The Health Implications of Grandparents Caring for Grandchildren in China

• Supported so farPremiseOne 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.1 of 3 cited sources support it · 2 without full text§ Research Hypotheses and Design · cites sources
• Own resultFindingGrandfathers engaging in high intensity care have worse self-reported health on average.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingThose heavily involved with child care are more likely to have a lower mean level of health than those who do not care for grandchildren.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingGrandparents living in three-generation households experience a slightly more rapid health decline than older adults who live independently.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingAmong grandparents in three-generation households, paternal grandparents have a significant health advantage over maternal grandparents.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingAmong coresiding grandparents, high intensity care for younger grandchildren accelerates health declines.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingAmong coresiding grandparents, a lighter level of care for younger grandchildren has a protective effect on health.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingThose involved with a light load of child care have a less accelerated path of health decline.From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingThere is a positive interaction effect between skipped-generation household and high income (0.14).From the paper’s own data. Not checkable against an outside source.§ 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. · own data
• Own resultFindingGrandfathers involved in intensive child care have worse health on average than grandmothers engaged in the same level of care.From the paper’s own data. Not checkable against an outside source.§ 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. · own data

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