Cited by 378Intergenerational Family Dynamics and CaregivingDemographic Trends and Gender PreferencesFinancial Literacy, Pension, Retirement Analysis
The Health Implications of Grandparents Caring for Grandchildren in China
Open accessChen, F., Liu, G.·2012·The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
DOI 10.1093/geronb/gbr132PMC PMC3267025
Abstract
OBJECTIVES: Caring for grandchildren is a common and normative experience for many Chinese grandparents. This study investigates the influence of child care provision on older adults' health trajectories in China. METHOD: Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories. We use propensity score weighting to take into account potential selection bias. RESULTS: Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income. Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents. Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect. In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average. DISCUSSION: Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts.
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Written from the paper’s full text.
TL;DR
This study asks whether caring for grandchildren helps or harms older adults’ health in China, using longitudinal data from 1991 to 2006. It finds that the health effect is not uniform: it depends on living arrangement, caregiving intensity, gender, rural/urban residence, and family income.
Key findings
- Skipped-generation grandparents did not show a self-reported health deficit, and higher family income appeared to buffer them; the interaction between skipped-generation living and high income was 0.14.
- Three-generation coresidence was linked to a slightly faster health decline, but paternal grandparents had better average health and slower decline than maternal grandparents in that arrangement.
- Among coresiding grandparents, high-intensity care for young grandchildren accelerated health decline, while light care had a protective association; high-intensity care was defined as 15 or more hours per week.
- Grandfathers and rural grandparents providing high-intensity care had worse self-reported health on average; the negative intensive-care coefficient of 0.09 was offset for urban grandparents by an interaction of −0.11. Grandfathers averaged 7 caregiving hours per week versus 21 for grandmothers.
Methods
- Data came from six China Health and Nutrition Survey waves (1991, 1993, 1997, 2000, 2004, 2006), selecting adults aged 55 and older and yielding 14,954 person-year records.
- The main analysis used growth curve models within a hierarchical linear modeling framework to estimate within-person and between-person health trajectories, with self-rated health reverse-coded so higher values meant better health.
- Grandparenting was measured first by living arrangement (noncoresidence, skipped-generation, three-generation, paternal/maternal) and then by caregiving intensity among coresiding grandparents with grandchildren aged 0–6 (high, low, no care). Propensity score weighting was used to address selection into coresidence and caregiving.
Limitations
- The paper states that child care measurement was limited to very young grandchildren, that only coresiding grandparents were examined, and that noncoresiding caregivers and care for nonfamily members were not studied.
- It also states that self-reported health was the only consistently available health measure across waves, that ADL results were less robust, and that endogeneity and selectivity are difficult to resolve fully despite propensity score weighting and lagged measures.
- The text makes evident that the CHNS sample is not nationally representative, although the authors note prior work suggesting its household and individual characteristics reflect national averages.
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- Premisecitation§ Research Hypotheses and Design
One of the major limitations of prior studies on the effect of caregiving on grandparents' health is the use of cross-sectional health indicators or health change between two time points at best.
“One of the major limitations of prior studies on the effect of caregiving on grandparents' health is the use of cross-sectional health indicators (Fuller-Thomson, Minkler, & Driver, 1997;Goodman & Silverstein, 2002;Pruchno & McKenney, 2002;Sands & Goldberg-Glen, 2000;Szinovacz & Davey, 2006) or health change between two time points at best (Bachman & Chase-Lansdale, 2005;Blustein et al., 2004;Hug”
Quote in the paperSubstantial claim1 of 3 sources checked - Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Grandfathers engaging in high intensity care have worse self-reported health on average.
“In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.”
Quote in the paperSubstantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Those heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.
“those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.”
Quote in the paperSubstantial claim - Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Grandparents living in three-generation households experience a slightly more rapid health decline than older adults who live independently.
“Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.”
Quote in the paperSubstantial claim - Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Among grandparents in three-generation households, paternal grandparents have a significant health advantage over maternal grandparents.
“Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.”
Quote in the paperSubstantial claim
- Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Among coresiding grandparents, high intensity care for younger grandchildren accelerates health declines.
“Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.”
Quote in the paperSubstantial claim - Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Among coresiding grandparents, a lighter level of care for younger grandchildren has a protective effect on health.
“Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.”
Quote in the paperSubstantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Those involved with a light load of child care have a less accelerated path of health decline.
“At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.”
Quote in the paperSubstantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
There is a positive interaction effect between skipped-generation household and high income (0.14).
“The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children.”
Quote in the paperSubstantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Grandfathers involved in intensive child care have worse health on average than grandmothers engaged in the same level of care.
“First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).”
Quote in the paperSubstantial claim - Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Rural grandparents engaging in high intensity care have worse self-reported health on average.
“In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.”
Quote in the paperSubstantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
The hypothesis that grandparents in skipped-generation households are burdened with heavy child care demands without parental support and have compromised health is not supported by the analysis.
“Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.”
Quote in the paperSubstantial claim - Findingown data§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.
Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health compared with those who do not live with grandchildren, particularly when they have higher family income.
“Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.”
- Also stated in: § Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving. · hedged
“First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.”
Quote in the paperSubstantial claim - Also stated in: § Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving. · hedged
- Findingown data§ Discussion and Conclusion
Testing cumulative effect of providing care in more than two waves and continuously across waves found no significant effects.
“We also tested the cumulative effect of providing care in more than two waves and providing care continuously across waves but did not find any significant effects.”
Quote in the paperNot a substantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
The negative effect associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model.
“The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).”
Quote in the paperSubstantial claim - Findingown data§ Discussion and Conclusion
Grandparents living in three-generation households experience an accelerated rate of health decline.
“Although there is evidence suggesting that the normative and cultural context could provide benefits for grandparents, our findings also indicate that grandparents living in three-generation households experience an accelerated rate of health decline.”
Quote in the paperSubstantial claim - Findingreasoning§ Discussion and Conclusion
For those financially worse off, they appear to have a health deficit.
“For those who are financially worse off, however, they appear to have a health deficit.”
Quote in the paperSubstantial claim - Findingcitation§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Grandfathers spend 7 hours per week in caring for grandchildren compared with 21 hours per week for grandmothers.
“For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.”
Quote in the paperNot a substantial claim - Findingreasoning§ Discussion and Conclusion
The findings on ADL are not as robust as those for self-rated health.
“In addition, we examined active daily living (ADL) as the outcome variable for available waves of the data, and the findings are not as robust as those for selfrated health.”
Quote in the paperSubstantial claim - Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
The level of child care intensity has different health implications for urban and rural grandparents.
“Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.”
Quote in the paperSubstantial claim - Findingown data§ Discussion and Conclusion
Grandparents in skipped-generation households do not appear disadvantaged in average health or rate of health decline, particularly when family income is high.
“Grandparents who live in skipped-generation household, however, do not appear to be disadvantaged either in their average level of health or rate of health decline, particularly when their family income is high.”
Quote in the paperSubstantial claim - Premisenone given§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Living with grandchildren means a higher possibility of getting involved with child care.
“Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.”
Quote in the paperSubstantial claim - Premisereasoning§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Grandparents who live with their children and grandchildren are a heterogeneous group, including caregivers and those who may need care themselves.
“Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.”
Quote in the paperSubstantial claim - Study design and conductreasoning§ Method
The estimates for the effects of living arrangements and caregiving status could be biased if selectivity is not taken into account.
“Therefore, the estimates for the effects of living arrangements and caregiving status could be biased if selectivity is not taken into account.”
Quote in the paperSubstantial claim- Rests on an assumption: Coresidence with grandchildren and intensive child care provision are selective in nature, as compared with occasional babysitting.
- Interpretationown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Additional economic resources provide a buffer effect for grandparents living with grandchildren without the presence of adult children.
“The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children.”
Quote in the paperSubstantial claim - Study design and conductown data§ Data and Sample
The loss to follow-up rate ranges from 8 to 14% from one wave of the survey to the next.
“The loss to follow-up rate ranges from 8 to 14% from one wave of the survey to next.”
Quote in the paperNot a substantial claim - Premisereasoning§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Coresidence with grandchildren cannot be simply equated with care for grandchildren.
“As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.”
Quote in the paperSubstantial claim - Premisecitation§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Grandfathers' child care involvement in China is very limited.
“Grandfathers' child care involvement in China is very limited.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Chen et al., forthcoming
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data§ Discussion and Conclusion
The findings provide some support for role enhancement theory, in which a low level of child care involvement is beneficial to health.
“On the one hand, the findings provide some support with the role enhancement theory, in which a low level of child care involvement is beneficial to health.”
Quote in the paperSubstantial claim - Study design and conductreasoning§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
The measures used do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults, despite controlling for SES and health insurance.
“Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.”
Quote in the paperSubstantial claim - Study design and conductnone given§ Discussion and Conclusion
The measurement of child care is limited to care for very young grandchildren.
