OBJECTIVES: Approximately 3.2 million children live with their grandparents or other relatives-a 40% increase in 10 years. This article presents selected findings from an exploratory study of the experience of 71 African-American women raising their grandchildren because of the crack epidemic. METHODS: The study was designed to describe the caregivers' self-reported physical and emotional health status and health-care-related behaviors through a combination of qualitative and quantitative data collected during two in-home interviews. RESULTS: Most respondents rated their health as good or fair, with little change over the previous year, or since caregiving began. Employed women were more likely not only to rate their health as excellent or good, but also to report that their health had deteriorated over the previous year. Other subgroups showing evidence of deteriorating health were those caring for several grandchildren and great-grandmothers. Caregivers without a confidante reported a positive health change. Although 80% of the sample reported receiving regular health care, one third had not been to the doctor in 3 years. Half reported breaking a medical appointment in the last year, most often because of caregiving demands. CONCLUSIONS: These findings have relevance for physicians and other health-care providers because they suggest that many grandparent caregivers may be or soon become the "hidden patients" of the crack cocaine epidemic.
OBJECTIVES: Approximately 3.2 million children live with their grandparents or other relatives-a 40% increase in 10 years. This article presents selected findings from an exploratory study of the experience of 71 African-American women raising their grandchildren because of the crack epidemic. METHODS: The study was designed to describe the caregivers' self-reported physical and emotional health status and health-care-related behaviors through a combination of qualitative and quantitative data collected during two in-home interviews. RESULTS: Most respondents rated their health as good or fair, with little change over the previous year, or since caregiving began. Employed women were more likely not only to rate their health as excellent or good, but also to report that their health had deteriorated over the previous year. Other subgroups showing evidence of deteriorating health were those caring for several grandchildren and great-grandmothers. Caregivers without a confidante reported a positive health change. Although 80% of the sample reported receiving regular health care, one third had not been to the doctor in 3 years. Half reported breaking a medical appointment in the last year, most often because of caregiving demands. CONCLUSIONS: These findings have relevance for physicians and other health-care providers because they suggest that many grandparent caregivers may be or soon become the "hidden patients" of the crack cocaine epidemic.