Giorgio Di Gessa

The impact of caring for grandchildren on the health of grandparents in Europe: A lifecourse approach

Grandparents are becoming an increasingly important source of childcare. However, caring for grandchildren may have negative health consequences particularly for grandparents with intensive commitments such as those with primary care responsibilities. To date most studies on this issue are based on cross-sectional data and do not take earlier life circumstances into account. Thus, it is not known whether (or to what extent) the relationship between grandparental childcare and health is due to cumulative advantage or disadvantage throughout the lifecourse or to the impact of grandchild care per se. Employing data from waves 1-3 of the Survey of Health, Ageing and Retirement in Europe we investigated the longitudinal relationship between grandparental childcare (i.e. intensive and non-intensive) and health once cumulative histories of advantage or disadvantage are taken into account. We used latent class analysis to categorise respondents according to childhood socio-economic and health conditions drawing on life history information. Experiences in adulthood (e.g. periods of ill health) were also captured. We created a latent continuous physical health variable based on self- and observer-measured indicators. OLS regression was used to explore the association between physical health at wave 2 and grandparental childcare at baseline, controlling for conditions in childhood and adulthood, and for health and socio-economic characteristics. We found a positive longitudinal association between grandchild care and health even after earlier life health and socio-economic conditions were taken into account. However, this significant association was found only for grandmothers, and not grandfathers. Our results suggesting the health benefits of grandchild care are important given the widespread provision of grandparental childcare in Europe. However, further research on underlying mechanisms and causal pathways between grandchild care and grandparent health, as well as on gender differences in the pattern of association, is needed.

The Health Impact of Intensive and Nonintensive Grandchild Care in Europe: New Evidence From SHARE

Objectives: Grandparents are an important source of childcare. However, caring for grandchildren may affect grandparents’ health in both positive and negative ways. Our study examines the association between grandparental childcare and grandparents’ health at 2- and 4-year follow-up. Method: Our study is based on grandparents aged 50 and older from Waves 1–4 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using multivariate analyses, we investigated associations between intensive and nonintensive grandparental childcare at Wave 2 and subsequent health (self-rated health, depressive symptoms, and disability) controlling for covariates and health at baseline. Associations between changes over time in grandparental childcare and health at follow-up were also explored. Multiple imputation techniques and sensitivity analyses were undertaken to investigate possible biases arising from sample attrition. Results: Grandparents looking after grandchildren, whether intensively or nonintensively, experienced some health benefits. Associations strengthened when attrition was accounted for, particularly if it is assumed that those who dropped out of the study were in poor health. Discussion: Our results show better health among grandparents who provided grandchild care in the European countries studied. These results are important given the widespread provision of grandchild care in Europe.

The relationship between active ageing and health using longitudinal data from Denmark, France, Italy and England

Background ‘Active ageing’ has been promoted as a strategy for extending quality of life and healthy life expectancy. However, there is limited evidence from nationally representative longitudinal studies on whether engagement among older adults is associated with better outcomes and few studies have considered possible bias arising from differential study attrition. Methods We investigate associations between the engagement of people aged 50–69 in three types of activity with self-rated health and depression 2 years later using nationally representative longitudinal data from four European countries (Denmark, France, Italy and England). Data were drawn from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe and the English Longitudinal Study of Ageing. Multivariable analysis was used to analyse associations between baseline activity and outcomes at follow-up controlling for socioeconomic, demographic and health-related variables at baseline. Multiple imputation techniques and sensitivity analyses were undertaken to investigate possible bias arising from sample attrition. Results Respondents in paid work at baseline were less likely to be depressed or to report poor or fair health at follow-up than those who were ‘inactive’, although not in Italy. Engagement in formal and informal activities was not significantly associated with health at follow-up. Sensitivity analyses showed that assuming that those in bad health were over-represented among study attritors weakened the association between work at baseline and health at follow-up. Conclusions Engagement in paid work may help maintain health in later life, although mechanisms and contextual influences need further investigation.