“First, although our study is one step forward for studying grandparenting in that we go beyond coresidence and examine care intensity, our measurement of child care is limited to the care for very young grandchildren.”
Quote in the paperNot a substantial claim - Interpretationreasoning§ Discussion and Conclusion
The higher health of paternal grandparents living with sons' families suggests the benefit of a culturally preferred living arrangement.
“Paternal grandparents living with their sons' families evidently enjoy a higher mean level of self-reported health and less rapid health decline than coresiding maternal grandparents, suggesting the benefit of a culturally preferred living arrangement.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Discussion and Conclusion
Abundant economic resources appear to provide a buffering effect.
“Abundant economic resources thus appear to provide a buffering effect.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Discussion and Conclusion
The less robust findings on ADL may be because caregiving requires basic functional ability, making selection effect stronger.
“Because caregiving must require older adults to have basic functional ability, the less robust findings on ADL may not be surprising because the selection effect may be stronger.”
Quote in the paperSubstantial claim- Rests on an assumption: Caregiving requires older adults to have basic functional ability.
- Interpretationreasoning§ Discussion and Conclusion
The finding that grandfathers engaged in intensive care of younger children are more susceptible to a more rapid health decline illustrates the centrality of gender variation in shaping family ties and the meanings of family roles.
“The finding that grandfathers who are engaged in intensive care of younger children are more susceptible to a more rapid health decline illustrates the centrality of gender variation in shaping family ties and the meanings of family roles.”
Quote in the paperSubstantial claim - Interpretationreasoning§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
Given substantial differences in social systems for rural and urban populations, the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.
“Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.”
Quote in the paperSubstantial claim- Rests on an assumption: There are wide discrepancies in socioeconomic and health care resources between urban and rural residents, with rural grandparents disadvantaged in health capitals.
- Rests on an assumption: Rural grandparents lack pension programs and are more likely to be dependent on their children.
- Rests on an assumption: Urban grandparents are more financially independent and have more resources, such as a larger social network and easier access to transportation.
- Rests on an assumption: The cultural imperative of filial piety and the expectation of adult children providing support for parents are stronger for rural than urban older adults.
- Study design and conductown data§ Discussion and Conclusion
Lagging care intensity and coresidence in the analysis did not change the results.
“In addition, we lagged the care intensity and coresidence in the analysis, but the results were not different.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 37
- May combine two claims. 32
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation§ Key VariablesA previous study using the SRH measure from the CHNS demonstrated that it well captures the health trajectory of individuals over the life course.
“A previous study using the SRH measure from the CHNS also demonstrated that it well captures the health trajectory of individuals over the life course (Chen, Yang, & Liu, 2010).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Chen, Yang, & Liu, 2010 source
Classified as probably not a substantial claim.
Premisecitation§ Research Hypotheses and DesignA recent comprehensive US study finds that caring for grandchildren has no dramatic and widespread negative effects on a range of health and health behavior indicators when controlling for grandparents' characteristics and prior health.
“Indeed, a recent comprehensive study using a longitudinal and nationally representative data set in the United States (the Health and Retirement Study) finds that caring for grandchildren has no dramatic and widespread negative effects on a range of health and health behavior indicators when controlling for grandparents' characteristic and prior health rather than the consequences of caregiving (H”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Hughes et al., 2007 source
May combine two claims.
Findingown data§ MethodComparison of models using the propensity score weight versus not shows that the magnitude of the grandparenting variables is slightly larger than those without the adjustment, suggesting potential positive selection effects were captured.
“Comparison of models using the weight versus not shows that the magnitude of the grandparenting variables (e.g., high intensity of care) is slightly larger than those without the adjustment, suggesting potential positive selection effects (i.e., healthier grandparents may be more likely to care for grandchildren) were captured by using propensity score weighting (results available upon request).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.Heavy involvement in child care does not have a universally adverse effect on health; caregiving has varied effects by gender and urban/rural residence.
“Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.
“The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.Care intensity affects grandparents' health trajectories; the effect is not linear and differs in its effect on the mean level and the rate of health decline.
“The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2)”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.The effect of grandparents' caregiving is conditioned by the level of intensity and shaped by the characteristics of the caregiver and the context of caregiving.
“They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Discussion and ConclusionHeavy involvement in child care accelerates health decline, while grandparents with a light child care load enjoy a better health level on average.
“Our subsequent finding shows that whereas heavy involvement in child care accelerates health decline, grandparents with a light child care load enjoy a better health level on average.”
Quote in the paperSubstantial claimMay combine two claims.
Findingreasoning§ Discussion and ConclusionPaternal grandparents living with their sons' families have a higher mean level of self-reported health and less rapid health decline than coresiding maternal grandparents.
“Paternal grandparents living with their sons' families evidently enjoy a higher mean level of self-reported health and less rapid health decline than coresiding maternal grandparents, suggesting the benefit of a culturally preferred living arrangement.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.Urban grandparents providing intensive care do not suffer from a clear health disadvantage, whereas rural grandparents engaged in high intensity care have worse health compared with all other groups.
“As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown data§ Discussion and ConclusionIn additional analyses, even a low level of child care involvement has a negative effect on health level when one is combining work and care, suggesting risk of double burden or role conflict.
“Interestingly, in some additional analyses of the interaction between work status and caregiving intensity, we find that even a low level of child care involvement has a negative effect on health level when one is combining work and care, suggesting the risk of double burden or role conflict (results observed in a subsample of married grandparents, not shown).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Data and SampleThe overall working sample excludes missing values (less than 6%) on any variable included in the analysis.
“The overall working sample also excludes missing values (less than 6%) on any variable included in the analysis.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ MethodThe study did not include the interaction term between age-squared and grandparenting variables because they were not significant.
“We did not include the interaction term between age-squared and grandparenting variables because they were not significant.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductcitation§ Key VariablesSelf-reported health has been consistently documented to be a valid measure of health and a robust predictor of mortality and survival.
“We use this measure of self-reported health (SRH) as our main dependent variable, as it has been consistently documented to be a valid measure of health and a robust predictor of mortality and survival (Farmer & Ferraro, 1997;Hays, Schoenfeld, & Blazer, 1996;Idler & Angel, 1990;Idler & Benyamini, 1997;Johnson & Wolinsky, 1993).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Farmer & Ferraro, 1997
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Hays, Schoenfeld, & Blazer, 1996 source
- cites Idler & Angel, 1990
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Premisecitation§ Role Strain or Role Enhancement: The Role of Grandparents in the Context of ChinaIn China, it is common for grandparents to live with children and grandchildren and to provide care for their grandchildren on a regular basis.
“In contrast, in China, it is common for grandparents to live with children and grandchildren and to provide care for their grandchildren on a regular basis (Chen, Short, & Entwisle, 2000;Hermalin, Roan, & Perez, 1998;Olson, 1990;Unger, 1993).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Chen, Short, & Entwisle, 2000 source
- cites Hermalin, Roan, & Perez, 1998
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Olson, 1990
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Role Strain or Role Enhancement: The Role of Grandparents in the Context of ChinaAs a result of a strictly enforced household registration system, urban residents are more likely to have a higher living standard, to receive retirement income, and to have better access to health insurance programs and health care facilities than rural residents.
“As a result of a strictly enforced household registration system, urban residents are more likely to have a higher living standard, to receive retirement income, and to have better access to health insurance programs and health care facilities than rural residents (F.Wang & Mason, 2007;Zimmer & Kwong, 2003).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites F.Wang & Mason, 2007
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Zimmer & Kwong, 2003 source
May combine two claims.
Interpretationown data§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.Lighter care involvement may provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.
“This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ MethodThe quadratic term was added due to its better empirical fit and a theoretical expectation of a nonlinear pattern of health decline.
