Health and ageing in low, middle and high-income countries (1)

Using the data from the longitudinal survey “Well-being of Elderly in Anhui Province, China” conducted in 2001, 2003, and 2006 respectively, this study examines the impact of adult children’s out-migration on Chinese rural elders’ psychological well-being. The results show that, controlling the characteristics of the elders, the change of migrant sons has a negative effect on the elders' psychological well-being, especially for the older men, while, an increase in migrant daughters are associated with deterioration in psychological well-being of older women. Due to the gender roles and division in family, traditional living arrangement moderated the negative effect of adult children's out-migration on psychological well-being of older women. However, for older men, living with adult children implies an increase of demand, therefore, worsens their psychological well-being. These findings support an extension of economics of labor migration theory that incorporates the stress–health outcome framework.

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.

It is widely believed that family background has a significant influence on children’s life. The vast majority of the existent literature has focused on the relationship between parents’ education and income and the education and income of their children. Surprisingly, much less work has been done on the intergenerational transmission of health. The main objective of this paper is to examine the correlations of health across generations using the Indonesia Family Life Survey (IFLS). We take advantage of the richness of IFLS and examine several health measures of respondents, including self-reports and biomarkers. As measures of health of both parents, IFLS has information on whether they are dead at the time of the last wave in 2007, their general health status and whether they have difficulties with any ADLs at the time of the survey or just before death. The findings suggest strong intergenerational correlations between the measures of parental health, schooling, and the health of their adult children. We also examine how these intergenerational correlations might differ for respondents born in the more developed parts of Indonesia compared to the less developed areas. Interestingly, these health associations are much lower for respondents who were born in Java or Bali.

This paper examines the determinants of chronic health conditions and explains their persistence, using a panel data set from the Indonesian Family Life Survey (IFLS). I incorporate dynamics into a health demand function, finding strong correlations between lagged and current health measures when nothing else is controlled. This could represent the influence of lagged health or fixed unobserved factors such as genetic endowments and childhood health. To disentangle these, I estimate the influence of lagged health by using first-difference two-step generalized method of moments (FD-GMM), where the first-differencing removes fixed unobserved factors and keeps only lagged health. I found that it is this fixed effect, representing both genetic endowments and childhood health, that is most important in explaining later life chronic conditions. The impact of past health conditioning on the fixed effect, captured by the coefficients on lagged health measures, is weak, with estimated coefficients relatively close to zero. These results are robust to potential measurement errors in health and to sample attrition. Socio-economic status also has very little influence on current health, again conditioned on the fixed effect and on the influence of lagged health.

BACKGROUND The disabled elderly, who utilize more health services than their counterparts, put a heavy pressure on the health system. However, our knowledge of the disease pattern in disability burden among the Chinese elderly remains limited.

METHODS Based on a nationally representative data, we used the attribution method to obtain disability prevalence by disease and then employed the Sullivan method to produce life expectancy with disability (LED) by disease. The analyses were carried out at both disease group level and individual disease level.

RESULTS At the disease group level, ear, eye, circulatory and musculoskeletal diseases and injury and poisoning were the 5 leading causes of disability burden in terms of their contributions to disability prevalence and LED. At the individual disease level, presbycusis, cataract, cerebrovascular disease, osteoarthritis and unclassified injury totally accounted for 64% of disabilities and caused males and females aged 60 to have 3.04 and 3.76 years of LED, respectively.

CONCLUSIONS Along with the epidemiologic transition, chronic diseases have become the predominant contributor to disability burden among the elderly population in China. And, presbycusis, cataract, cerebrovascular disease, osteoarthritis and unclassified injuries should be the priorities in fighting ag

Though well-established in developed settings, the form of the education-health relationship is less well known in developing settings, particularly in sub-Saharan Africa (SSA). Using three waves of the Malawi Survey of Families and Households (MLSFH), I estimate annual probabilities of entering into physical disability and death by age, sex, and educational attainment. I use these transition probabilities to estimate life and health expectancies by generating synthetic cohorts of individuals via microsimulation. Individuals in SSA experience substantial disability, but individuals with more education are less likely to transition to disability and death. Males with 4 or more years of education live on average 3 years longer than males with less than 4 years of education, with all of these additional years lived in active life. Females with more education do not live longer overall, but do live proportionately more of their lives without disabilities.