The health and wellbeing of grandparents caring for grandchildren: The role of cumulative advantage/disadvantage

我们的项目集中在一个以前被忽视的研究领域：为孙辈提供照顾如何影响祖父母的健康和福祉？随着人口老龄化，促进老年人的健康和福祉是一个关键的政策问题，而欧洲各地的社会、经济和人口变化表明，祖父母在为家庭提供托儿支持方面的作用越来越大。尽管老年人面临着在工作岗位上工作更长时间和照顾体弱多病的家庭成员的竞争压力，但祖父母在照顾孩子方面也面临着额外的压力。这被认为是由于鼓励更多母亲加入有偿劳动力的政策、家庭破裂率和单身母亲率的上升，以及家庭的经济压力。这一重要的经济和社会作用在很大程度上被政策制定者忽视或视为理所当然，而承担这些托儿角色对老年人的健康影响尚不清楚。这个问题影响着数百万人。英国有1400万祖父母，其中许多人处于工作年龄：50岁以上的祖父母中有25%不到60岁，40%不到65岁。在英国，有16岁以下孙子的祖父母中，17%的人每周至少花10个小时照顾孙子，大约1 / 30的人全职照顾孙子，或者和孙子住在一起。先前的研究表明，那些对孙子负有“初级照顾”责任的祖父母或承担了大量祖父母角色的祖父母往往是最弱势的，健康状况最差的。然而，由于这主要来自横断面数据，尚不清楚这是否或在多大程度上是由于整个生命过程中的累积不利因素，还是由于孙辈照顾本身的影响。需要更好地了解孙辈照顾与祖父母健康和福祉之间的潜在机制和因果关系。早期关于孙辈照顾和祖父母健康之间关系的研究结果尚无定论，研究人员认为，这可能是因为这种关系可能因社会经济环境而异，最弱势群体受到的不利影响最大。利用英国老龄化纵向研究（ELSA）和欧洲健康、老龄化和退休调查（SHARE），我们将研究祖父母当前健康和幸福状况的长期社会、健康和经济决定因素，重点关注孙辈照顾的干预作用。我们将专注于了解累积的优势和劣势如何与孙子照顾相互作用，影响祖父母的健康和福祉。利用收集到的生活史信息，我们将能够探索不同生活经历与祖父母当前健康和幸福之间的关系。例如，我们将能够捕捉一生的经历，如儿童时期在机构护理中度过的时间，单亲父母，儿童时期健康状况不佳以及成年后健康状况不佳和残疾的时期，失业时期，离婚经历，丧偶和单亲家庭，伴侣健康状况不佳/残疾的时期，以及频繁的搬家。这样的分析将使我们更好地了解生活轨迹对祖父母健康结果的累积影响。我们还将探讨随着时间的推移，祖父母的育儿和其他社会经济和人口因素是如何影响祖父母自己的健康和福祉的。这一点很重要，因为了解参与儿童保育对老年人的健康和福祉的影响将提供重要证据，使欧洲各地的决策者能够确保祖父母在儿童生活中的作用得到更好的支持，并最大限度地减少对健康的任何有害影响。

Our project focuses on a previously neglected area of research: how does providing care for grandchildren impact on the health and wellbeing of grandparents? Promoting the health and wellbeing of older people is a critical policy issue as the population ages, while social, economic and demographic changes across Europe point to an increasing role for grandparents in providing childcare support to families. Despite competing pressures on older workers to remain in the workforce for longer and to provide care to frail family members, there are additional pressures on grandparents to provide childcare. This is thought to be due to policies encouraging more mothers into the paid workforce, increases in rates of family breakdown and single motherhood, and financial pressures on families. This vital economic and social role is largely overlooked or taken for granted by policymakers, and the health impacts on older people of taking on these childcare roles are not known.This issue affects millions of people. There are 14 million grandparents in the UK, many of working age: 25% of grandparents over the age of 50 are under 60, and 40 per cent are under 65. In Britain, 17% of grandparents with a grandchild under 16 provide intensive levels of childcare of at least ten hours a week and around one in thirty provides full time care to, or lives with a grandchild. Prior research suggests those grandparents with 'primary care' responsibilities for a grandchild or who undertake intensive grandparenting roles are often among the most disadvantaged and in the poorest health. However, since this is mostly drawn from cross-sectional data, it is not known whether or to what extent this is due to cumulative disadvantages throughout the life course or to the impact of grandchild care per se. A better understanding of the underlying mechanisms and causal pathways between grandchild care and grandparent health and wellbeing is needed.Earlier findings on the relationship between grandchild care and grandparent health are inconclusive and researchers have suggested that this may be because this relationship is likely to vary by socio-economic circumstances with those in the most vulnerable groups being the most adversely affected. Using the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE) we will examine the long-term social, health and economic determinants of grandparents' current health and wellbeing status, focusing on the intervening role of grandchild care. We will focus on understanding how cumulative advantage and disadvantage interacts with grandchild care to affect grandparent health and wellbeing. Using the life history information collected we will be able to explore the relationship between different life experiences and grandparents' current health and wellbeing. For example, we will be able to capture lifetime experiences such as time spent in institutional care as children, with single parents, periods of poor health as children and with ill-health and disability as adults, periods of unemployment, experiences of divorce, widowhood and single parenthood, periods of partner's ill health/disability, and frequent house moves. Such an analysis will provide us with a better understanding of the cumulative impact of life course trajectories on health outcomes among grandparents. We will also explore how variations over time in grandparent childcare and other socio-economic and demographic factors affect grandparents' own health and wellbeing. This is important as understanding the health and wellbeing impact of engagement in childcare on older people will provide important evidence to enable policy makers across Europe to ensure that the role of grandparents in children's lives is better supported and any deleterious effects on health are minimised.