“We then add a quadratic term due to its better empirical fit and a theoretical expectation of a nonlinear pattern of health decline.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoning§ Abstract Objectives.Caring for grandchildren is a common and normative experience for many Chinese grandparents.This study investigates the influence of child care provision on older adults' health trajectories in China. Method.Using data from the China Health and Nutrition Survey (1991, 1993, 1997, 2000, 2004, and 2006), we apply growth curve models to examine the effect of living arrangements and intensity of caregiving for grandchildren on older adults' health trajectories.We use propensity score weighting to take into account potential selection bias. Results.Grandparents living in skipped-generation households do not suffer from a deficit in self-reported health, particularly when they have higher family income.Those living in three-generation households experience a slightly more rapid health decline than older adults who live independently, although the paternal grandparents in this type of household have a significant health advantage over the maternal grandparents.Among the coresiding grandparents, high intensity care for younger grandchildren accelerates health declines, whereas a lighter level of care has a protective effect.In addition, rural grandparents and grandfathers engaging in high intensity care have worse self-reported health on average.Discussion.Our findings suggest that grandchild care does not have a universally beneficial or detrimental effect on health, but rather its effect depends on the form and level of caregiving and is further shaped by individual characteristics, as well as normative and structural contexts. I NCREASED life expectancy and substantially reduced child mortality in most countries around the world mean that more and more people live to be grandparents and experience an extended period of grandparenthood.Grandparents often provide care and assistance to their grandchildren, with the levels of care provision ranging from uninvolved, to occasional babysitting, to full-time custodial care (Hirshorn, 1998;Landry-Meyer, 1999).Living arrangements also vary from not living together, to coresidence (where parents, grandchildren, and grandparents share the same residence), to "skipped-generation" households (where parents are not present) (Pebley & Rudkin, 1999).How can such varied levels of care for grandchildren influence the well-being of grandparents?Do the benefits of grandparenting (e.g., emotional reward and social support) outweigh the negative effects (e.g., psychological, physical, and financial strain) or vice versa?These questions have become more important than ever in the 21st century, as grandparents are becoming more central to family life in many countries.For example, in the United States, grandparents are fulfilling more family functions as a response to marital instability and broader demographic shifts (Bengtson, 2001;Uhlenberg, 2009; also see review by Swartz, 2009).In China, grandparents caring for grandchildren are common for many families, reflected by a high level of coresidence between grandparents and grandchildren as well as extensive sharing of child care responsibilities in urban and rural areas (Chen, Liu, & Mair, forthcoming).Although the active involvement by grandparents undoubtedly brings numerous benefits to adult children and grandchildren alike, its implications for the well-being of the grandparents are far less clear. The purpose of the study is thus to examine the health consequences of grandparents caring for grandchildren in China, where intergenerational ties are traditionally strong.We maintain that it is essential to understand the phenomenon in the unique historical, cultural, and socioeconomic context of China.Although caring for grandchildren can be physically and psychologically demanding for aging grandparents, at the same time, it can be a manifestation of family cohesion enjoyed by the older adults and therefore provide health benefits.We argue that the health implications of caregiving naturally depend on the structure and intensity of care and that the normative and cultural contexts also play an indispensable role.For example, in light of the persistence of patrilineal and patriarchal tradition in China, could paternal and maternal grandparents be affected differently while performing the same tasks?Does the gendered nature of care affect grandfathers and grandmothers in distinctive ways?Given the conspicuous urban/rural divide in Chinese society, could rural grandparents face additional challenges because of their vulnerable situations to begin with?These questions are vital to understanding the role of The Health Implications of Grandparents Caring for Grandchildren in China grandparenthood in family systems as well as the health implications of grandchild care in contemporary China.The study used propensity score weighting to take into account potential selection bias.
“We use propensity score weighting to take into account potential selection bias.”
- Also stated in: § Research Hypotheses and Design · plain
“Thus, in the analysis, we use propensity score weighting method to control for such selectivity.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Guo & Fraser, 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Rests on an assumption: Coresidence with grandchildren and intensive child care provision are selective in nature, as compared with occasional babysitting.
- Also stated in: § Research Hypotheses and Design · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ MethodThe study dropped all three-way interaction terms because they were not significant.
“Because all the three-way interaction terms were not significant, they were dropped from the analyses.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductcitation§ Data and SampleAlthough the CHNS data are not a representative sample of China, previous studies using the CHNS data suggest that the characteristics of the households and individuals well reflect national averages.
“Although the CHNS data are not a representative sample of China, previous studies using the CHNS data have suggested that the characteristics of the households and individuals well reflected the national averages (e.g., see Du, Lu, Zhai, & Popkin, 2002;Entwisle & Chen, 2002;Short, Ma, & Yu, 2000).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.
Study design and conductreasoning§ Data and SampleBecause individuals remaining in the sample are likely to be healthier, the study addresses this potential selection bias in the method section.
“Because individuals remaining in the sample are likely to be healthier, we will address this potential selection bias in the method section.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationreasoning§ Research Hypotheses and DesignThe context of China is different in that grandparents' caregiving is normative and common, so the process of negative selection is much less of a concern.
“The context of China is different in that grandparents' caregiving is normative and common.Thus, the process of negative selection is much less of a concern.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ Research Hypotheses and DesignA recent study in China found that older adults living in three-generation households or with grandchildren in skipped-generation households have better psychological well-being than those in single-generation households.
“A recent study in China found that older adults living in three-generation households or with grandchildren in skipped-generation households have better psychological well-being than those in single-generation households (Silverstein, Cong, & Li, 2006).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Silverstein, Cong, & Li, 2006 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Interpretationreasoning§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.Remittances sent back to grandparents by adult children could help improve overall family well-being and strengthen intergenerational ties.
“In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ MethodThe study estimated Generalized Linear Mixed Models with ordinal logit link in preliminary analysis but did not present these results because the fixed and random effect coefficients and variance estimates are qualitatively similar from these two sets of analyses.
“Given that self-reported health is an ordinal variable, we estimated Generalized Linear Mixed Models (GLMM) with ordinal logit link using SAS PROC GLIMMIX in our preliminary analysis but did not present these results because the fixed and random effect coefficients and variance estimates are qualitatively similar from these two sets of analyses.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Role Strain or Role Enhancement: The Role of Grandparents in the Context of ChinaIn the United States, grandparents often do not choose to take care of their grandchildren full time but step in under troubled circumstances.
“In the United States, grandparents often do not”
Quote in the paperNot a substantial claim0 of 3 sources checkedMay combine two claims.
Premisecitation§ Role Strain or Role Enhancement: The Role of Grandparents in the Context of ChinaMany parents choose to leave their children behind under grandparents' care in order to seek better job opportunities, with an estimated 144.4 million temporary migrants from rural to urban China.
“In addition, with an estimated 144.4 million temporary migrants (the so-called”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites National Bureau of Statistics in China, 2002
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown data§ MethodThe quadratic rate was modeled but not presented due to insignificant results.
“We modeled the quadratic rate of b 2i but did not present it due to insignificant results.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Role Strain or Role Enhancement: The Role of Grandparents in the Context of ChinaFrequent contact with grandchildren is associated with high levels of life satisfaction.
“Frequent contact with grandchildren has been found to be associated with high levels of life satisfaction (Forsyth, 1994;Forsyth et al., 1992;Goodman & Silverstein, 2001;Kivnick, 1981;Peterson, 1999).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Forsyth, 1994
- cites Forsyth et al., 1992
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Goodman & Silverstein, 2001 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Role Strain or Role Enhancement: The Role of Grandparents in the Context of ChinaRemittances from adult children often help to compensate for the effort of grandparent caregiving and to strengthen the intergenerational bond.
“Although it could be potentially burdensome for grandparents, remittances from their adult children often help to compensate for the effort and to strengthen the intergenerational bond (Cong & Silverstein, 2008).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Cong & Silverstein, 2008 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Data and Sample753 individuals in the working sample died by the end of 2006.
“Among them, 753 individuals died by the end of 2006.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
Interpretationreasoning§ Research Hypotheses and DesignThe potential of positive selection cannot be ruled out, in that grandparents could be healthier to begin with.
“However, the potential of positive selection cannot be ruled out, in that they could be healthier to begin with.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationreasoning§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.Grandfathers' worsened health condition could be due to a combination of lack of support from grandmothers, stress associated with widowhood, and traditional gender role expectations.
“Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.”
Quote in the paperSubstantial claim- Rests on an assumption: In Chinese culture, child care provision is viewed as a feminine role.
- Rests on an assumption: Grandfathers are not culturally expected to be in nurturing roles and often do not do so when grandmothers are present.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Discussion and ConclusionScholars and policy makers have long been concerned about undermining traditional family values and weakened filial practices in rural China during collectivization and a further erosion of parental authority and power shift to the younger generation since economic reforms.
“On the other hand, scholars and policy makers have long been concerned about undermining traditional family values and weakened filial practices in rural China during the collectivization of agriculture in the 1950s and a further erosion of parental authority and power shift to the better educated and more resourceful young generation since the economic reforms beginning in the late 1970s (Davis &”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Davis & Harrell, 1993
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Parish & Whyte, 1978
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites D. Wang, 2004
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion and ConclusionNoncoresiding family members are increasingly likely to be involved in each others' lives.
“Indeed, noncoresiding family members are increasingly likely to be involved in each others' lives (Whyte, 2003).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Whyte, 2003
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductown data§ Discussion and ConclusionThe analysis addresses endogeneity by using propensity score weighting in growth curve analysis.
“In our analysis, we address this issue by using propensity score weighting in our growth curve analysis.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductreasoning§ Discussion and ConclusionThe issue of endogeneity and selectivity are not easily addressed.
