Becoming a Grandparent Affects Hospitalization Risks: Emulating a Target Trial in a Swedish National Birth Cohort

Josephine Jackisch , Max-Planck Institute for Demographic Research
Can Liu, Stockholm University

Most adults experience the birth of a grandchild. Yet, evidence on whether the transition to grandparenthood impacts disease risks remains inconclusive. This study aims to estimate the impacts of the birth of a first grandchild on cause-specific hospitalization risks. In order to avoid typical sources of bias, we borrow from an emulated target trial design to estimate cause-specific hospitalization risks in a national birth cohort of Swedes born in 1953 (n=869,272) and their generational linkages across patient and civic registers. We conducted 24 yearly trials (1993-2016), each comparing the five-year risks of hospitalizations by ICD-10 chapters of individuals, who in the trial-start year had their first biological grandchild (treatment) to those who remain non-grandparents (control). The marginalized effect of becoming a grandparent on hospitalizations was estimated through a pooled logistic regression, using weights to adjust for baseline and time-varying demographic, socioeconomic, and health confounders and for censoring. Grandparents exhibited higher risks of hospital admissions for almost all causes. Overall, grandparents had an additional 25 circulatory-related events (95%CI: 22–27), 17 musculoskeletal (95%CI: 15–19), and 16 endocrine or metabolic (95% CI 14–18) events per 1,000 persons compared to non-grandparents during a five-year follow-up. An exception is cancer, with grandmothers having similar hospitalization risk as the non-grandmothers. The results were driven by younger grandparents. Our findings suggest that becoming a grandparent might increase the risk of hospitalization. Prevention efforts could benefit especially those working-age grandparents.

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 Presented in Session 31. Flash Session Family Relationships, Social Networks, Health and Wellbeing in Later Life