How do grandparents influence child health and development? A systematic review

• Published in: Social science & medicine (1982) Vol. 239; no. 239; pp. 1 - 32
• Main Authors: Sadruddin, Aalyia F.A., Ponguta, Liliana A., Zonderman, Anna L., Wiley, Kyle S., Grimshaw, Alyssa, Panter-Brick, Catherine
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2019; Pergamon Press Inc
• Subjects: Caregivers; Caregiving; Child; Child development; Children; Childrens health; Clinical outcomes; Cognitive development; Cognitive-behavioral factors; Coresidence; Development; Emotions; Family; Family roles; Financial support; Generation; Grandchildren; Grandparents; Health; Health behavior; Health problems; Health status; Heterogeneity; Intergenerational relationships; Literature reviews; Mental health; Operational definitions; Parenting; Participation; Policy; Policy implementation; Research design; Residence; Systematic review; Parenting; Policy; Generation; Health; Development; Family; Research design; Child
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2019.112476

Grandparents are often a key source of care provision for their grandchildren, yet they are sidelined in caregiving research and policy decisions. We conducted a global, systematic review of the literature to examine the scope and quality of studies to date (PROSPERO database CRD42019133894). We screened 12,699 abstracts across 7 databases, and identified 206 studies that examined how grandparents influence child health and development. Indicators of grandparent involvement were contact, caregiving behaviors, and financial support. Our review focused on two research questions: how do grandparents influence child health and development outcomes, and what range of child outcomes is reported globally? We examined study design, sample characteristics, key findings, and outcomes pertaining to grandchildren’s physical health, socio-emotional and behavioral health, and cognitive and educational development.  Our search captured studies featuring grandparent custodial care (n = 35), multigenerational care (n = 154), and both types of care (n = 17). We found substantial heterogeneity in the data provided on co-residence, caregiving roles, resources invested, outcomes, and mechanisms through which “grandparent effects” are manifested. We identified two important issues, related to operationalizing indicators of grandparent involvement and conceptualizing potential mechanisms, leading to gaps in the evidence base. Currently, our understanding of the pathways through which grandparents exert their influence is constrained by limited data on what grandparents actually do and insufficient attention given to interpersonal and structural contexts. We present a conceptual framework to explicitly measure and theorize pathways of care, with a view to inform research design and policy implementation. We underscore the need for more robust data on three indicators of caregiver involvement—contact, behavior, and support—and for careful description of structural and interpersonal contexts in caregiving research. •First systematic review of the global evidence linking grandparents to child outcomes.•Discusses heterogeneous findings for grandparent custodial and multigenerational care.•Operationalizes three indicators of grandparent involvement.•Presents a conceptual framework to measure and theorize pathways of care.•Identifies research and policy issues affecting grandparents and their grandchildren.