The health effects of caregiving by grandparents in Taiwan: an instrumental variable estimation

Previous research on the health effects of caring for grandchildren has had variable findings, including both positive and negative effects on the health of grandparents. The estimated effects of caregiving may be affected by selection, with the health of grandparent affecting the likelihood of undertaking caregiving. The health effects of caregiving also likely differ according to the cultural motivations for caregiving by grandparents. This paper assesses whether selection into caring for grandchildren affects the estimated effects of caregiving on the health of Taiwanese grandparents. We used four waves (1993-2003) of the Survey of Health and Living Status of the Elderly in Taiwan to estimate the effect of grandparent caregiving on self-rated health, mobility, and depression. To control for unobserved selection into caregiving, we employed time-varying instrumental variables (the number of grandchildren and marital status of adult children) in addition to person fixed effects. After adjusting for baseline differences, caregivers had better self-rated health, fewer mobility limitations, and fewer depressive symptoms compared to the non-caregivers, which suggest evidence of health improvement for grandparents. Instrumental variable analysis showed that caring for grandchildren was endogenously determined with grandparents' mobility limitations, and grandparent caregivers benefited from a significant reduction in the number of mobility limitations. Our finding suggests that caring for grandchildren can be beneficial for the health of Taiwanese grandparents and supports our hypothesis that a culturally expected role of caregiving results in role enhancement.