Ageing in Asia, societal and family support

The death of a child is one of the most traumatic events that a parent can experience. The psychological and physical consequences of bereavement are well established, and the consequences are more severe for mothers than fathers. However, little is known about how the death of an adult child affects parental wellbeing in old age or how the deceased child’s sex may moderate the association. We use data from the Taiwanese Longitudinal Study of Aging (TLSA) to investigate how the death of a son or a daughter differentially affects the wellbeing of older parents, measured by depressive symptoms and self-rated health. We find that for mothers, a son’s death is associated with an increase in depressive symptoms and a decline in self-rated health, but fathers’ health is not adversely affected by a son’s death. There is little evidence that a daughter’s death has a negative effect on either maternal or paternal wellbeing. We situate these findings within their social and cultural contexts and discuss social policies that would reduce gender and health inequality.

Using data from a survey of four towns in Yi County of Anhui Province taken in 2008, this paper analyzes the effects of sons’ marital status on intergenerational transfers, including financial transfers, instrument transfers, and emotional transfers provided to parents, as well as co-residence arrangements. Random-effect regression analysis showed that son’s marital status has strong effects on financial transfers to and co-residence with parents. Compared with married sons who received more marriage help with marriage costs from their parents, older unmarried sons (so-called forced bachelors) transfer less finance to their parents, and are more likely to live with their parents. Parents’ intergenerational transfers to sons, as well as the parents’ own needs and sons’ capability all affect the intergenerational transfers from sons. In addition, whether they co-reside with parents also influences parents’ financial transfers from their sons. These results show that both theories of exchange and altruism are simultaneously relevant in the context of the marriage squeeze of contemporary rural China.

China's family planning policy has to make a transformation, an important direction of which is to improve family development capacity. However, positive effects of current policy have also damaged greatly to families in mainland China through destroying their basic survival and sustainable ability, and causing failure to their self-development evenly. Therefore, to achieve goals of the social and family harmony and population control, the state should make the developmental family planning policy based on capacity building with doing some necessary adjustments.

By using the data from the survey of Chinese Healthy Longevity Survey conducted in 2008, this paper focuses on effects of different living arrangements on their cost of direct daily health care for Chinese elderly. Having taken effect of zero and heteroscedasticity in the latent variable model into account, this paper employs Tobit regression model and bootstrap error estimation to understand living arrangement disparities in the direct daily health care cost. Our results indicate that variable of respondents’ living arrangement is significantly associated with direct daily health care cost. Those living in nursing homes cost more than those living with their children or live alone. Meanwhile, it also turns out that medical insurance for seniors is deficient for elderly. There is no phenomenon of medical insurance abuse, but medical insurance shortage in the field of seniors’ medical insurance. When we combine the desired living arrangement with this study, the following policy implications are obvious: convert sickness-oriented health consciousness to health-oriented consciousness.; continue to carry out and deepen ‘home-based care’ for the elderly grounded on community.; continue to reform medical insurance, increase coverage of medical insurance, and establish long-term care insurance for the Chinese elderly.

Social institutions and the patriarchal system in India deprive women of taking the role of head of the household when their husbands are alive and most often, they have to depend on children once they become widows. We unravel these unwritten social norms conventionally practiced in terms of intergenerational co-residence of elderly females versus males with children in self or spouse support providing and in child headed support receiving households from the perspective of the elderly. Analysis of nationally representative samples of 15,649 females and 16,240 males 60 years and above revealed that co-residence in child headed households among elderly females is 53.6 percent as against 26.5 percent among elderly males. More than 70 percent of widowed or widower/divorced/separated elderly co-reside in child headed support receiving households. The vulnerable non-literate, economically dependent and physically immobile females are more likely to co-reside in child headed households than their male counterparts. About 56 percent of elderly males lived with children in self or spouse headed households indicating that children too benefit from parents particularly for housing.