“Fourth, the issue of endogeneity and selectivity are not easily addressed.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationcitation§ Discussion and ConclusionThe findings are in line with role strain theory, in which intensive caregiving can be physically taxing and takes away resources from aging adults, leading to more rapid health decline.
“On the other hand, our findings are in line with the role strain theory, in which intensive caregiving can be physically taxing and takes away resources from aging adults, leading to more rapid health decline (Jendrek, 1993;M. Minkler, 1999).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
Interpretationreasoning§ Discussion and ConclusionThe lack of normative support could make daily caregiving more difficult and stressful for grandfathers, given that they are not culturally expected to be in nurturing roles and often do not do so when grandmothers are present.
“Given that grandfathers are not culturally expected to be in nurturing roles and often do not do so when the grandmothers are present, the lack of normative support could make daily caregiving more difficult and stressful.”
Quote in the paperSubstantial claim- Rests on an assumption: In Chinese culture, child care provision is viewed as a feminine role.
- Rests on an assumption: Grandfathers are not culturally expected to be in nurturing roles and often do not do so when grandmothers are present.
Classified as probably not a substantial claim.
Study design and conductown data§ Discussion and ConclusionSelf-reported health is used because it is the only measure of health consistently available across all waves of the data.
“Third, we use self-reported health because it is the only measure of health that is consistently available across all waves of the data.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).
Interpretationreasoning§ Discussion and ConclusionTaking care of grandchildren could be even more emotionally rewarding when it is altruistically motivated and not compelled by economic necessity.
“Taking care of grandchildren could be even more emotionally rewarding when it is altruistically motivated and not compelled by economic necessity.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion and ConclusionGrandparents who do not live with grandchildren could also play a significant role in taking care of their grandchildren.
“Grandparents who do not live with grandchildren could also play a significant role in taking care of their grandchildren.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.
Interpretationnone given§ Discussion and ConclusionCaring for school-aged children may not be as physically draining, but grandparents' interaction with grandchildren may take on other forms and could have health implications.
“Although caring for school-aged children may not be as physically draining, grandparents' interaction with grandchildren may take on other forms and could have health implications as well.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Results Do living arrangements with grandchildren affect the health trajectories of older adults?Results presented in Table 2 address this question.We begin with a reduced model that is depicted in Equation 4 (Model 1).The control variables on sociodemographic and socioeconomic characteristics and health behaviors are then added one group after the other (Models 2 and 3).The results across the models consistently show that both coresidence and family lineage matter, although the effects are different for the intercept and linear growth rate model.We caution that these two sets of variables have to be interpreted together because for a grandparent to be identified as "paternal," he or she has to coreside with the grandchildren, either in a skippedgeneration or three-generation household.To illustrate the effects of these variables more effectively, we present the predicted health trajectories of older adults by living arrangements in Figure 1, based upon the estimates from Model 3 in Table 2, with all the other control variables set to their sample means (for continuous variables) or modes (for categorical variables).First, grandparents who live in skipped-generation households (either maternal or paternal) do not seem to suffer from a health disadvantage compared with those who do not live with grandchildren.Second, compared with older adults who do not live with their grandchildren, grandparents living in three-generation households Thus, the hypothesis that grandparents in skippedgeneration household could be burdened with heavy child care demands without the support of parents and their health may be compromised is not supported in our analysis.As Silverstein and colleagues (2006) suggested, this type of living arrangement is quite different from the U.S. setting.Instead of being "associated with a breakdown in parenting by middle generation" (S263), it could reflect "optimal family functioning," where grandparents fill the parental role while migrant children are away.In exchange, remittances sent back to the grandparents by the adult children could help improve overall family well-being and strengthen the intergenerational tie.Could the parents in skipped-generation households benefit from the improved economic well-being of the household?We find some evidence by testing for an added interaction term between living arrangements and family income (see Model 4).The positive interaction effect between skipped-generation household and high income (0.14) results suggest that additional economic resources do provide a buffer effect for those grandparents living with grandchildren without the presence of adult children. As indicated earlier in the paper, coresidence with grandchildren cannot be simply equated with care for grandchildren.Grandparents who live with their children and grandchildren are a heterogeneous group, including not only those who are caregivers but also those who may need care themselves.Nonetheless, living with grandchildren certainly means a higher possibility of getting involved with child care.Thus, we restrict the next part of the analysis to those who are living with grandchildren at each survey year and examine the effect of caregiving intensity.The analytical results shown in Table 3 suggest that care intensity affects grandparents' health trajectories, however, as hypothesized, the effect is not linear and differs in its effect on the mean level and the rate of health decline (see Model 1 in Table 3 and predicted health trajectories in Figure 2): those who are heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.At the same time, those who are involved with a light load of child care have a less accelerated path of health decline.This supports our hypothesis that the lighter care involvement may indeed provide a beneficial effect on health, whereas intense grandchild care may be physically and psychologically draining.The finding is consistent with an earlier U.S. study in which light babysitting was found to be beneficial to health (Hughes et al., 2007). Finally, Model 2 and in Table 3 added the interaction between gender, urban/rural residence, and caregiving intensity, respectively.They clearly support our hypothesis that the effect of grandparents' caregiving is not only conditioned by the level of intensity but also shaped by the characteristics of the caregiver and the context of caregiving.Heavy involvement in child care does not have a universally adverse effect on health; instead, caregiving has varied effects by gender and urban/rural residence.This is consistent with a longitudinal study in the United States that found "the effect of grandchild care on grandparents' health are contingent on the context and circumstance of that care" (Hughes et al., 2007, S115).First, grandfathers who are involved in intensive child care have worse health on average than the grandmothers who are engaged in the same level of care (see Figure 3).Grandfathers' child care involvement in China is very limited.An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).For example, grandfathers only spend 7 hr per week in caring for grandchildren compared with 21 hr per week for grandmothers.Thus, their worsened health condition could be due to a combination of the lack of support from grandmothers, the stress associated with widowhood, and perhaps equally important traditional gender role expectations.In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.For those grandfathers who are engaged in heavy child care duties, the lack of normative support or even associated "stigma" may add to the stress and in turn lead to a worsened health condition.This finding is consistent with a recent U.S. study that found that the adverse health effect of having a grandchild in the home is more pronounced for men than women (Blustein et al., 2004). Interestingly, the level of child care intensity also has different health implications for urban and rural grandparents.The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).As Figure 4 shows, urban grandparents who are providing intensive care do not suffer from a clear health disadvantage, whereas it is obvious that rural grandparents engaged in high intensity care have worse health compared with all other groups of grandparents.Although we control for SES and health insurance in the model, the measures we have do not entirely capture the wide extent of differences in living standards, support systems and access to health care for rural and urban older adults.Given the substantial differences in social systems for these two segments of the population, it is expected that the rural grandparents' disadvantage was further magnified with added stress associated with intense caregiving.An earlier study by the research team suggests that grandfathers' involvement was much lower than grandmothers' and that their heavy involvement is often preceded by the unavailability of grandmothers.
“An earlier study by the research team suggests that grandfathers' involvement was much lower than that of the grandmothers and that their heavy involvement is often preceded by the unavailability of grandmothers (Chen et al., forthcoming).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Chen et al., forthcoming
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Discussion and ConclusionThe examination of care is limited to coresiding grandparents.
“Second, our examination of care is limited to coresiding grandparents.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Premisecitation§ Discussion and ConclusionRelations among household members can create tensions and conflicts and thus be harmful to health, particularly in a cultural context that emphasizes harmony.
“Although the household is a crucial context for social support, relations among its members can create tensions and conflicts and thus be harmful to health, particularly in a cultural context that emphasizes harmony (Lai, 1995;Rook, 1984).”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisenone given§ Discussion and ConclusionSome grandparents provide care to coresiding grandchildren, while other grandparents may require care themselves.
“In addition, although some grandparents provide care to coresiding grandchildren, other grandparents may require care themselves.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductnone given§ Discussion and ConclusionLiving arrangements and caregiving could be endogenous to health.
“We treat health as an outcome in the analysis, but living arrangements and caregiving could be endogenous to health.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
Interpretationreasoning§ Discussion and ConclusionThe added burden of intensive care for grandchildren could further exacerbate the vulnerable situation of rural older adults coupled with a lack of institutional recognition and support.
“The added burden of intensive care for grandchildren could further exacerbate the vulnerable situation of the rural older adults coupled with a lack of institutional recognition and support.”
Quote in the paperNot a substantial claim- Rests on an assumption: There are wide discrepancies in socioeconomic and health care resources between urban and rural residents, with rural grandparents disadvantaged in health capitals.
- Rests on an assumption: Rural grandparents lack pension programs and are more likely to be dependent on their children.
