Grandparent Caregiving and Self-Rated Health among Rural Chinese Older Adults: A Longitudinal Study Using Latent Difference Score Analysis

Background: Caregiving for grandchildren has effect on the physical health of older adults. Physical well-being may also affect the daily activities of grandparent caregivers. Therefore, there may be a reciprocal effect between grandparent caregiving and health. However, few studies have tested this dynamic relationship. This study examined how grandparent caregiving and self-rated health (SRH) changes over time among rural Chinese older adults and whether a reciprocal effect exists between them. Methods: Four waves of the longitudinal study of older adults in Anhui province of China were used for this study, featuring 1,696 older grandparents who completed at least the first wave in 2001 and were followed up or not in 2003, 2006, and 2009. Latent difference score analyses were applied using Mplus 5.1 and Amos 5. Results: Results show that both grandparent caregiving and SRH decreased significantly over time. Grandparent caregiving in a previous wave significantly predicted subsequent change in SRH, indicating that more grandparent caregiving resulted in a greater change in SRH. On the other hand, SRH had a significant effect on subsequent change in grandparent caregiving, showing that better SRH led to lesser changes in grandparent caregiving in later waves. SRH played a leading role in the prediction effect. Conclusions and implications: This study found a reciprocal effect between grandparent caregiving and SRH. This indicates that grandparent caregiving can be physically demanding and may lead to greater changes in SRH, whereas good SRH is a necessary precondition of caring for grandchildren. The study also found a leading predicting role of SRH, which suggests that SRH as a personal resource is extremely important because it partially determines whether and how intensely rural Chinese grandparents can care for their grandchildren.