Substance abuse epidemics and changes in incarceration and foster care policies have recently placed more young children in grandparent custody. Grandmothers bear much of this caregiving responsibility. Our objective was to compare grandparent caregivers of preschool-aged children (grandparent(s) only or in multigenerational households) to parent caregivers, by caregiver sex, in their mental health, available emotional support, and capacity to manage parenting demands. Using U.S. National Survey of Children's Health data (2016-2019), we used survey-weighted logistic regression models adjusted for socio-demographic confounders and conducted sub-group analyses by caregiver sex. Among 30,046 families with a child aged 1-5 years, 776 (4.1%) were grandparent-only, 817 (3.3%) multigenerational, 28,453 (92.7) parent-headed (weighted percentages). Most caregivers (78.7%) were in Excellent/Very Good mental health, but grandfathers in grandparent-only households were less so. Despite being more likely to parent alone, caregivers in grandparent-only households had about twice the odds of having a source of emotional support (adjusted prevalence odds ratio [aPOR] = 2.07; 95% confidence interval [CI] 1.12, 3.83). Grandmothers, in particular, had greater odds of handling day-to-day parenting demands (aPOR = 2.40, 95% CI 1.35, 4.27) and of reporting rarely/never feeling angry with the child in their care (aPOR = 2.77, 95% CI 1.53, 5.01), compared to mothers in parent households. Caregivers in multigenerational households displayed no differences as compared to parents except for grandfathers in multigenerational households who were more likely often bothered by the child. Despite increasing demands on grandparents, they generally reported faring as well as or better than parent caregivers, especially grandmothers. Their prior experience and social support may make them resilient.
Keywords: Foster care; grandparents; mental health; parenting; stress.