- Rests on an assumption: The cultural imperative of filial piety and the expectation of adult children providing support for parents are stronger for rural than urban older adults.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Discussion and ConclusionThe study does not examine care of grandparents for nonfamily members due to data limitation.
“In addition, we do not examine the care of grandparents for nonfamily members due to data limitation.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown data§ Discussion and ConclusionThe influence of heavy involvement with child care on health differs for urban and rural grandparents, providing evidence that the consequence of grandchild care is not universal and is contingent on context and circumstances.
“The finding that the influence of heavy involvement with child care on health differs for urban and rural grandparents provides another piece of evidence that the consequence of grandchild care is not universal and contingent on the context and circumstances of the care.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Premisenone given§ Discussion and ConclusionCoresidence facilitates easy access of grandparents to grandchildren.
“First, the analysis of the influence of living arrangements provides us with an initial understanding of the structural context of caregiving, as coresidence facilitates easy access of grandparents to grandchildren.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion and ConclusionCaring for grandchildren could be considered a reciprocal form of intergenerational exchange that ensures old age support in later life.
“Caring for grandchildren could be considered a reciprocal form of intergenerational exchange that ensures old age support in later life (Cong & Silverstein, 2008;Croll, 2006).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
Interpretationown data§ Discussion and ConclusionThe study helps identify grandparent caregivers at greater risk: grandfathers and rural grandparents engaged in intensive care.
“Further, our study helps to identify grandparent caregivers who are at greater risks and grandfathers and rural grandparents engaged in intensive care.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Discussion and ConclusionPrevious research suggests that grandparents' caregiving for grandchildren could inject a sense of meaning and purpose in life, induce a more active lifestyle, and facilitate family bonding.
“Previous research suggests that grandparents' caregiving for grandchildren could inject a sense of meaning and purpose in life, induce a more active lifestyle, and facilitate family bonding (Pruchno & McKenney, 2002;Silverstein et al., 2006;Waldrop & Weber, 2001).”
Quote in the paperNot a substantial claim0 of 3 sources checked
56 of 56
The paper relies on this without support.
Coresidence with grandchildren and intensive child care provision are selective in nature, as compared with occasional babysitting.
“Coresidence with grandchildren and intensive child care provision are most likely to be selective in nature (as compared with occasional babysitting).”
The authors state this as an assumption.
The measures of potential needs for child care by adult children are important predictors of grandparents' engagement in child care and do not have direct effects on grandparents' health.
“The last two measures are particularly important because we consider them important predictors of whether grandparents are engaged in child care or not, while at the same time, the measures should not have direct effects on grandparents' health.”
The paper relies on this without support.
In rural China, parents can be particularly dependent on their children for financial security in old age.
“In rural China, parents can be particularly dependent on their children for financial security in old age.”
The paper relies on this without support.
Health change usually does not take place suddenly but is likely a gradual, interactive, and cumulative process.
“Nonetheless, health change usually does not take place suddenly but is likely a gradual, interactive, and cumulative process.”
The paper relies on this without support.
Coresidence with children and grandchildren does not happen at random.
“In addition, coresidence with children and grandchildren does not happen at random.”
The authors state this as an assumption.
The residuals and random effects in the growth curve models are normally distributed.
“with eti assumed to be independently and normally distributed with a mean of 0 and a constant variance of s 2 , and with both u 0i and u 2i assumed to have multivariate normal distribution.”
The paper relies on this without support.
In Chinese culture, child care provision is viewed as a feminine role.
“In Chinese culture (as in many other cultures), child care provision is viewed as a feminine role.”
The paper relies on this without support.
There are wide discrepancies in socioeconomic and health care resources between urban and rural residents, with rural grandparents disadvantaged in health capitals.
“With wide discrepancies in socioeconomic and health care resources between urban and rural residents, rural grandparents are clearly at a disadvantage with regard to health capitals.”
The paper relies on this without support.
Rural grandparents lack pension programs and are more likely to be dependent on their children.
“With an absence of pension programs, they are much more likely to be dependent on their children.”
The paper relies on this without support.
Urban grandparents are more financially independent and have more resources, such as a larger social network and easier access to transportation.
“In comparison, urban grandparents are much more financially independent and have more resources at their disposal (e.g., larger social network and easier access to transportation).”
The paper relies on this without support.
The cultural imperative of filial piety and the expectation of adult children providing support for parents are stronger for rural than urban older adults.
“On the one hand, the cultural imperative of filial piety, the need, and the expectation of adult children providing support for parents are stronger for rural than urban older adults.”
The paper relies on this without support.
Strong intergenerational bonds define Chinese tradition, and caring for grandchildren is often not perceived as a privilege or burden but a normative way of life for many grandparents.
“In a context where strong intergenerational bonds define its tradition, caring for grandchildren is often not perceived as a privilege or burden but a normative way of life for many grandparents.”
The paper relies on this without support.
Grandchild care is not an isolated event but an essential part of a dynamic system of family exchange.
“It is not an isolated event but an essential part of a dynamic system of family exchange.”
The paper relies on this without support.
Grandfathers are not culturally expected to be in nurturing roles and often do not do so when grandmothers are present.
“Given that grandfathers are not culturally expected to be in nurturing roles and often do not do so when the grandmothers are present, the lack of normative support could make daily caregiving more difficult and stressful.”
The paper relies on this without support.
Caregiving requires older adults to have basic functional ability.
“Because caregiving must require older adults to have basic functional ability, the less robust findings on ADL may not be surprising because the selection effect may be stronger.”
15 of 15
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Reported coefficient signs do not support the claimed urban buffer
MajorWith higher scores indicating better health, a positive 0.09 care effect is not a negative effect. Adding the stated −0.11 urban interaction gives an urban effect of −0.02, rather than removing a negative effect.
“The negative effect that is associated with intensive care (0.09) is wiped out for urban grandparents when adding the interaction term (-0.11) in the intercept model (Model 3 in Table 3).”
“We have reverse-coded selfrated health so that higher values indicate better health.”
Caregiving categories disagree at exactly 15 hours
MinorThe text assigns 15 hours per week to high-intensity care, while the table defines that category as more than 15 hours. The classification of someone providing exactly 15 hours is inconsistent.
“We operationalize caregiving load as "high intensity" (i.e., 15 or more caregiving hours per week), "low intensity" (i.e., 1-14 caregiving hours per week), and "no-care" (reference group).”
“High intensity (more than 15 hr per week)”
2 of 2
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Cited by
Sorted by citations
Grandparents Raising Grandchildren: What Have We Learned Over the Past Decade?
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Impact of Caring for Grandchildren on the Health of Grandparents in Taiwan
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Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents
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“In China, among grandparents who provided intensive grandchild care, grandfathers were found to experience a faster decline in self-rated health than grandmothers (Chen & Liu, 2011).”
BackgroundResultInfluentialThe Demography of Grandparenthood: An International Profile
Léopold, T., & Škopek, J. (2015) · Social Forces · doi:10.1093/sf/sov066 · Cited by 161 · see citing works
“…daughters (Arpino, Pronzato, and Tavares 2014); role strain, role enhancement, and associated health effects of “on-time” and “off-time” grandparenthood (Chen and Liu 2012); the division of labor in grandparent couples (Leopold and Skopek 2014); grandparental influence on the intergenerational…”
Living Arrangements and Health of Older Adults in India
Samanta, T., Chen, F., & Vanneman, R. D. (2014) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbu164 · Cited by 157 · see citing works
“Similarly, living arrangement categories 3 and 4 distinguish whether the coresidence with grandchildren (or lack thereof) shape elderly health outcomes through positive lifestyle changes (e.g., quit smoking or drinking) or physical strain (as a result of caregiving responsibilities) as suggested by studies on grand-pa…”
BackgroundInfluentialSelf-citationThe Health Impact of Intensive and Nonintensive Grandchild Care in Europe: New Evidence From SHARE
Gessa, G. D., Glaser, K., & Tinker, A. (2015) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbv055 · Cited by 151 · see citing works
“Chen and Liu (2012), using the longitudinal China Health and Nutrition Survey, found no differences in SRH between coresiding and noncoresiding grandparents; however, coresiding grandparents who provided more than 15 hr per week of grandchild care were more likely to report worse SRH.”
BackgroundMethodLuo, Y., Pan, X., & Zhang, Z. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.09.052 · Cited by 150 · see citing works
Grandparenting, health, and well-being: A systematic literature review
Danielsbacka, M., Křenková, L., & Tanskanen, A. O. (2022) · European Journal of Ageing · doi:10.1007/s10433-021-00674-y · Cited by 120 · see citing works
“In this review, 5/34 studies concerning custodial grandparents were conducted with data from Asian countries, and the results were either nonsignificant (Chen and Liu 2012; Choi and Zhang 2018), positive (Chung and Park 2018; Ku et al.”
