Bequest Motives of older people in Rural China: From the Perspective of Intergenerational Support.
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ABSTRACT:
SUBMITTER: Jiang Q
PROVIDER: S-EPMC4883116 | biostudies-other | 2015 Jun
REPOSITORIES: biostudies-other
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Project description:BackgroundDepression often coexists with other chronic conditions in older people. The COACH study is an ongoing random controlled trial (RCT) to test the effectiveness of a primary-care-based collaborative care approach to treat co-morbid hypertension and depression in Chinese rural elders. In the COACH model, a team-village doctor (VD), aging worker (AW), and psychiatrist consultant-provides collaborative care to enrolled subjects in each intervention village for 12 months. This study examines how COACH was implemented and identifies facilitators and barriers for its more widespread implementation.MethodsFive focus groups were conducted, two with VDs, two with AWs, and one with psychiatrists, for a total of 38 participants. Transcripts were analyzed using qualitative content analysis.ResultsCOACH care-team members showed shared understanding and appreciation of the team approach and integrated management of hypertension and depression. Team collaboration was smooth. All members regarded COACH to be effective in reducing depressive symptoms and improving patient health. Facilitators to implementation include training, leaders' support, geographic proximity between VD and AW pairs, preexisting relationships among care-team members, comparability of COACH activities and existing practices of VDs and AWs, and care team members' caring about older members of their villages. Barriers to sustainability include frustration of some VDs related to their low wages and feelings of overload of some AWs.ConclusionsCOACH was positively perceived and successfully implemented. The findings offer guidance for planning primary-care-based collaborative depression care in low- and middle-income countries.
| S-EPMC7170762 | biostudies-literature
Project description:As health challenging rural elderly in an aging population, more attention is being paid on impact of family intergenerational support on the health of the elderly. This paper investigates the effects of children's intergenerational economic support and non-economic support on physical, mental, and functional health of rural elderly in China in the mean while. This paper applies the 2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS), in particular, applying exploratory factor analysis to ascertain latent variables and Structural Equation Model (SEM), and analyzes the impacts of "Upward" intergenerational support on health of rural elderly. As resulted, after controlling the socioeconomic status of the rural elderly, the family "upward" intergenerational support influences the elderly's physical health at a percentage of 11.7%, mental health 29.8%, and physiological function 12.6%. Moreover, "Upward" economic support has a positive effect on physiological function (P<0.05). "Upward" non-economic support has negative effects on physiological function and mental health (P<0.05), while it has a positive effect on physical health. In addition, economically independent rural elderly are more likely to benefit from the health of "upward" intergenerational support, especially mental health. In particular, those results are robust. "Upward" intergenerational support plays an important role for the health of rural elderly. For the rural elderly of economic independence, to improve the quality of care and spiritual support, it is important to solve the health problems. In addition, it is necessary to build a comprehensive old-age security and support system for family, community, and society jointly to improve the health of the rural elderly.
| S-EPMC8213075 | biostudies-literature
Project description:OBJECTIVES:The objective of this analysis was to examine older adults' preferences for economic support in the context of competition between grandparents and grandchildren for the middle generation's financial resources in rural China. Specifically, it examined how relative need, lineage, and gender of grandchildren depicted in a vignette were evaluated and how personal characteristics of the evaluators influenced beliefs for which generation should receive more support. METHOD:The sample consisted of 989 older adults participating in three waves of a longitudinal study in Anhui Province, China. Multinomial logistic regression was applied to examine how older respondents evaluated the relative priority of grandparents versus grandchildren in their claim for monetary assistance using a hypothetical vignette with randomized conditions. RESULTS:Relatively greater need of either the vignette grandparent or grandchild increased their priority to receive economic support. The vignette granddaughter was most disadvantaged in the competition with her paternal grandparent. Respondents who were single, in worse functional health, and whose children all migrated gave the vignette grandparent greater priority; those who coresided with children gave the vignette grandparent lower priority. DISCUSSION:Findings support the altruistic perspective on filial support and the corporate group/mutual aid model of family functioning, within the family system that differentiates patrilineal from matrilineal lines of descent. Under budget constraints, selective children are considered to have legitimate claims on the resources of the middle generation, tempering filial piety toward aging parents. Lack of personal resources plays a role in whether self-interest shapes beliefs that favor older over younger generations.
