Precautionary health measures such as mammograms and cholesterol tests that identify the risk of heart disease are critical for the well-being of women over 50. Add the responsibility of providing sustained care for a grandchild, and these preventive examinations become even more important.

Yet grandmothers in the first two years of caring for a grandchild take fewer preventive measures to protect their health compared to grandmothers of the same age who are not raising children, according to a USC Davis School of Gerontology study.

“Given that this group is already at risk for poor health outcomes because of their advanced age and vulnerability to chronic conditions, poor preventive behavior might precipitate a decline in health over time, a situation which could render the grandmother unable to care for her grandchild,” writes lead author Lindsey Baker, a postdoctoral fellow at the USC Davis School.

In their recent paper in the Journal of Gerontology, Baker and co-author Merril Silverstein, USC professor of gerontology and sociology, looked at five types of protective health behaviors: influenza vaccination, cholesterol screening, monthly breast self-examination, mammography and Pap tests, used to identify risk factors for cervical cancer.

Grandmothers between the ages of 50 and 75 were divided into those who had cared for a grandchild for more than two years, those who had cared for a grandchild for two years or less and those who did not care for a grandchild.

Their findings indicate that grandmothers in the early stages of caring for a grandchild were significantly less likely than grandmothers not raising grandchildren to undergo flu vaccination or cholesterol screening. They also were less likely to get Pap tests, the researchers found.

Even among grandmothers for whom raising a grandchild was not a financial or emotional strain, preventive health examinations were less likely in the first two years of caring for a grandchild, according to the study.

“This implies that even grandparents and grandchildren in households traditionally seen as stable and therefore not generally targeted by state and federal programs, may be at adverse risk if lower use of health screening results in greater prevalence of disease and disability among caregiving grandparents,” Baker said.

However, after two years of caring for a grandchild, what was once a health burden becomes a potential health benefit. Baker and Silverstein found that caregiving grandmothers increasingly were health conscious once they made the transition into full-time care, becoming more likely than those not raising grandchildren to adopt preventative health measures such as flu vaccinations and monthly breast self-exams.

“Long-term caregivers are particularly motivated to maintain a healthy lifestyle, in order to be prepared to care for the child in the future,” Baker said. “As grandmothers adapt to their new role, this motivation begins to outweigh constraints on service use.”

Baker and Silverstein write that healthy habits among long-term grandparents do not fully offset the lack of preventive health examinations during the crucial transition period.

The researchers advocate for support groups that target a range of interventions such as checkups, screenings and inoculations aimed at promoting healthy behavior among new grandparent caregivers.

“Many of these support groups are already available on a local level,” Baker said. “They provide ride-share programs or babysitting drop-off centers so grandmothers can go through health checkups.”

Baker also emphasized the need for greater awareness, especially in low-income areas where many grandmother caregivers live: “They need to know not only that such programs exist, but that services such as cholesterol tests and flu shots are inexpensive or available at low cost for many older adults.”

Data came from the 2000, 2002 and 2004 waves of the University of Michigan Health and Retirement Study, which surveys more than 22,000 Americans over the age of 50 every two years.

The study was supported by the National Institute on Aging.