BackgroundResultRace/ethnic differentials in the health consequences of caring for grandchildren for grandparents
Chen, F., Mair, C. A., Bao, L., & Yang, Y. C. (2015) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/gbu160 · Cited by 110 · see citing works
Self-citationZhou, J. W., Mao, W., Lee, Y., & Chi, I. (2016) · Research on Aging · doi:10.1177/0164027515623332 · Cited by 104 · see citing works
“SRH has proven to be a valid measure of health in many studies and captures the health trajectory of individuals over the life course (Chen & Liu, 2012; Chen, Yang, & Liu, 2010).”
BackgroundMethodInfluentialDolbin-MacNab, M. L., & Yancura, L. A. (2018) · The International Journal of Aging and Human Development · doi:10.1177/0091415016689565 · Cited by 99 · see citing works
“This development resulted in a massive migration of working-aged adults from rural villages to urban areas (Chen & Liu, 2012).”
BackgroundInfluentialHayslip, B., Blumenthal, H., & Garner, A. (2014) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbu165 · Cited by 91 · see citing works
“Chen and Liu (2012) found that skipped generation grandparent caregivers did not experience health difficulties, especially if they enjoyed a greater income.”
BackgroundParticipation in Productive Activities and Health Outcomes Among Older Adults in Urban China
Li, Y., Xu, L., Chi, I., & Guo, P. (2013) · The Gerontologist · doi:10.1093/geront/gnt106 · Cited by 88 · see citing works
Hank, K., Cavrini, G., Gessa, G. D., & Tomassini, C. (2018) · European Journal of Ageing · doi:10.1007/s10433-018-0468-1 · Cited by 86 · see citing works
“1997), particularly among grandparents with primary care responsibilities or who co-reside with grandchildren and provide high levels of childcare (Chen and Liu 2012; Minkler and Fuller-Thomson 2005; Minkler et al. 1997).”
BackgroundDanielsbacka, M., Tanskanen, A. O., Coall, D. A., & Jokela, M. M. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.03.031 · Cited by 76 · see citing works
“Indeed, a negative effect may arise when no grandparental investment exists at all (Drew and Silverstein, 2007) or when grandparental investment reaches its highest level (e.g., in the form of custodial care; Baker and Silverstein, 2008; Chen and Liu, 2012; Grinstead et al., 2003; Hughes et al., 2007; Taylor et al., 2…”
BackgroundHealthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors
Zeng, Y., Wan, Y., Yuan, Z., & Fang, Y. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18062969 · Cited by 77 · see citing works
“In some cases, grandparents help perform child care duties and even continue to help their adult children financially [52].”
BackgroundGuo, M., Xu, L., Liu, J., Mao, W., & Chi, I. (2015) · Ageing and Society · doi:10.1017/s0144686x15000446 · Cited by 72 · see citing works
Kim, H.-J., Kang, H., & Johnson-Motoyama, M. (2017) · Journal of Family Studies · doi:10.1080/13229400.2016.1194306 · Cited by 70 · see citing works
“Supplementary grandchild care is common in Asian countries such as China (Chen & Liu, 2012) and has become increasingly popular in many European countries (Di Gessa, Glaser, Price, © 2016 Informa UK Limited, trading as Taylor & Francis Group CONTACT Hye-Jin Kim hyejin@ku.edu Ribe, & Tinker, 2016; Hank & Buber, 2009; M…”
BackgroundPsychological Well‐Being of Older Chinese‐American Grandparents Caring for Grandchildren
Tang, F., Xu, L., Chi, I., & Dong, X. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14455 · Cited by 71 · see citing works
“According to the role strain theory, grandparents who provide extensive care may experience role strain and associated effects on employment, self-care, or relationships with their spouse or others.(14) Consequently, the high level of caregiving stress may negatively affect grandparents’ mental and physical health,(14…”
Guo, M., Chi, I., & Silverstein, M. (2015) · Ageing & Society · doi:10.1017/s0144686x15001403 · Cited by 60 · see citing works
Grandparent Caregiving, Race, and Cognitive Functioning in a Population-Based Sample of Older Adults
Sneed, R. S., & Schulz, R. (2017) · Journal of Aging and Health · doi:10.1177/0898264317733362 · Cited by 65 · see citing works
“…generally associate the provision of this form of support with numerous adverse physical health outcomes, including poorer self-rated health (Chen & Liu, 2012; Minkler & Fuller-Thomson, 1999), increased frailty (Chen, Mair, Bao, & Yang, 2015), and greater coronary heart disease risk (Lee,…”
BackgroundHilbrand, S., Coall, D. A., Gerstorf, D., & Hertwig, R. (2016) · Evolution and Human Behavior · doi:10.1016/j.evolhumbehav.2016.11.010 · Cited by 62 · see citing works
“These detrimental effects are most pronounced when grandparents provide custodial childcare (Chen & Liu, 2012; Ross & Aday, 2006).”
BackgroundSilverstein, M. D., & Zuo, D. (2020) · Aging & Mental Health · doi:10.1080/13607863.2020.1852175 · Cited by 64 · see citing works
Chan, A. C. Y., Lee, S.-K., Zhang, J., Banegas, J., Marsalis, S., & Gewirtz, A. H. (2023) · The gerontologist · doi:10.1093/geront/gnac026 · Cited by 65 · see citing works
Health and Grandparent–Grandchild Well-Being
Hayslip, B., Blumenthal, H., & Garner, A. (2014) · Journal of Aging and Health · doi:10.1177/0898264314525664 · Cited by 60 · see citing works
“Chen and Liu (2012) found that skipped-generation grandparent caregivers did not experience health difficulties over time, especially if they enjoyed a greater income.”
BackgroundGlaser, K., Price, D., Gessa, G. D., Ribe, E., Stuchbury, R., & Tinker, A. (2010) · Cited by 70 · see citing works
The Health of Grandparents Raising Grandchildren: A Literature Review
Hadfield, J. C. (2014) · Journal of Gerontological Nursing · doi:10.3928/00989134-20140219-01 · Cited by 58 · see citing works
The health effects of caregiving by grandparents in Taiwan: an instrumental variable estimation
Ku, L. E., Stearns, S. C., Houtven, C. H. V., & Holmes, M. (2012) · Review of Economics of the Household · doi:10.1007/s11150-012-9154-9 · Cited by 59 · see citing works
Caring as curing: Grandparenting and depressive symptoms in China
Choi, S., & Zhang, Z. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114452 · Cited by 58 · see citing works
The Delay of Grandparenthood: A Cohort Comparison in East and West Germany
Léopold, T., & Škopek, J. (2015) · Journal of Marriage and the Family · doi:10.1111/jomf.12169 · Cited by 52 · see citing works
“As a result, the meaning of grandparenthood (Kivnick, 1982), the style of grandparenting (Neugarten & Weinstein, 1964), and the benefits and burdens associated with the grandparent role (Chen & Liu, 2012) become “a matter of individual circumstance” (Burton & Bengtson, 1985, p. 66).”
BackgroundKomonpaisarn, T., & Loichinger, E. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.05.031 · Cited by 52 · see citing works
Informal care provision across multiple generations in China
Falkingham, J., Evandrou, M., Qin, M., & Vlachantoni, A. (2019) · Ageing and Society · doi:10.1017/s0144686x19000369 · Cited by 52 · see citing works
“This, combined with high employment rates among women, a relatively short period of maternity leave (three to six months after the birth) and recent substantial rural to urban migration, has meant that Chinese grandparents have become more involved in grandchild care, a trend further supported by the relatively young…”
BackgroundGrandparenthood in China and Western Europe: An analysis of CHARLS and SHARE
Zhang, J., Emery, T., & Dykstra, P. A. (2018) · Advances in Life Course Research · doi:10.1016/j.alcr.2018.11.003 · Cited by 50 · see citing works
Wang, C. D. C., Hayslip, B., Sun, Q., & Zhu, W. (2019) · The International Journal of Aging and Human Development · doi:10.1177/0091415018824722 · Cited by 50 · see citing works
Longitudinal impacts of grandparent caregiving on cognitive, mental, and physical health in China
Zeng, Y., Chen, Y., & Lum, T. Y. S. (2020) · Aging & Mental Health · doi:10.1080/13607863.2020.1856779 · Cited by 52 · see citing works
Resourcefulness Training for Grandmothers: Preliminary Evidence of Effectiveness
Zauszniewski, J. A., Musil, C. M., Burant, C. J., & Au, T. K. (2013) · Research in Nursing & Health · doi:10.1002/nur.21574 · Cited by 48 · see citing works
“More and more grandmothers are raising grandchildren worldwide (Chen & Liu, 2012).”
