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Publication Date: August 31, 2003 Permanent Link: http://www.urban.org/url.cfm?ID=310842 No. B-55 in Series, "New Federalism: National Survey of America's Families" The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders. When parents are not able to take care of their children, grandparents often step in. Grandparents most often take on this responsibility when a parent has a severe emotional, mental health, alcohol, or drug problem, or when abuse or neglect has occurred and the grandparent does not want the grandchild placed in a foster home (Jendrek 1994). Grandparents may also become primary caregivers in cases of teenage pregnancy (Minkler and Fuller-Thomson 1999; Minkler, Berrick, and Needell 1999). In 1999 approximately 1.3 million children, or 1.8 percent of the child population, were cared for by their grandparents without a parent present, according to the National Survey of America's Families (NSAF).1 Historically, the number of children in the care of their grandparents has fluctuated between 1.3 and 2.1 percent of all children between 1940 and 1995 (Hernandez 1993; Pebley and Rudkin 1999).2 Grandparent care arrangements can come about in different ways. NSAF data suggest that for most children (1.1 million in 1999) these arrangements are made privately, within the family. For other children (200,000 in 1999), child welfare is involved. Child welfare agencies may intervene in families in which abuse or neglect is suspected and either offer services to the families or, if the risk is imminent or ongoing, remove the children from their homes and place them in state-supervised care. The child welfare agency may seek to place the child with a grandparent following an investigation of abuse or neglect or a grandparent already caring for an abused or neglected child may seek the assistance of the child welfare agency. Regardless of how the arrangement came about, all children living with grandparents have experienced a separation from a parent, which can be traumatic (Bowlby 1980). Yet research suggests that living with a relative, rather than with a nonrelative or in an institution, may minimize this trauma by providing the child with a sense of family support (Dubowitz et al. 1994). Furthermore, many grandparents find meaning and satisfaction in being able to provide stability and security for a grandchild (Waldrop and Weber 2001). However, taking care of a grandchild may create or exacerbate a number of health and financial hardships for a grandparent caretaker. In previous work we have looked at children in relative care generally, their well-being, service needs, and receipt of different services. In this brief we focus specifically on children in grandparent care because they live in a common type of relative care arrangement, yet one with unique characteristics. The majority of children in relative care families (58 percent) live with a grandparent. We find children in grandparent care tend to be younger and live with older caregivers who have less formal education compared with children in the care of aunts and uncles, cousins, or siblings. Given these differences, we might expect that grandparents would face challenges distinct from those faced by other relative caregivers. Children in grandparent care are in fact more likely to live in poverty and with a caregiver in poor health, but both groups experience similarly high levels of housing problems, food insecurity, and poor caregiver mental health. Children in grandparent care are also as likely as children in other types of relative care to have health, behavioral or emotional, or school problems. Yet despite these hardships and the well-being challenges of the children in their care, many grandparents, like other relative caregivers, do not receive the services they need. Findings are based on data from the 1999 NSAF, a nationally representative survey that measures the economic, health, and social characteristics of over 44,000 households. This analysis uses information on the sample of children under age 18 cared for by a grandparent without a parent present in the household. Information on the children was obtained from the adult in the household most knowledgeable about the child's education and health care. In this brief, these adults are the children's grandparents, also referred to as the caregivers. Grandparent CareA Distinct ArrangementThis brief focuses on children in grandparent care because they live with a distinct group of relative caregivers with characteristics that not only distinguish them from other relative caregivers, but also highlight some of the challenges they may face in caring for young children at an older stage in their lives. For example, children in grandparent care live with much older caregivers (see table 1). Seventy percent of children in grandparent care are living with a caregiver who is over age 50, compared with 13 percent of children in relative care. Children in grandparent care also live with caregivers with less formal education. Thirty-three percent of children in grandparent care live with a caregiver who has less than a high school degree compared with 12 percent of children living with other relatives. Children in grandparent care also tend to be younger than children in the care of other relatives. Nearly a third (29 percent) of children living with grandparents are under the age of 6, compared with 11 percent of children living with other relatives.3 Approximately equal percentages of children in grandparent and other relative care (48 and 51 percent, respectively) live with a married caregiver.
