Peer-reviewed article
Intergenerational Caregiving Patterns, BMI, and Gender Gaps Among the Sandwich Generation in China
Liu J, Chen F ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This peer-reviewed study examines body mass index (BMI) and caregiving patterns among middle-aged and older Chinese adults (aged 45-69) who simultaneously care for aging parents and grandchildren. The research finds that individuals providing dual intergenerational care have higher BMI levels than those with single-generation caregiving responsibilities. Women are more likely to be high-intensity caregivers and show greater BMI increases from caregiving stress than men. The study highlights gender inequalities in caregiving burden and associated health risks for this 'sandwich generation.'
Key points
- Sandwich generation caregivers with both living parents and grandchildren under 16 have higher BMI (24.2) compared to counterparts (23.7)
- Females constitute a higher proportion of caregivers, particularly high-intensity caregivers, than males
- Females score approximately one unit higher in BMI than males on average (23.4)
- Simultaneous caregiving to both parents and grandchildren significantly increases BMI, while single-generation caregiving shows no similar effect
- High-intensity caregiving (1000+ hours annually) is associated with elevated BMI for females but not for males
Limitations
This study focuses on adult health outcomes rather than child well-being directly. It does not evaluate the impact of caregiving patterns on the health, development, or welfare of the children being cared for, only on the caregiver's BMI.
Abstract
Abstract Existing literatures yield established evidence about the heightened stress brought by multiple roles and potential role overload across work-family context, but little is known about the BMI levels of the “sandwich” caregivers within families and the associated gender inequalities. Indeed, the Chinese pivotal generations are exposed to unshared stress and higher health risks considering that intergenerational support still predominates the caregiving patterns for the oldest old and dependent children under current socioeconomic backgrounds. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study (CHARLS, N = 12186), we examine associations of BMI and intergenerational caregiving patterns among the “sandwich generation” aged 45 to 69. We find that the sandwich generation with at least one parent alive and one grandchild under 16 have higher BMI (24.2, within obesity range) than their counterparts (23.7, within normal range). A higher proportion of females act as caregivers and especially high-intensity caregivers than males, and they also score one-unit higher in BMI than males (23.4). Fixed effect regression results indicate that simultaneous caregiving to both parents and young grandchildren significantly advances individuals’ BMI levels, while no evidence shows similar negative effect of providing care to one generation. Moreover, high-intensity caregiving (1000 hours and above during the past year) is associated with elevated BMI for females but not for males. The gendered caregiving patterns and health implications inform the physical and psychological vulnerability of the pivotal generation and the necessities of gender-specific intervention in middle and later life.