| S-EPMC6377037 | biostudies-literature
Project description:ObjectivesAlthough researchers have linked intergenerational emotional cohesion (IEC) to psychological well-being (PWB) among older adults, the mechanisms and conditions under which IEC is related to PWB-particularly in rural areas-are less well understood. This study analyzed data from rural China to examine whether loneliness mediated the relationship between IEC and PWB, and whether friendship ties moderated the strength of the direct and indirect relationships between IEC and PWB.MethodsMediation and moderated mediation models were tested using a sample of rural adults aged 60 and older (N = 958) from the Longitudinal Study of Older Adults in Anhui Province, China. Measures included IEC, friendship ties, loneliness, and 2 PWB indicators-depressive symptoms and life satisfaction.ResultsThe results revealed that IEC was negatively related to loneliness, which in turn was associated with depressive symptoms and life satisfaction. Furthermore, this indirect pathway linking IEC and depressive symptoms (but not life satisfaction) was positively conditioned on the size of friendship ties.DiscussionThis study advances our understanding of the mechanism through which IEC influences PWB in older adults. Alleviating loneliness could help boost PWB. Other implications for practice and future research are discussed.
| S-EPMC8893140 | biostudies-literature
Project description:Background: Substantial evidence indicated that absolute income is directly associated with health. Few studies have, however, examined if relative income may be equally associated with health. This study aimed to investigate the association between absolute income/relative deprivation (RD) and self-rated health (SRH). We also investigated whether the urban-rural difference was existing in these associations. Methods: Using cross-sectional data of 7,070 participants in the Shandong Family Health Service Survey of older people, this study applied binary logistic model and semi-parametric model to estimate the effect of absolute income and relative deprivation on SRH of older people. The Kakwani Index was used as a measure of relative deprivation at the individual level. Results: Absolute income has a significant positive effect on the SRH among both urban and rural older people. When considered RD as a variable, both absolute income and RD have negative significant effects on SRH among all older people. In addition, the negative effect of RD on rural elderly is more pronounced than that of urban older populations. Semi-parametric regression results show that there was a complex non-linear relationship between income and SRH. Psychological distress substantially attenuated the association between relative deprivation and SRH. Conclusions: Relative deprivation is negatively associated with self-rated health in both urban and rural older people after controlling the absolute income. RD may partly explain the association between income inequality and worse health status. Compared with the urban elderly, the effect of income-based relative deprivation on SRH was more pronounced among the rural elderly, and more care should be given to the lower income and rural older populations.
| S-EPMC8291363 | biostudies-literature
Project description:The purpose of this study is to examine the relationship between adult children's education attainment and their parents' cognitive health, and to further explore the mechanism of intergenerational support. Based on empirical analysis of data from China Health and Retirement Longitudinal Survey, our study finds a positive association between children's educational attainment and parents' cognitive health. This correlation is provided for by emotional communication of informal caregiving, financial support, and healthy behaviors shaped in the parents by adult children. The strength of the effect varied by the adult child's gender. While sons' education attainment significantly improves parental cognitive parameters through informal caregiving, financial support, and development of healthy behaviors, the effect of daughters' education derives from financial support and healthy behaviors, not being related to informal caregiving. The study enriches the evidence on the mobility of children's human capital toward their parents and provides practical insights for advancing children's participation in family caregiving.
| S-EPMC8864153 | biostudies-literature
Project description:Recent commentators have distinguished 'weak' from 'strong' family societies, arguing that older people in less family-oriented societies receive less support from family members than those in countries with strong family ties (e.g. Southern Europe). This study explored the north-south divide in various dimensions associated with support for older people among selected European countries participating in a European Scientific Foundation network, 'Family Support for Older People: Determinants and Consequences' (FAMSUP). Employing data from a wide variety of sources (e.g. nationally representative surveys, censuses, and official publications) we used principal components and cluster analysis to investigate patterns across countries in four dimensions designed to be indicative of the balance between family and formally provided resources for older people and the socio-economic, demographic and policy contexts in which these are provided. Rather than a clear-cut north-south division European countries reflect a more complex classification in terms of support for older individuals when a wide range of measures associated with different dimensions of support for older people are used. Future research requires comparable cross-national data on key indicators of family support.