Income and Health HardshipsGiven demographic differences, we might expect more children in grandparent care to live with a caregiver experiencing financial, health, and possibly emotional hardships than children living with other relatives. In some ways, we find this expectation true. In terms of income, more children in grandparent care (37 percent) live in poor families (households where the income is below 100 percent of the federal poverty level, or FPL) than children living with other relatives (23 percent).4 While grandparents may have been financially stable when caring for themselves, their financial situation may become strained when they take on the care of their grandchildren. Many grandparents are likely to be retired and live on fixed incomes (Hardin, Clark, and Maguire 1997), unlike other younger relative caregivers who are still working. On other measures of financial hardship, however, children in grandparent families fare better or as well as children living with other relative caregivers. For example, it appears children living with grandparents are less likely to live in families facing housing difficulties (31 percent)either crowding or trouble paying billsthan children living with other relatives (51 percent). Grandparent caregivers may have accumulated more assets, such as a house. Child care needs also appear to be less in grandparent care arrangements, not surprising given many grandparents are retired. Nearly a third (30 percent) of children in grandparent care live with low-income single grandparents who work or two grandparents who both work, whereas 47 percent of children cared for by other relatives live in such families. Yet for those grandparents who do work or who need to return to work to help support the grandchild, finding and paying for child care can create a financial strain. Children in grandparent care also face similar levels of food insecurity as their counterparts living with other relatives.5 But notably, about half (48 percent) of children in both groups live in families experiencing food insecurity. With their income constraints, grandparents might have difficulty providing food for an additional child. Not surprisingly, given grandparents' older age, many have health problems. More children in grandparent care live with a caregiver in fair or poor health or who has a limiting condition than do children living with other relatives (54 and 32 percent, respectively).6 This means more than half the children living with grandparents have a caregiver with a health condition. This condition may present challenges when caring for the daily needs of infants or toddlers. In fact more young children in grandparent care are taken on few outings (31 percent) than are young children living with other relatives (3 percent). Even raising school-age children can be fairly demanding and require an active caregiver to attend school functions, take children to activities or lessons, or supervise after-school play. Emotionally, however, children in grandparent care live with caregivers who fare as well as other relative caregivers. We might expect grandparents to face more emotional challenges given they have reached a stage in life when they usually have finished parenting, and adding children to their households could be a difficult adjustment. Grandparents also may have to struggle with their own child's (the parent of their grandchild) problems while providing care for their grandchild. Yet despite these circumstances, percentages of children living with a caregiver in poor mental health or who is highly aggravated do not differ depending on whether the child is in the care of a grandparent or another relative. But it is notable that a third (32 percent) of children in grandparent care live with a caregiver experiencing poor mental health and nearly a quarter (23 percent) live with a highly aggravated caregiver. These data do not indicate whether a grandparent's aggravation or compromised mental health preceded the addition of the new child or was partly caused by the added caregiving responsibilities. However, other research has directly linked grandparent caregiving to higher levels of depression (Minkler et al. 2000). Children's Well-BeingThe trauma of being separated from a parent, and the experience of abuse or neglect, can lead to a variety of behavioral and emotional problems for children, including severe attachment disorders (Bowlby 1973, 1980; Karen 1998). Caring for a child with an attachment disorder may present parenting challenges no matter how loving and committed the new caregiver is (Hughes 1999). Many grandparents, and other relative caregivers as well, appear to be caring for children with poor well-being (see table 1). These children may exhibit difficulties in their physical health, emotional well-being, or ability to engage in school. About one-fifth of children living with grandparents (19 percent) and other relatives (21 percent) have either a limiting condition or are in fair or poor health. Approximately a tenth of 6- to 17-year-old children living with grandparents (9 percent) and other relatives (13 percent) exhibit high levels of behavioral or emotional problems. Twenty-six percent of children cared for by their grandparent and 30 percent of children cared for by other relatives have low levels of school engagement. Service ReceiptGiven grandparents' distinct characteristics, income hardship, and the fact that they are caring for children who sometimes experience difficulties, we look at the service needs and receipt of children in their care. Generally we find that while children living with grandparents receive similar levels of service as children living with other relatives, there are still gaps in receipt of needed services (see table 2).
