A new study of more than 38,000 adults across Europe finds that the relationships between intergenerational support and health may be more complicated—and more common—than previously thought.
It’s not unusual for grown children, parents, and grandparents to rely on each other—and these types of intergenerational support may become more common in countries with aging populations. But there is significant uncertainty about the impact that these intergenerational support relationships may have on physical and mental health.
Here, Anna Manzoni, coauthor of a paper on the work and a professor of sociology at NC State, explains more about the work:
This study looks at intergenerational support between generations, both up (with younger family members supporting older ones) and down (with older family members supporting younger ones). I know it also looks at both financial and practical support. What is practical support?
Practical support refers to care, including personal care—such as helping with washing or getting out of bed, household help, or grandchild care.
For this work, you looked at intergenerational support situations where at least one of the family members was over 60, right? And, specifically, you looked to see if there was any correlation between intergenerational support and indicators of physical or mental health of the people involved. What exactly were you looking at? And why might it be important?
Yes, we used data from the Survey of Health, Aging and Retirement in Europe (SHARE), which was collected from 2004-2017, and focused on respondents aged 60 or older whose youngest child was aged 25-60. We looked at indicators of parents’ health as outcomes, and we are interested in how providing and receiving support are associated with health outcomes.
Providing a broad picture of the health implications of intergenerational support is relevant in aging societies, where demand for care and social support in later life is higher. Intergenerational support is a way to cope with some of the challenges of aging societies, but it may have health implications. Furthermore, such implications may vary across health outcomes, for providers and receivers, as well as depending on the type of resources being transferred.
Ultimately, you were able to look at data from more than 38,000 people across 19 European countries. What were some of your key findings?
Overall, we found a negative association between providing intergenerational support and health, consistent with our hypothesis that lending support would indicate the presence of stressors and a reduction of resources. However, there was one exception. We found that those who provided practical support had higher self-rated health than people who neither gave nor received help. This was in line with our assumptions about protective mechanisms, such as relationship-building, self-esteem, and capacity development.
We found little support for the idea that receiving support had a protective effect on health. Instead, we found evidence against the hypothesis that individuals who receive support would have improved health. We also found that individuals who provide and receive support report poorer health than individuals who neither provide nor receive support.
Another unexpected finding related to lower physical and mental health among those who provide financial support downwardly, to their children. A possible explanation may be that nowadays parental support is an important pillar for reaching economic independence and parental worries about their children’s financial security may partly explain the negative association with health.
In terms of the receipt of support, we found that receiving practical support from children in particular was associated negatively with health, countering the assumption that receiving support is a way of stabilizing health. A possible explanation here may be related to the potential negative effects of dependency.
Observational studies, like this one, can only show correlations. They can’t prove causation. For example, your study found an association between older adults receiving support from their children or grandchildren and adverse health outcomes for the older adults. Is it possible that the adverse health trajectory is why they require the support in the first place? Is that an area for future study?
Our main contribution relates to presenting a nuanced approach to intergenerational support, distinguishing by role, type, and direction; and in showing health consequences of intergenerational support using both objective and subjective indicators, taking an “outcome-wide” approach. This allows us to comprehensively evaluate health implications of support, identifying vulnerable groups. We do not aim to show causal relationships.
Those interested in causal relationships should be wary of endogeneity/reverse causality issues, indeed, as the association between support and health may be confounded by earlier health. While our analytical strategy (fixed effects models) adjusted for unobserved between-person differences, such factors might still moderate what we’re interested in estimating in those fixed effects models. We conducted some robustness tests, which showed that earlier health on the one hand may act as a buffer or coping resource to mitigate potential stressors arising from the provision of practical and the receipt of financial support. On the other hand, older adults with greater health resources might also be more likely to decline in health, and specifically mental health, faster when starting to receive support. However, looking at causal relationships is beyond the scope of our work, and could be a focus of future research.
What are some of the other questions this work raises? In other words, how do you think the research community can build on this work?
Our study has broad consequences. First, while the availability of intergenerational support may boost fertility decisions among adult children and enable aging in place among older parents, it may also have negative consequences. Increased geographical mobility might reduce opportunities for practical support, concentrating the support load on those family members that live nearby. Digital participation of older adults has increased steadily, enabling exchange with family members from various generations and, potentially, support that does not require co-presence. Future challenges might call for more flexible support needs; for example, climate change may pose health threats to older age groups, calling for ad-hoc support arrangements. To buffer the shocks of such crises it’s important that potential supporters are not overburdened with providing support on a regular basis; accordingly, exhaustive reliance on intergenerational support should be assessed critically.
The paper appears in the Journal of Marriage and Family.
Source: NC State