In view of population size, scarcity of resources, existing poverty, insufficient health facilities and the absence of a social security system, ageing is going to be a major problem in Bangladesh. Thus, this paper examines how many years the elderly expect to be in good health, and what are the correlates of self-rated health (SRH). The data used in this study come from 896 elderly from Rajshahi district in Bangladesh and from United Nations projected population figures. Results show that individuals at age 60 expected about 41 percent of their remaining life to be in good health, while individuals at age 80 and above expected only 21 percent of their remaining life to be in good health. Having exercised during the 6 months prior to the survey was the single most important correlate of SRH: odds ratio = 5.49 (4.03-7.47) without any adjustment. While rural-urban differentials, gender inequality and some health decline in old age are inevitable, four factors (exercise behaviour, sufficiency of income, physical limitations, and facing abusive behaviour) are to a certain extent modifiable and therefore provide a potential for improvement in SRH and in healthy life expectancy in Bangladesh.

Unprecedented growth in the elderly population shares is experienced in China and India, and this study focuses on the implications for overall cognitive functioning development in these countries. Age-related decline in certain cognitive abilities can imply a decrease in overall cognition levels. Although the cognitive ability levels among the 50 plus are lower in India, China ages faster than India – leading to the average cognition levels to fall faster in China and reducing the differences between the two countries. Improvements in education levels, however, could potentially have an opposing effect. We estimate that projected educational increases could lead to a stabilization of our human capital measure for China and a slight increase for India, in spite of aging.

Matriliny is practised among nearly one million Khasi people living in Meghalaya Plateau in the Northeastern region of India. Descent and lineage in this system is from the mother’s clan line and ancestral property passes through the youngest daughter who is the custodian of ancestral property. The Khasi society exists as an island amidst a strong patriarchal Indian society and has survived till date in spite of modern forces constantly working against its continuance. The prevalent system has its unique living arrangements where the elderly segment looks for support and care. The paper aims at understanding the pattern of living arrangements among the Khasi people and study the health and gender dimensions of ageing in Khasi society under the influence of this unique social system. Based on data collected from selected Khasi villages in the plateau, the study presents the empirical reality confronting the matrilineal Khasis.

Using the data from the waves of the survey “Well-being of Elderly in Anhui Province, China” conducted in 2001-2006, this study examines gender differences in medical expenditure of the rural elderly and its effect factors. The results show that proportion of older women who have medical expenditure is higher than that of older men, however, the former spend less than the latter. Tobit models for males and females separately are employed to identify gender differences in the effect factors of medical expenditure of older people. The results show that the older men's medical expenditure dependents on the predisposing factors, while the older women's expenditure relies on the enabling factors such as family and intergenerational supports, which reveals that older men tend to rely on their own economic conditions to meet the medical needs, while older women tend to rely on the financial support from their families. These results tell that, due to the cumulative disadvantages lasting a lifetime, with even worse health and greater demand for medical services, the older women’s medical expenses are relatively less than older men’s. Thus, the elderly vulnerable groups like older women should be of greater concern to policy-makers in future.

The study is based on the Indonesia 2005 Population Intercensal Survey covering older persons aged 60 years and above in 388 selected districts. The study finds a wide range of percentage of being in good health, from 7% to 68% across districts. Sex, type of districts, and location of the districts are taken into account in the analysis. It shows that the corresponding percentage is generally lower among female elderly population than male elderly. Those living in urban districts, cities, tend to report better health status than those in regencies. Cities located in Java/Bali islands have the highest percentage of elderly in good health than other districts in other islands. Functional capacity varies across districts. Percentage of reporting “no help needed” in functioning physical activities ranges from 30% to 96%. In addition, this study also takes into account different types of ADLs (getting dressed, using toilet, taking a bath, and eating) and IADL (preparing meal). The regression analysis shows that good self-reported health status (SRHS) is significantly associated with overall functional capacity. However, good SRHS is statistically significant with difficulty in bathing and eating, as well as with difficulty in preparing meal.