Abstract
Grandparenthood is a significant social role for older adults and may have important health implications. Parenthood itself has been associated with some protective health effects, although findings have been mixed. Whether grandparenthood is associated with important long-term health effects such as mortality is largely unknown. This study examines the grandparenthood-mortality nexus, and whether it is modified by gender and education. Longitudinal data from the Health and Retirement Study (HRS) were used, comprising twelve biennial follow-up waves from 1992 to 2014 with linked data on vital status derived from the National Death Index. Submodules assessed participants’ family structure during follow-up. The sample included 24,325 participants aged > 51 years with at least one child. Cox proportional hazard models were used to test the association between grandparenthood and mortality risk with adjustment for socio-demographic variables, for social variables including characteristics of and contact with children, and for health variables, including measures of overall, functional and mental health. Stratified models assessed these associations separately by gender and education. Grandparenthood was associated with a substantially increased mortality risk in women (fully adjusted HR = 1.65; 95% CI 1.27-21.14), and increased with larger number of grandchildren. No significant association was found for men (fully adjusted HR=1.25; 95% CI 0.97-1.62). Mortality risks associated with grandparenthood were highest among grandparents with low levels of education. The findings are among the first to suggest a potential grandparenthood survival “penalty”, especially for grandmothers. Higher levels of education appear to mitigate this negative survival effect among grandparents.
Highlights
In 11/2016 Robert and Rosalie Kane began a 3-round Delphi study to re-imagine long-term care (LTC), which took as a starting premise that LTSS in the United States fails to comport to the values and preferences of consumers
From Round 1 we developed programmatic building blocks, which we classified as: housing suggestions; services suggestions; housing and/or technology heavy suggestions; policy or regulation suggestions;new philosophical approaches; and long-range social engineering
At Round 2, respondents rated the importance of the original value list and rated the principles and building blocks
Summary
In 11/2016 Robert and Rosalie Kane began a 3-round Delphi study to re-imagine long-term care (LTC), , which took as a starting premise that LTSS in the United States fails to comport to the values and preferences of consumers. Round 1 asked respondents to rate and add to a list of values important to LTC< but largely was an open-ended request for respondents’ ideas, Round 2 was fielded in 6/2018 with all data collection completed by 11/2018 (the delay partly due to Robert Kane’s sudden death on March 6, 2017 and the time needed to analyze, summarize and present the complex and detailed responses to the first round). Round 3, to be fielded in 4/2019., will provide participants with the ratings of values, principles and programmatic building blocks at Round Two, and the open-ended comment of respondents in explanation of their ratings.
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