Custodial grandmothers' physical, mental, and economic well-being : comparisons of primary caregivers from low-income neighborhoods

Abstract: To examine the implications of custodial grandparent care, we compared the material hardship, mental health, and physical well-being of custodial grandmothers (n = 90) and biological mothers (n = 1,462) using data from Welfare, Children, and Families: A Three-City Study. Custodial grandmothers reported significantly more physical health problems but less psychological distress than mothers. Younger grandmothers and grandmothers who sought out more social support were the most disabled and financially strained. Implications for policy and practice addressing the needs of grandmothers raising grandchildren are discussed. Key Words: caregiving, economic distress, grandmothers raising grandchildren, health, low-income families. Over the past few decades, American families have increasingly relied on grandparents to assume caregiving responsibility for their grandchildren (Bryson & Casper, 1999). In the 2000 Census, 2.4 million "grandparent caregivers" for grandchildren younger than 18 years of age were identified, and approximately two thirds of these caregivers were women (Simmons & Dye, 2003). These caregiving arrangements are especially prevalent in low-income communities as growing numbers of kin offer a safety net for families in crisis (Kornhaber, 1985). Yet, perceptions about grandmothers' caregiving status have differed in research and policy arenas. For example, past research has generally compared custodial grandmothers to other types of grandmothers, such as coresiding or noncaregiving grandmothers (e.g., Caputo, 1999; Pebley & Rudkin, 1999; Szinovacz, 1998). In contrast, social welfare systems often treat custodial grandmothers as primary caregivers or "mothers." For example, just six states administer formal exemptions from work requirements or time limits to custodial grandmothers under the age of 60 if their families are receiving Temporary Assistance for Needy Families (TANF) aid (Hutson, 2002). In the present study, we adopt a policy perspective and view custodial grandmothers as a type of primary caregiver or mother, rather than a type of grandmother. This distinction highlights the variation in low-income families with children and emphasizes the unique needs and circumstances facing different groups of primary caregivers so that practitioners and policymakers will be better informed. Thus, we endeavored to (a) compare the material hardship, mental health, and physical well-being of custodial grandmothers and mothers from low-income neighborhoods; (b) determine whether differences in demographic characteristics, caregiving burden, or social support sources account for any discrepancies in caregivers' hardship and health; and (c) examine whether subgroups of custodial grandmothers are particularly at risk for adverse outcomes. Background and Significance Almost 15% of American grandmothers have raised one or more grandchildren for at least 6 months (Szinovacz, 1998). National household surveys have shown that higher proportions of custodial grandparent care are evident among families living below the poverty line and among African American families (Caputo, 2001). These care arrangements frequently involve multiple grandchildren (Caputo, 1999; Szinovacz) and last longer than 6 months (Fuller-Thomson, Minkler, & Driver, 1997). Custodial grandmothers are more likely to be single, have lower levels of education, and are significantly younger than noncaregiving or coresidential grandmothers (Pebley & Rudkin, 1999; Pruchno & McKenney, 2000). Custodial grandmother kinship care arrangements tend to form in response to urgent needs or problems facing parents and in more extreme cases, parental absence or incapacitation, stemming from substance abuse, AIDS, incarceration, abandonment, or death (Burnette, 1999; Whitley, Kelley, & Sipe, 2001). Grandparents may also serve as formal or informal guardians when children have been removed from their homes by child protective services because of parental abuse or neglect (Jendrek, 1994; Whitley et al. …