BackgroundIntergenerational Family Relations
Tanskanen, A. O., & Danielsbacka, M. (2018) · Routledge eBooks · doi:10.4324/9781315107806 · Cited by 92 · see citing works
Zhu, D., Mahmud, A. A., & Liu, W. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1188887 · Cited by 47 · see citing works
“Moreover, the combination of advanced age and a high burden of caregiving for grandchildren accelerates the decline in global cognitive function and episodic memory among these grandparents (66), aligning with previous studies in China that highlight the accelerated cognitive decline resulting from high-intensity care…”
BackgroundFacing “Double Jeopardy”? Depressive Symptoms in Left-Behind Elderly in Rural China
Song, Q. (2016) · Journal of Aging and Health · doi:10.1177/0898264316659964 · Cited by 46 · see citing works
“Time taking care of grandchildren is controlled, as it can be influenced by adult children’s migration and also has an effect on older adult’s mental health (F. Chen & Liu, 2012; Chu, Xie, & Yu, 2011; Ku et al., 2013; Silverstein et al., 2006; Zeng & Xie, 2014).”
BackgroundChoice and Constraint in the Negotiation of the Grandparent Role: A Mixed-Methods Study
McGarrigle, C. A., Timonen, V., & Layte, R. (2018) · Gerontology and Geriatric Medicine · doi:10.1177/2333721417750944 · Cited by 46 · see citing works
“A positive association between nonintensive grandparenting and better health outcomes has been found across 11 European countries (Glaser, Di Gessa, & Tinker, 2014), Australia (Burn & Szoeke, 2015), and in both China and Taiwan (Chen & Liu, 2012; Tsai et al., 2013).”
BackgroundLin, Z., & Li, N. (2022) · Perspectives on Psychological Science · doi:10.1177/17456916221091831 · Cited by 42 · see citing works
Wen, M., Ren, Q., Korinek, K., & Trinh, H. N. (2019) · Social Science Research · doi:10.1016/j.ssresearch.2019.01.004 · Cited by 44 · see citing works
Quirke, E., König, H., & Hajek, A. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-029605 · Cited by 45 · see citing works
The One-Child Policy, Elder Care, and LGB Chinese: A Social Policy Explanation for Family Pressure
Hildebrandt, T. (2018) · Journal of Homosexuality · doi:10.1080/00918369.2017.1422946 · Cited by 41 · see citing works
“Having a large family, grandparenting, and multigenerational living is also seen as critical to ensure care as citizens age (Chen & Liu, 2012; Sanders & Sun, 2006).2 This is best understood by examining the social policy context in the next section.”
BackgroundGrandparenting and Self-Rated Health Among Older Korean Women
Choi, S., & Zhang, Z.-M. (2018) · Research on Aging · doi:10.1177/0164027518766419 · Cited by 30 · see citing works
Yang, Y., Zhang, B., Meng, H., Liu, D., & Sun, M. (2019) · Medicine · doi:10.1097/md.0000000000015162 · Cited by 40 · see citing works
“The cultural expectations of caring for grandchildren and doing housework are a well-known phenomenon in China.”
BackgroundInfluentialGrandparent caregiving and cognitive functioning among older people: evidence from Korea
Ahn, T., & Choi, K. D. (2018) · Review of Economics of the Household · doi:10.1007/s11150-018-9413-5 · Cited by 43 · see citing works
Downward transfer of support and care: understanding the cultural lag in rural China
Qiu, F., Zhan, H. J., Liu, J., & Barrett, P. M. (2020) · Ageing and Society · doi:10.1017/s0144686x2000152x · Cited by 39 · see citing works
Liao, S., Qi, L., Xiong, J., Yan, J., & Wang, R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010021 · Cited by 40 · see citing works
“Moreover, a handful of research further investigated the frequency [36], intensity [37], number of grandchildren [38], and cohabitation of grandparent caregiving [39], but also failed to reach an agreement on the optimal patterns of grandparenting that can contribute to cognition [40–42].”
BackgroundGrandchild care and life satisfaction of older adults: Empirical evidence from China
Dong, X., Ling, H., Yang, T., & Wang, K. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1081559 · Cited by 37 · see citing works
“Even as the labor force frequently shifts due to regional economic differences, leaving children behind has become common today (Chen and Liu, 2012).”
BackgroundStress and optimism of elderlies who are caregivers for elderlies and live with children
de Oliveira, N. A., Souza, É. N., Luchesi, B. M., Inouye, K., & Pavarini, S. C. I. (2017) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2017-0088 · Cited by 35 · see citing works
Magaña, I., Martínez, P., & Loyola, M. S. (2020) · Journal of Clinical Nursing · doi:10.1111/jocn.15450 · Cited by 34 · see citing works
Smartphone Use, Technology Affordance for Healthcare and Elders' Life Satisfaction
Li, G., Jin, C., Zhao, B., & Wu, B. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.861897 · Cited by 36 · see citing works
“Other studies have shown that living with adult children may lead to less free time because of the need to take care of grandchildren and to do household duties; these may have an adverse impact on cognitive function of the elderly (93, 94).”
BackgroundTransnational families and the well-being of children and caregivers who stay in origin countries
Mazzucato, V. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.11.030 · Cited by 35 · see citing works
Wang, S., Li, S., & Hu, W. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2022.115528 · Cited by 35 · see citing works
Consequences on depression of combining grandparental childcare with other caregiving roles
Arpino, B., & Goméz-León, M. (2019) · Aging & Mental Health · doi:10.1080/13607863.2019.1584788 · Cited by 31 · see citing works
Craigs, C., Twiddy, M., Parker, S. G., & West, R. (2014) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2014.06.009 · Cited by 33 · see citing works
Shi, X. (2022) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2022.03.018 · Cited by 32 · see citing works
Liu, H., & LOU, V. W. Q. (2017) · Age and Ageing · doi:10.1093/ageing/afx032 · Cited by 32 · see citing works
The Rise and Prominence of Skip‐Generation Households in Lower‐ and Middle‐Income Countries
Zimmer, Z., & Treleaven, E. (2020) · Population and Development Review · doi:10.1111/padr.12349 · Cited by 32 · see citing works
Depressive symptoms in the context of Chinese grandparents caring for grandchildren
Tang, F., Li, K., Jang, H., & Rauktis, M. B. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1910788 · Cited by 34 · see citing works
“As shown in a previous study (Chen & Liu, 2012), Chinese grandfathers who provided intensive grandchild care had a faster decline in selfrated health than did grandmother counterparts.”
BackgroundResultInfluentialChung, S., & Park, A. (2017) · Aging & Mental Health · doi:10.1080/13607863.2017.1376312 · Cited by 31 · see citing works
“In China, although grandparents living in three-generation households experience higher rates of health decline, non-intensive grandchild care was beneficial to their health (Chen & Liu, 2012).”
BackgroundYang, F., & Liu, X. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105648 · Cited by 31 · see citing works
Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren
Zhao, D., Zhou, Z., Shen, C., Ibrahim, S. H., Zhao, Y., Cao, D., & Lai, S. (2021) · BMC Public Health · doi:10.1186/s12889-021-11886-3 · Cited by 32 · see citing works
Tsai, F. (2016) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2016.01.009 · Cited by 30 · see citing works
“…and is further shaped by individual characteristics, this study controlled the selfreported health and found that elders stopped to take care of grandchild had significantly higher risk of having worse depressive symptoms than elders not taking care of grandchild at all (Chen & Liu, 2011).”
BackgroundThe experiences of grandparents raising grandchildren in Indonesia
Fauziningtyas, R., Indarwati, R., Alfriani, D., et al. (2018) · Working with Older People · doi:10.1108/wwop-10-2018-0019 · Cited by 30 · see citing works
“Studies in the USA, China, and Europe explained that grandparents serve as an important form of support for multigenerational families and as the centers of intergenerational solidarity models (Chen and Liu, 2012; Hayslip, 2014; Muller and Litwin, 2011; Uhlenberg, 2009).”
BackgroundChen, H., & Zhu, Z. (2021) · BMC Public Health · doi:10.1186/s12889-021-10617-y · Cited by 30 · see citing works
Yang, X., & Yin, D. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031255 · Cited by 31 · see citing works
“In other words, adult children provide financial support and security for the elderly parents, and, at the same time, the elderly alleviate the pressure of adult children, and are able to care for grandchildren [38], which is also a reasonable embodiment of the hierarchical theory of needs [39].”
BackgroundWang, Y., & Gonzales, E. G. (2019) · China Journal of Social Work · doi:10.1080/17525098.2019.1591697 · Cited by 28 · see citing works
Grandchild Caregiving and Cognitive Health Among Grandparents in Rural South Africa
Jennings, E. A., Farrell, M. T., & Kobayashi, L. C. (2021) · Journal of Aging and Health · doi:10.1177/08982643211006592 · Cited by 28 · see citing works
“…such as poorer cognitive functioning in verbal fluency (although not in numeracy or word recall) (Arpino & Bordone, 2014); issues with pain and mobility, greater stress, and lower life satisfaction (Bowers & Myers, 1999; Clottey et al., 2015); and accelerated health decline (Chen & Liu, 2012).”