All grandparents caring for a grandchild are eligible for financial assistance, yet few receive it. Regardless of their incomes, grandparents can receive Temporary Assistance for Needy Families (TANF) child-only payments to help pay for their grandchild's care.7 Payment amounts differ from state to state; in 2000 they ranged from $68 to $514 per month for one child, with an average of $238 per month.8 These amounts decline for each additional child and do not vary depending on the age of the child. Grandparents caring for a child involved with the child welfare system can receive foster care payments if the child is taken into state custody and the grandparent meets foster care licensing requirements.9 In 1999 basic foster care payments differed from state to state and ranged on average from $250 to $657 per month depending on the age of the child, with an overall national average of $403 per month.10 Additional foster payments are made at the same rate for additional children. Moreover, foster parents typically receive supplemental payments for clothing, school expenses, or for the care of special needs children. Yet despite their eligibility for assistance, only 29 percent of children in grandparent care live in families receiving foster care or child-only payments.11 This percentage does not differ significantly from the 24 percent of children living with other relatives who receive this assistance. Many grandparents, like other relative caregivers, also do not receive help for food insecurity or housing problems. Of those children in low-income grandparent families, 16 percent live in families receiving housing assistance.12 For families with food insecurity, income-eligible grandparent households can receive food stamps to supplement their food supply, and can include their grandchild in their food stamps grant. Of children in low-income grandparent care families, 43 percent live in families receiving food stamps. Levels of food and housing assistance are similarly low for children living with other relative caregivers. Few grandparent caregivers, or other relative caregivers, receive needed mental health services. For about one in five (19 percent) children with a grandparent caregiver in poor mental health, the grandparent is receiving needed services. This percentage is similarly low for children living with other types of relative caregivers in poor mental health (21 percent). However, for many children in either grandparent care or relative care, the relative appears connected to social supports in the community. For 82 percent of children living with a grandparent and 83 percent living with another relative, their caregiver knows of at least one source of help in the community, such as a place to turn for help with housing or food problems, drug or alcohol problems, or to get away from a violent family member. Additionally, for 84 percent of children in grandparent care and 90 percent of children living with another relative, their caregiver attended a religious service at least a few times during the survey year. Health coverage appears to be a problem for few grandparent and relative care households. Most children in grandparent and other relative care live with an insured caregiver (85 and 79 percent, respectively). And similarly high levels of children themselves in grandparent (81 percent) and other relative care (80 percent) have health insurance. Yet while these percentages are high, it is curious that any children in these groups are uninsured. All children in relative care are eligible to receive Medicaid, either through the foster care system or through a child-only grant made in their name. Yet just 47 percent of children in grandparent care and 36 percent of children living with other relatives receive Medicaid. Also, despite their health coverage, notable percentages of young children (ages 0-5) living with grandparents and other relatives did not have a well-child care visit in the survey year (26 and 36 percent, respectively). These percentages were similarly high for older children (ages 6-17) in both grandparent and relative care (38 and 41 percent, respectively). ConclusionGrandparent care is a unique relative care arrangement. Children in grandparent care are more likely to live with a caregiver who is older and has less formal education than children living with other relatives. A higher percentage of very young children are in the care of grandparents than are in the care of other relatives. Given these distinctions, we might expect more children in grandparent care to live with a caregiver experiencing hardships than children living with other relative caregivers. We do find more children in grandparent care than in other relative care live with a caregiver experiencing poverty and health problems. But caregiver struggles with housing and child care appear to be less for children living with grandparents than for children living with other relatives. And similar shares of children