What Drives National Differences in Intensive Grandparental Childcare in Europe

Objectives. Grandparents play an important role in looking after grandchildren, although intensive grandparental childcare varies considerably across Europe. Few studies have explicitly investigated the extent to which such cross-national variations are associated with national level differences in individual demographic and socio-economic distributions along with contextual-structural and cultural factors (e.g., variations in female labor force participation, childcare provision, and cultural attitudes). Methods. We used multilevel models to examine associations between intensive grandparental childcare and contextual-structural and cultural factors, after controlling for grandparent, parent, and child characteristics using nationally representative data from the Survey of Health, Ageing and Retirement in Europe. Results. Even controlling for cross-national differences in demographic and socio-economic distributions, contextual-structural factors play an important role in explaining grandparental childcare variations in Europe. In particular, higher levels of intensive grandparental childcare are found in countries with low labor force participation among younger and older women, and low formal childcare provision, where mothers in paid work largely rely on grandparental support on an almost daily basis. Discussion. Encouraging older women to remain in paid work is likely to have an impact on grandchild care which in turn may affect mothers’ employment, particularly in Southern European countries where there is little formal childcare.

Is being in paid work beyond state pension age beneficial for health? Evidence from England using a life-course approach

Background Given the current policy emphasis in many Western societies on extending working lives, we investigated the health effects of being in paid work beyond state pension age (SPA). Until now, work has largely focused on the health of those who exit the labour force early. Methods Our data come from waves 2–4 of the English Longitudinal Study of Ageing, including the life history interview at wave 3. Using logistic and linear regression models, we assessed the longitudinal associations between being in paid work beyond SPA and 3 measures of health (depression, a latent measure of somatic health and sleep disturbance) among men aged 65–74 and women aged 60–69. Our analyses controlled for baseline health and socioeconomic characteristics, as well as for work histories and health in adulthood and childhood. Results Approximately a quarter of women and 15% of men were in paid work beyond SPA. Descriptive bivariate analyses suggested that men and women in paid work were more likely to report better health at follow-up. However, once baseline socioeconomic characteristics as well as adulthood and baseline health and labour market histories were accounted for, the health benefits of working beyond SPA were no longer significant. Conclusions Potential health benefits of working beyond SPA need to be considered in the light of the fact that those who report good health and are more socioeconomically advantaged are more likely to be working beyond SPA to begin with.

The Dynamics of Paid and Unpaid Activities Among People Aged 50-69 in Denmark, France, Italy, and England

In the context of the current policy emphasis on extending working lives, we investigate whether the relationship between participation in paid work, other formal, and informal activities among people aged 50–69 is complementary or competitive. We also investigate differences in associations between countries using comparable longitudinal data from Denmark, France, Italy, and England. We find positive associations between informal and formal engagement in cross-sectional and longitudinal analyses. Paid work was negatively associated with formal and informal engagement, and respondents who stopped working were more likely to be engaged in formal (Denmark and France) and informal activities (England and Italy) at follow-up than respondents who continued working. However, the strongest predictor of formal and informal engagement at follow-up was baseline engagement. In the context of policy aims to extend working lives and broaden older people’s participation in other productive activities, new balances between work and other forms of engagement are still to be found.

Relationship between employment histories and frailty trajectories in later life: Evidence from the English Longitudinal Study of Ageing