BackgroundTo, W. M., Gao, J. H., & Leung, E. Y. W. (2020) · SAGE Open · doi:10.1177/2158244020982993 · Cited by 27 · see citing works
Li, Y., Han, W., & Hu, M. (2021) · Health & Social Care in the Community · doi:10.1111/hsc.13493 · Cited by 27 · see citing works
Resourcefulness Training for Grandmothers Raising Grandchildren
Zauszniewski, J. A., Musil, C. M., Burant, C. J., Standing, T. S., & Au, T.-Y. (2013) · Western Journal of Nursing Research · doi:10.1177/0193945913500725 · Cited by 26 · see citing works
“Email: jaz@case.edu Raising grandchildren is becoming more prevalent across the globe (Chen & Liu, 2012).”
BackgroundCaring for Grandchildren and Grandparents’ Physical and Mental Health Changes
Yoo, J., & Russell, D. W. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01618-y · Cited by 26 · see citing works
“The results of this study supported the results of Chen and Liu (2012), who argued that the personal attributes and existing health status could affect the decision of grandchild care and the changes in health status while caring grandchildren.”
InfluentialThe physical health dilemmas facing custodial grandparent caregivers: Policy considerations
Taylor, M. F., Marquis, R., Coall, D. A., Batten, R., & Werner, J. (2017) · Cogent Medicine · doi:10.1080/2331205x.2017.1292594 · Cited by 26 · see citing works
“In conclusion, if these health issues were addressed higher levels of social capital support would likely translate into lower morbidity rates (Chen & Liu, 2012).”
BackgroundInfluentialLiu, J., & Chen, F. (2021) · Research on Aging · doi:10.1177/01640275211058433 · Cited by 26 · see citing works
Self-citationLow, S. S. H., & Goh, E. C. L. (2015) · Journal of Intergenerational Relationships · doi:10.1080/15350770.2015.1111003 · Cited by 25 · see citing works
“Some studies found mixed outcomes for grandparents caring for grandchildren in China (e.g., Chen & Liu, 2012); numerous reported positive health (Guo, Pickard, & Huang, 2008; Sands, Goldberg-Glen, & Thornton, 2005) and mental health (Guo et al., 2008) among grandparents from China (Guo et al.,…”
BackgroundLongitudinal Evidence on Grandparenting and Cognitive Function in Older Adults in China
Pan, X., Zhang, D. “., & Shi, L. (2020) · Journal of Intergenerational Relationships · doi:10.1080/15350770.2020.1742845 · Cited by 26 · see citing works
Notter, I. R. (2022) · The Journals of Gerontology: Series B · doi:10.1093/geronb/gbab164 · Cited by 24 · see citing works
“Further, Chen & Liu (2012) argue that when grandchild care is less intensive, the benefits of the role’s emotional rewards and social support are highlighted and improve health; meanwhile a heavier care responsibility worsens health.”
BackgroundGrandmothers and the gender gap in the Mexican labor market
Marcos, M. Á. T. (2022) · Journal of Development Economics · doi:10.1016/j.jdeveco.2022.103013 · Cited by 24 · see citing works
Teerawichitchainan, B., & Low, T. Q. Y. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113914 · Cited by 24 · see citing works
Kumar, S. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113832 · Cited by 22 · see citing works
Zhao, M., Zhu, Z., Kong, C., & Zhao, C. (2021) · BMC Public Health · doi:10.1186/s12889-021-10892-9 · Cited by 24 · see citing works
Zhang, J., Fokkema, T., & Arpino, B. (2021) · Journal of Family Issues · doi:10.1177/0192513x211041992 · Cited by 26 · see citing works
Mothers’ and grandmothers’ caregiving for young children in Chile: Roles and responsibilities.
Zegers, M., & Reynolds, S. (2022) · Journal of Family Psychology · doi:10.1037/fam0000984 · Cited by 22 · see citing works
Caring for grandchildren and life satisfaction of grandparents in China
Shen, K., & Yang, X. (2022) · Aging and Health Research · doi:10.1016/j.ahr.2022.100095 · Cited by 25 · see citing works
Changes in Grandparental Childcare During the Pandemic and Mental Health: Evidence From England
Gessa, G. D., Bordone, V., & Arpino, B. (2022) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbac104 · Cited by 22 · see citing works
“…2019), and factors such as intensity and health outcomes add to the complexity of the relationship, several studies have found that grandparents providing secondary grandchild care tend to report better health (Chen & Liu, 2012; Di Gessa et al., 2016a, 2016b; Hughes et al., 2007; Ku et al., 2013).”
Navarro-Martínez, R., Mafla-España, M. A., & Cauli, O. (2022) · Nutrients · doi:10.3390/nu14235141 · Cited by 22 · see citing works
“It has been suggested that grandparents who take on intensive parenting roles are often among the most disadvantaged and in the poorest health [66].”
BackgroundResultTaylor, M., Marquis, R., Coall, D., & Werner, J. (2018) · Child Care in Practice · doi:10.1080/13575279.2017.1297772 · Cited by 17 · see citing works
“Notwithstanding current assertions that the numbers of custodial grandparents are escalating worldwide (Chen & Liu, 2012), an accurate global quantification of the phenomenon remains elusive, largely because of variations in the types of data that individual countries collect.”
BackgroundThe Cambridge Handbook of the International Psychology of Women
Cheung, F. M., & Halpern, D. F. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108561716 · Cited by 23 · see citing works
Chen, F., Bao, L., Lin, Z., Zimmer, Z., Gultiano, S. A., & Borja, J. B. (2017) · Ageing and Society · doi:10.1017/s0144686x17000599 · Cited by 20 · see citing works
Self-citationYang, Y. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1963952 · Cited by 20 · see citing works
“As suggested by previous research, the two role theories complement each other, and one may outweigh the other depending on the context (Chen & Liu, 2012).”
MethodGlaser, K., Gessa, G. D., & Tinker, A. (2014) · London School of Economics and Political Science Research Online (London School of Economics and Political Science) · Cited by 20 · see citing works
Grandparenting and Cognitive Functioning in China
Xu, H. (2021) · Population Research and Policy Review · doi:10.1007/s11113-020-09628-1 · Cited by 22 · see citing works
“…health problems, and incarceration, Chinese grandparents tend to willingly engage in full-time or even custodial grandchild care in exchange for financial support from adult migrant children, which in turn, acts as a buffer against caregiving stress and burden (Chen and Liu 2012; Burnette et al.”
BackgroundInfluentialZhang, L., Huang, R., Lei, J., Liu, Y., & Liu, D. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05604-7 · Cited by 24 · see citing works
“In China, it is common for families to rely on skip-generation child raising [49, 50], with a majority of children (70”
BackgroundShenk, M. K., Morse, A., Mattison, S. M., Sear, R., Alam, N., Raqib, R., Kumar, A., Haque, F., Blumenfield, T., Shaver, J. H., et al. (2021) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2020.0027 · Cited by 18 · see citing works
Chen, L., Li, Y., & Yang, Q. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710790 · Cited by 17 · see citing works
“Following the trend toward rapidly increasing life expectancies [1], China’s old-age dependency ratio is expected to rise from 17.”
BackgroundResultInfluential
- Authors
- Chen, F., & Liu, G.
- Affiliations
- University of Maryland, College Park (US)
- Duke University (US)
- Venue
- The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-12-07
- Volume
- 67B
- Issue
- 1
- Pages
- 99-112
- ISSN
- 1079-5014 (ISSN-L)
- 1758-5368
- PMC
- PMC3267025
- OpenAlex
- W2134956216
- Cited by
- 378
- References
- 75
- Citations by year
- 2026: 22 · 2025: 41 · 2024: 33 · 2023: 24 · 2022: 39 · 2021: 43 · 2020: 70 · 2019: 17 · 2018: 18 · 2017: 16 · 2016: 16 · 2015: 12 · 2014: 10 · 2013: 7 · 2012: 2
- FWCI
- 18.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series B (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion)
- PubMed Central (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Social Sciences › Gender Studies › Demographic Trends and Gender Preferences
- Social Sciences › Business, Management and Accounting › Accounting › Financial Literacy, Pension, Retirement Analysis
- Keywords
- grandparenting, grandchild care, older adults' health, health trajectories, skipped-generation households, three-generation family, living arrangements, care intensity
- MeSH terms
- Aged, China, Family, Family Characteristics, Female, Health Status
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