Social workers increasingly serve families in which grandparents are raising their grandchildren. Many grandparents have found raising a grandchild a rewarding experience (Bahr, 1994; Giarrusso, Silverstein, & Feng, 2000; Minkler & Roe, 1993), and the outcomes for the grandchildren often are positive (Solomon & Marx, 1995). However, grandparent caregivers are significantly more likely to be living in poverty (Bryson & Casper, 1999; Harden, Clark, & Maguire, 1997), to be depressed (Fuller-Thomson & Minkler, 2001; Strawbridge, Wallhagen, Shema, & Kaplan, 1997), to have limitations in their activities of daily living (Minkler & Fuller-Thomson, 1999), to have higher rates of heart disease (Lee, Colditz, Berkman, & Kawachi, 2003) and to have poorer self-rated health (Marx & Solomon, 2000) than their non-caregiving peers. Between 1970 and 1997, the number of children under age 18 living in grandparent-headed households increased by 76 percent (Lugaila, 1998). By 2001 there were more than 2,400,000 grandparents raising their grandchildren in the United States (U.S. Census Bureau, 2002a). The cross-sectional nature of census data tends to underestimate the extent of the phenomenon. Earlier research indicated, for example, that more than one in 10 U.S. grandparents had raised a grandchild for six months or more at some point in their lives (Fuller-Thomson, Minkler, & Driver, 1997). Grandparent involvement in child rearing and surrogate parenting has been shown to be considerably more common among many communities of color than among white communities (Simmons & Dye, 2003; Szinovacz, 1998), with groups such as African Americans and American Indians/Alaskan Natives (AI/AN) having a well-documented history of such involvement (compare Bahr, 1994; Hunter & Taylor, 1998; Shomaker, 1989;Weibel-Orlando, 1997).