living with grandparents and other relatives live with food insecurity or a caregiver with mental health problems. Grandparents also care for children with similar challenges in terms of their well-being as do other kin caring for related children. And while levels of service receipt did not necessarily differ for children living with grandparents compared with children living with other relative caregivers, many in both groups do not receive services for which they are eligible. Many child welfare agencies are adapting services to better serve kin caregivers involved with the child welfare system (DHHS 2001). Research has suggested that relatives are more likely to receive such services as financial assistance, food stamps, or Medicaid for the child when they are involved with child welfare (Ehrle and Geen 2002). However, the majority of grandchildren are being cared for by grandparents privately, without involvement of the child welfare system. Thus these families may need to seek the support of other agencies. Several agencies are available to provide these services. For instance, the welfare agency provides child-only payments and in some states coordinates with the child welfare agency to provide added supports to relative caregivers (Andrews et al. 2002). Furthermore, the Older Americans Act (OAA) provides funds to local aging agencies for the National Family Caregiver Support Program (NFCSP), which includes services to grandparents and other relative caregivers over the age of 60.13 And many local organizations, such as churches and community centers, have recognized the need to support relative caregivers and provide support groups, respite care, and legal services (Generations United 2000). Finally, some local school systems offer services to help grandparents (Generations United 2000). These findings provide insights on three important aspects of service delivery that may be useful to shaping future programs and services to grandparent caregivers.
While ideally all children would live with their parents, often this is not possible. Grandparents provide an important service by caring for their grandchildren when parents cannot. Child rearing at an older age can be difficult, and children who have been separated from their parents require particular attention. To help grandparents raise these children it is important to ensure that grandparents are aware of and have access to existing supports and services. Notes1. This estimate is comparable to those provided
by the U.S. Census Bureau. Using the 1998 Current Population Survey (CPS), the Census estimated that 1.4 million children were living with grandparents. The NSAF data suggest there is a 95 percent likelihood that the population estimate for 1999 is in between 1.1 and 1.5 million
children. ReferencesAndrews, Cynthia, Roseana Bess, Amy Jantz,
and Victoria Russell. 2002. "Collaboration between State Welfare and Child Welfare Agencies." Washington, D.C.: The Urban Institute. Assessing the New Federalism Policy Brief A-54. About the AuthorsCynthia Andrews Scarcella is a research associate in the Urban Institute's Population Studies Center, where she specializes in research on child welfare, child care, and related child and family well-being issues. Jennifer Ehrle is a research associate with the Urban Institute's Population Studies Center, where she specializes in research on abuse, neglect, and the child welfare system and other policy issues related to the well-being of children and families. Rob Geen is a senior research associate in the Urban Institute's Population Studies Center, specializing in child welfare and related child, youth, and family issues. About the SeriesThis series presents findings from the 1997 and 1999 rounds of the National Survey of America's Families (NSAF). Information on more than 100,000 people was gathered in each round from more than 42,000 households with and without telephones that are representative of the nation as a whole and of 13 selected states (Alabama, California, Colorado, Florida, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, New York, Texas, Washington, and Wisconsin). As in all surveys, the data are subject to sampling variability and other sources of error. Additional information on the NSAF can be obtained at http://newfederalism.urban.org. The NSAF is part of Assessing the New Federalism, a multiyear project to monitor and assess the devolution of social programs from the federal to the state and local levels. Alan Weil is the project director. The project analyzes changes in income support, social services, and health programs. In collaboration with Child Trends, the project studies child and family well-being. The ANF project is currently supported by The Annie E. Casey Foundation, The Robert Wood Johnson Foundation, the W. K. Kellogg Foundation, The John D. and Catherine T. MacArthur Foundation, and The Ford Foundation. Related Publications
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