1. The health and wellbeing of grandparents caring for their grandchildren: The role of cumulative advantage / disadvantage Glaser K, Di Gessa G, and Tinker A Institute of Gerontology, Department of Social Science, Health & Medicine, King’s College London, United Kingdom ESRC ES/K003348/1 Secondary Data Analysis Initiative October 14, 2014 Mary Sumner House, Westminster, London

2. Outline Funder, partnerships and timescale Previous work Background Key research questions Findings Summary 2

3. The research study – funding, partnerships and timescale Funded by the Economic and Social Research Council (ESRC), and in partnership with Grandparents Plus, Calouste Gulbenkian Foundation, and the Beth Johnson Foundation April 2013 - October 2014 Project’s webpage: http://www.grandparentsplus.org.uk/health- impacts-of-caring 3

4. Previous work: Grandparenting in Europe What drives national differences in intensive grandparental childcare in Europe Supported by Calouste Gulbenkian Foundation and in partnership with Grandparents Plus and the Beth Johnson Foundation. Key Findings: – Younger fitter grandparents who are not working provide most of the care – GMs most likely to be providing care when mothers are usually working full-time and in countries where there is less state support for families. http://www.grandparentsplus.org.uk/grandparenting-in-europe-project 4

5. 3. Background Studies (mostly US) show grandparents with ‘primary care’ responsibilities for grandchildren are among most disadvantaged/poorest health. Most research based on cross-sectional data; do not know whether due to previous disadvantage or impact of grandchild care per se. Work based on longitudinal data inconclusive: may be because grandchild care at different intensity levels related to different outcome or not been able to take into account prior disadvantage (childhood & adulthood). 5

6. Key questions: How does grandparent health vary by grandchild care (and socio-economic factors)? What is the impact of grandparental childcare on health & wellbeing once we take prior health status into account? What is the impact of grandparental childcare on health & wellbeing once we take different life histories into account? How does cumulative advantage / disadvantage affect association between grandchild care and grandparents’ health and wellbeing? 6

7. Why is our study unique? Examine the effects of caring for grandchildren on health and wellbeing among European grandparents using: Representative longitudinal data from 10 European countries with detailed information on grandparental childcare and health & wellbeing. Life history data – we can look at lifetime experiences (e.g. health and socio-economic position in childhood and adulthood). 7

8. Survey Ageing Health and Retirement in Europe (SHARE) ~14,500 grandparents aged 50+ at baseline; ~ 8,000 with history data. ~ 6,500 complete cases 10 countries have longitudinal data: Denmark, Sweden, Austria, France, Germany, Switzerland, Belgium, the Netherlands, Spain and Italy. 8

9. SHARE « During the last 12 months, have you looked after your grandchild[ren] without the presence of the parents? » If so i) «how often?» [daily, weekly, monthly, less often] ii) «about how many hours?» Intensive grandparental childcare if grandchildren were looked after by grandparents on a daily basis or at least 15 hours per week 9

10. Percentage distribution of grandparental care 2004/5 & 2006/7 SHARE Grandparental childcare2004/52006/7 Not looking after grandchild49.348.1 Looking after grandchild Intensive9.012.2 Non-intensive37.839.7 Total100.0 N14,5608,485 10

11. Grandparental childcare & health 11

12. Percentage distribution of grandparental care, 2004/05 SHARE Grandparental childcare Not looking after gcld Non- intensive IntensiveTotal Education: Low54.431.514.1100.0 Education: Medium 44.743.811.6100.0 Education: High40.249.110.8100.0 N7,1831,1991,87214,560 12

13. Percentage distribution of grandparental care, 2004/05 SHARE Grandparental childcare Not looking after gcld Non- intensive IntensiveTotal Retired55.433.011.6100.0 In paid work35.453.211.4100.0 Other46.036.917.1100.0 N7,1831,1991,87214,560 13

14. Factors associated with the likelihood of poor or fair SRH, logistic regression analysis Grandparental childcare SRH w3SRH W4ADL w4Depressive symptoms Odds Ratios SRH poor/fair6.78**5.17** 1 + ADL disabilities5.76** Depressive symps4.71** Non-intensive0.82*0.84*0.81*0.91 Intensive0.76*0.870.830.85 N6,3155,4565,4555,401 14 Notes: In addition living arrangements; gender, age, education, main activity status, wealth, social engagement, no. grandchildren, age of youngest grandchild and country.

15. Life history characteristics grandparents at age 10 or in adulthood Not looking after Not intensive IntensiveTotal All 4 household amenities35.757.27.1975 1-3 household amenities41.544.314.24,718 No household amenities56.428.315.32,588 2+ periods of ill health53.033.013.8572 1 or no periods of ill health 45.041.313.77,736 15 Distribution of grandparental care by lifetime experiences

16. Factors associated with the likelihood of poor or fair SRH, logistic regression analysis Grandparental childcare SRH w3SRH W4ADL w4Depressive symptoms Odds Ratio SRH poor/fair6.16**4.56** 1 + ADL disabilities5.35** Depressive symps4.58** SRH<good at age 101.62**1.32*1.271.49** Non-intensive0.82*0.84*0.860.93 Intensive0.77*0.850.870.84 N5,9564,7614,7594,718 16 Notes: In addition living arrangements; gender, age, education, main activity status, wealth, social engagement, no. grandchildren, age of youngest grandchild and country.

17. Grandparental childcare & Quality of Life (QoL) Grandparental childcare MeanRangeNF value Not look after grandchild in last week 41.960-5754346.88** Look after grandchild in last week 43.1615-57402 17

18. Linear Regression Quality of Life - ELSA Grandparental childcareModel IModel II Coefficient CASP-190.70** Looked after grandchild in past week 2.48*0.32 Adjusted R-square0.020.50 N3,5433,149 18 Notes: Model I age & gender; Model II also wealth tertiles.

19. Summary Grandchild care – both intensive and non- intensive – positively associated with good health over time. Relationship remains even when taking into account childhood and adulthood disadvantage. 19

20. English Longitudinal Study of Ageing (ELSA) In the UK we continue to know little about the family lives of older people. We need to know more about support family members provide each other, including grandparental care. We need to know more about family members. 20

21. Many thanks. Questions, comments and feedback are welcome. karen.glaser@kcl.ac.uk 21