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The concept of a “community of care” should be adopted in relation to the care of children, extending beyond just mothers to include grandparents and others. “Family resilience” should be supported.
A review of 206 studies of care by grandparents has proposed a more coherent framework to analyse and understand how care by grandparents contributes to children’s development and health.
The research identifies:
- two types of care by grandparents
- custodial care in skipped generation families (no parent present)
- care within multigeneration families (one or both parents present)
- three measurements of involvement of grandparents
- contact – e.g., co-residency, visit frequency
- behavior – e.g., feeding, washing, transport
- support – e.g., school fees, home expenses
- two types of contextual factor that influences care by grandparents
- personal – e.g., age of child/grandparent, health of child/grandparent, gender of child/grandparent, cultural norms of family care, the parental relationship (status/quality)
- structural – e.g., race, class, neighbourhood, situations of conflict or crisis, available of care in the community, income, loss of parental care through death or incarceration
- three types of child outcomes from care by grandparents
- physical health – e.g., health, diet, growth, accidental injury
- socioemotional health – e.g., mental health, behavior, substance use
- cognitive development – e.g., academic achievement, language development, school readiness
In addition to making recommendations about more systematic research in the future, the researchers offer directions for policy and practice.
- The concept of a “community of care” should be adopted in relation to the care of children, extending beyond just mothers to fathers, grandparents, friends, neighbors, siblings, other relatives, paid caregivers, teachers and pastors. Policy should promote networks of support and “family resilience”. More evaluations are needed of interventions that engage with communities of care.
- Better support in practice and policy directly to grandparents in “family-level care”, including financial assistance, health, education and housing support.
- Attention to gender bias in how grandmothers and grandfathers are viewed, similar to perceptions of mothers and fathers. Male carers are often framed in more negative terms than female carers.
Grandparental care is increasing around the world. Extended lifespans, decreasing family size, increased maternal employment, higher divorce rates, more single-parent households, economic stagnation and increasing drug use are all expanding the caring role of grandparents. Grandparents are often the first to assume caring of children when parents are unable to do so.
In the USA in 2018, 7.8% of 0-18 year olds lived with both a parent and a grandparent in three-generation families, and 2.3% lived with a grandparent without a parent present in skipped-generation families. In a study of several East European countries, 29.7% of households contained at least one grandparent; the figure in Western European countries is 5.5%. In Asia, a huge number of children in rural areas live with their grandparents because their parents have gone to cities to find work. And although Africa has a strong tradition of multigeneration care of children, it is also seeings an increase in care by grandparents in the wake of the HIV/AIDS epidemic and parental migration.
Research interest in grandparents has increased recently, and we’ve also seen some developments in support programmes that target grandparents who have custody of children. In the USA, the Supporting Grandparents Raising Grandchildren Act was signed into federal law in 2018, largely in response to the opioid crisis, which is affecting parental care. Support for grandparents includes information about school systems, access to mental health services and building community support networks.
Of the 206 studies of grandparents reviewed, 68 were from Africa, 60 from the USA, 32 from Europe, 17 from Africa, 12 from Latin America, three from Australia and two from Israel. Twelve were multi-country studies.
Sadruddin AFA, Ponguta LA, Zonderman AL, Wiley KS, Grimshaw A & Panter-Brick C (2019), How do grandparents influence child health and development? A systematic review, Social Science & Medicine, 239