Background Given the acceleration of population ageing and policy changes to extend working lives, evidence is needed on the ability of older adults to work for longer. To understand more about the health impacts of work, this study examined the relationship between employment histories before retirement and trajectories of frailty thereafter. Methods The sample comprised 2765 women and 1621 men from the English Longitudinal Study of Ageing. We used gendered typologies of life-time employment and a frailty index (FI). Multilevel growth curve models were used to predict frailty trajectories by employment histories. Results Women who had a short break for family care, then did part-time work till 59 years had a lower FI after 60 years than those who undertook full-time work until 59 years. Women who were largely family carers or non-employed throughout adulthood, had higher levels of frailty at 60 years but experienced a slower decline with age. Men who worked full-time but early exited at either 49 or 60 years had a higher FI at 65 years than those who worked full-time up to 65 years. Interaction between employment histories and age indicated that men in full-time work who experienced an early exit at 49 tended to report slower declines. Conclusions For women, experiencing distinct periods throughout the lifecourse of either work or family care may be advantageous for lessening frailty risk in later life. For men, leaving paid employment before 65 years seems to be beneficial for decelerating increases in frailty thereafter. Continuous full-time work until retirement age conferred no long-term health benefits.

Do work and family care histories predict health in older women

Abstract Background Social and policy changes in the last several decades have increased women’s options for combining paid work with family care. We explored whether specific combinations of work and family care over the lifecourse are associated with variations in women’s later life health. Methods We used sequence analysis to group women in the English Longitudinal Study of Ageing according to their work histories and fertility. Using logistic regression, we tested for group differences in later life disability, depressive symptomology and mortality, while controlling for childhood health and socioeconomic position and a range of adult socio-economic circumstances and health behaviours. Results Women who transitioned from family care to either part-time work after a short break from the labour force, or to full-time work, reported lower odds of having a disability compared with the reference group of women with children who were mostly employed full-time throughout. Women who shifted from family care to part-time work after a long career break had lower odds of mortality than the reference group. Depressive symptoms were not associated with women’s work and family care histories. Conclusion Women’s work histories are predictive of their later life disability and mortality. This relationship may be useful in targeting interventions aimed at improving later life health. Further research is necessary to explore the mechanisms linking certain work histories to poorer later life health and to design interventions for those affected.

Trends in the prevalence of grandparents living with grandchild(ren) in selected European countries and the United States

Research from the United States has shown significant increases in the prevalence of three-generation households and in households consisting solely of grandparents and grandchildren. Such shifts in household composition, which are associated with socio-economic disadvantage, may reflect the activation of grandparents as a latent network of support in response to social and demographic changes such as rising partnership disruption. However, to date, little is known in Europe about trends in grandparent households or whether these households are also likely to be disadvantaged. Moreover, we know little about how the familistic and defamilised policy environments in Europe may affect the activation of such latent kin networks. Employing the Integrated Public Use Microdata Series—International and the Office for National Statistics’ Longitudinal Study for England and Wales, we used multivariate techniques to investigate changes in prevalence over time in co-residence with a grandchild across Austria, England and Wales, France, Greece, Portugal, Romania, and the United States. We expected increases in grandparent households in Portugal and Greece, familistic societies with few public alternatives to family support. However, only Romania (like the US) showed an increase in the percentage of people aged 40 and over co-residing with their grandchildren in three-generation households between the late 1970s and 2002. Given rises in poverty and limited support for low-income families in Romania, rises in grandparent coresidence may reflect a coping strategy among poorer families to increasing financial hardship. Regardless of the trends, grandparent households in all the countries studied remained associated with socio-economic disadvantage.

What do we know about grandparents? Insights from current quantitative data and identification of future data needs

Against the background of a ‘new wave’ of empirical studies investigating various aspects of grandparenthood across a broad range of regional contexts, this article aims to take stock of what has been achieved so far and which lessons we can learn from this for the future. Our focus is on the measurement of grandparenthood and grandparenting in quantitative social surveys and the implications this has for the substantive questions we can ask and the answers we can get out of such data. For several broader questions—who is a grandparent and when does this transition happen; what does it mean to be a grandparent; and what are the implications of grandparenthood for families?—we review previous questionnaire items from a variety of surveys as well as studies in which they were used. We identify relevant issues related to these questions which cannot be adequately addressed with currently available data, but should be considered in new or ongoing survey projects. The answers provided by recent studies as well as the many still open questions identified here indicate excellent prospects for scholarship on grandparents in the years to come.