| S-EPMC5547690 | biostudies-other
Project description:This paper examines the experiences of seeking healthcare for rural Chinese older people, a population who experiences the multiple threats of socio-economic deprivation, marginalization, and lack of access to medical care, yet have been relatively overlooked within the existing scholarly literature. Based on ethnographical data collected from six-month fieldwork conducted in a rural primary hospital in Southern China, this paper identifies a widespread discouraging, dispiriting attitude regarding healthcare-seeking for rural older members despite the ongoing efforts of institutional reforms with a particular focus on addressing access to health services amongst rural populations. Such an attitude was expressed by older people's families as well as the public in their narratives by devaluing older members' health care demands as "unworthy of care and treatment" ("buzhide zhi" in Chinese). It was also internalized by older people, based on which they deployed a family-oriented health-seeking model and strategically downgraded their expectation on receiving medical care. Moreover, underpinning this discouragement and devaluation, as well as making them culturally legitimate, is the social expectation of rural older people to be enduring and restrained with health-seeking. Simultaneously, this paper highlights the sourc2e of institutional and structural impediments, as they intersect with unfavorable socio-cultural values that normalize discouragement and devaluation.
| S-EPMC7143512 | biostudies-literature
Project description:Using retrospective global reports, studies have found that middle-aged adults in the United States provide intermittent support to their aging parents and more frequent support to grown children. To date, studies have not examined support middle-aged adults provide to different generations on a daily basis. Daily support may include mundane everyday exchanges that may (or may not) affect well-being.Middle-aged adults (N = 191, mean age 55.93) completed a general interview regarding family ties, followed by interviews each day for 7 days (N = 1,261 days). Daily interviews assessed support (e.g., advice, emotional, practical help) participants provided each grown child (n = 454) and aging parent (n = 253). Participants also reported daily mood.Most participants provided emotional support (80%), advice (87%), and practical help (69%) to a grown child and also provided emotional support (61%) and advice (61%) or practical help (43%) to a parent that week. Multilevel models confirmed generational differences; grown children were more likely to receive everyday support than parents. Providing support to grown children was associated with positive mood, whereas providing support to parents was associated with more negative mood.Daily intergenerational support was more common than studies using global reports of support have found. Some daily support may be fleeting and not stand out in memory. The findings were consistent with the intergenerational stake hypothesis, which suggests middle-aged adults are more invested in their grown children than in their parents. Nonetheless, middle-aged adults were highly involved with aging parents.
| S-EPMC5019045 | biostudies-literature
Project description:Backgroundthe number of childless older people is increasing in China, but relatively little is known about the role of childlessness in health outcomes. This study investigates the relationship between childlessness and three health outcomes: difficulty with Instrumental Activities of Daily Living (IADLs), self-rated health and depression.Methodsthis study includes 13,171 individuals aged 50 and above from national survey data of the second wave of the China Family Panel Study (2012). Binary/multinomial logistic and ordinary least squares regression models are presented.Resultschildless individuals whose children have all died exhibit worse health outcomes than individuals with children, but this effect is influenced by demographic characteristics, socio-economic status and social security. On the other hand, individuals who are childless due to other reasons (involuntary or voluntary) are less likely to report difficulty with IADLs and to report depression than older people with all children alive after controlling for demographic and socio-economic and social security factors.Conclusionsthe death of a child has an adverse effect on people's health for both childless people whose children have all died and those who have lost a child but have other children alive. These two groups are in the most vulnerable position, which could also suggest that their children have died because they grew up in a vulnerable family. The government needs to improve the social security for these two groups and provide social services (particularly mental health services) to older people who have lost a child; these could contribute to alleviating some of the adverse effects of the death of a child.
| S-EPMC6016684 | biostudies-literature