverty skipped-generation households)

❖Reasons: parental support needs and social welfare reforms

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Glaser, K., Stuchbury, R., Price, D., Di Gessa, G., Ribe, E. and Tinker, A., 2018. Trends in the prevalence of grandparents living with grandchild (ren) in selected European countries and the United States. European

Journal of Ageing, pp.1-14.

Data & Analytic Approach

❖IPUMS (Integrated Public Use Microdata Series) International – harmonised samples of census data.

❖England & Wales: the ONS Longitudinal Study

❖Descriptive and bivariate analyses

❖Multinomial logistic regression to investigate how grandparent households vary across selected European countries and U.S.

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Three-generation grandparent households

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Figure 1 Percentage of people aged 40 years or more coresiding with both adult children and grandchildren (aged 0-17)

Source: IPUMS-International (Minnesota Population Center, 2017) and ONS Longitudinal Study

00.5

11.5

22.5

33.5

44.5

55.5

66.5

77.5

88.5

99.510

10.511

1980s 1990s 2000s 2010s

Austria

England/Wales

France

Greece

Portugal

Romania

USA

Household Features –2000sUS, Portugal, and

France both grandparents more common in skipped-generation households

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COUNTRY THREE -GENERATION SKIPPED -G ENERATION

Grandmother only

Both Grandparents

Grandmother only

Both grandparents

Austria 40.2 48.4 35.7 57.4

England & Wales

33.9 59.8 40.4 54.9

France 49.2 39.9 32.8 62.1

Greece 48.2 42.2 29.5 64.7

Portugal 43.9 47.7 32.1 65.3

Romania 41.2 49.9 32.5 64.0

US 47.3 42.7 42.4 51.7

Multinomial logit regressionThree gen: female, younger, widow or div/sep,

lower education (stronger for skipped), unemp & not active (latter stronger for skipped E & W), born abroad, own home.Skipped gen: female, older, widow or div/sep (not as strong – much lower odds for both), lower education, unemp & not active, more likely to be born abroad (except US), not own home

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Three -Generation

Skipped-Generation

England & Wales

1980s 1.00 1.00

1990s 0.88*** 1.15

2000s 0.35*** 1.67***

2010s 0.83*** 1.71***

US

1980s 1.00 1.00

1990s 1.33*** 1.69***

2000s 1.59*** 2.51`***

2010s 1.69*** 2.52***

Summary Grandparent Households:

❖Most countries significant decline in three-generational households since the late 1970s/early 1980s. Only Romania showed an increase like the US.

❖All countries grandparent coresidenceassociated with socio-economic disadvantage.

❖Regardless of overall trends, grandparent households in countries studies appeared to be coming more common among grandparents able to provide rather than need support.

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Media Coverage25

Grandparents & HealthI. What is the impact of grandparental

childcare on health & wellbeing once we take prior health status into account?

II. What is the impact of grandparental childcare on health & wellbeing once we take different life histories into account?

III. What role does cumulative advantage / disadvantage play in the association between grandchild care and grandparents’ health and wellbeing?

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Grandparents & Health: Background❖Studies (mostly US) grandparents with ‘primary care’ responsibilities for grandchildren most disadvantaged/poorest health.

❖Most research uses cross-sectional data; not know whether due to previous disadvantage or impact of grandchild care per se.

❖Research using longitudinal data inconclusive: may be because grandchild care at different intensity levels related to different outcomes or not been able to take into account prior disadvantage (childhood & adulthood).

Grandparental childcare & health

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0

10

20

30

40

SRH as poor orfair

1 + ADLdisability

Depressivesymptoms

%

Health

Health Indicators by grandparental childcare: SHARE 2004/05

Not looking after

Non-intensive

Intensive

Percentage distribution of grandparental care, 2004/05 SHARE

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Grandparental childcare

Not looking after gcld

Non-intensive

Intensive Total

Education: Low 54.4 31.5 14.1 100.0

Education: Medium

44.7 43.8 11.6 100.0

Education: High 40.2 49.1 10.8 100.0

N 7,183 1,199 1,872 14,560

Distribution of grandparental care by lifetime experiences

Not looking

afterNot intensive Intensive

In couple >80% 71.0 78.9 83.2

Never-worked (W) 27.9 14.4 29.1

Suffered hunger 13.6 8.9 9.5

Advantaged & good health at 1019.2 33.5 17.3

Disadvantaged & good health at

age 1073.5 58.7 75.8

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Di Gessa, G., Glaser, K., Tnker, A. The impact of caring for grandchildren on the health of grandparents in Europe: A lifecourse approache Social Science & Medicine, 152 (2016), 166-175.

Results –linear regression

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Latent health 0.558 < 0.001

In lowest cognitive quintile – 0.049 0.005

Depressive symptoms – 0.094 < 0.001

Obese – 0.077 < 0.001

Smoking – 0.009 0.543

2 or more marital unions – 0.018 0.352

In paid work for 1-75% of working life – 0.022 0.114

Has never worked – 0.046 0.019

Has suffered long periods of ill health – 0.154 <0.001

Has suffered hunger – 0.022 0.228

Has suffered any ‘adverse’ event – 0.019 0.298

Disadvantaged & good health at age

10

0.001 0.932

Disadvantaged & poor health at age 10 – 0.039 0.054

Not intensive 0.033 0.010

Intensive 0.033 0.019

Summary: Grandparent childcare & Health

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Grandchild care – both intensive and non-intensive – positively associated with good health over time.

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Relationship remains even when taking into account childhood and adulthood disadvantage.

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Hank, K., Cavrini, G., Di Gessa, G. and Tomassini, C., 2018. What do we know about grandparents? Insights from current quantitative data and identification of future data needs. European Journal of Ageing, pp.1-11.

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Activities grandparents do when they look after grandchildren (e.g. look after them when are ill, prepare meals, or take them to and from school, etc.)

2

Why they do it (e.g. help out financially, difficult to refuse, etc.).

3

Attitudes/Perceptions

ELSA Grandparenting Section

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Periodicity, i.e. when in year childcare occurred (e.g. during school terms, the holidays or throughout the whole year);

2

Frequency (e.g. 1 day or more days per week of care)

3

Amount (number of hours of care) provided during these specific periods.

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What grandparents actually do when they look after grandchildren (e.g. look after them when are ill, prepare meals, or take them to and from school, etc.)

FOR EACH: was this // frequently // occasionally // rarely

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Why they do it (e.g. help out financially, difficult to refuse, etc.).

Many thanks.

Questions, comments and feedback are welcome.

karen.glaser@kcl.ac.uk

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