Search

This paper examines the relationship between community care services and ageing in place in urban China. Using data from the 2010 Sample Survey on Aged Population in Urban/Rural China, and within the framework of a revised version of Andersen's model, the paper applies multilevel models and analyses the effects of community care on the preference between ageing in place and institutional care, and reveals that ageing in place is preferred even in urban China. However, the existence of community care services had no significant effect on the preference for ageing in place. The paper concludes by arguing that China needs to develop its community care services and promote the idea of community care in both culture and policy. Realising ageing in place also requires a multidisciplinary approach. A model of shared care, between family and state, is particularly appropriate for China. [ABSTRACT FROM AUTHOR]

Aiming at 'ageing healthier and ageing better', a certain amount of highquality informal care should be available for elderly persons with physical disability as formal care is barely accessible in China. The demographic transition and family structural changes have dramatically weakened traditional norms of filial piety and the structure of intergenerational transfers. This article employed nationwide representative data from the first wave (2011) of Chinese Health and Retirement Longitudinal Study (CHARLS) in order to identify the duration of informal care provision at home for frail elders (1122 in rural areas and 577 in urban areas, total 1699), measured in monthly hours, before estimating the associations between intergenerational transfers and the received time of informal care with Tobit Model analysis. Results showed that financial support from the younger generation was unexpectedly negatively associated with the monthly hours of care, implying a reduction of caring support along with increasing financial transfers towards older parents. The lack of informal care could not be compensated by having more children, co-residing with children, or increasing the parent-to-child/grandchild transfers. Spouses were shown to replace children as the major caregivers. In addition, the communitybased long-term care system needs to be promoted to sustain and develop informal care, as the latter will become increasingly important with changing family dynamics. Finally, the received time of informal care, rather than the severity of physical disability measured by difficulty with ADLs or IADLs, was introduced to identify the actual demand for care by elders. The paper argues that it is important to reconceptualise and re-investigate the duration of care provision in the Chinese context in order to develop standards of payment as part of long-term care policies. [ABSTRACT FROM AUTHOR]

The public long‐term care insurance (LTCI) scheme has been implemented in a few countries. Although the hypotheses of crowding‐out, crowding‐in and specialisation can facilitate our understanding of the relationship between LTCI and informal care use, existing studies may suffer from reverse causality. Employing a quasi‐experimental design, this study examined the policy effect of LTCI on informal care use among community‐dwelling older adults in China. Based on the data from three waves of the Chinese Longitudinal Healthy Longevity Survey, a staggered difference‐in‐differences (DID) with propensity score matching (PSM) approach was used to analyse the impact of LTCI on probability and hours of informal care use. The results showed that, for disabled older adults, LTCI reduced 43.3% of the probability and 82.4% of the weekly hours of informal care. LTCI also exhibited a spillover effect among nondisabled older adults through reducing the probability and weekly hours of informal care by 5.2% and 12.2%, respectively. Therefore, we argue that policymakers can consider rolling out the scheme for the entire country. Meanwhile, measures are needed to avoid a sharp decrease in informal care provision. [ABSTRACT FROM AUTHOR]

Non‐communicable diseases (NCDs) have become the major contributors to premature death and disability in China. This study used the repeated cross‐sectional datasets of the 2008, 2011, 2014, and 2018 Chinese Longitudinal Healthy Longevity Survey, with a total number of 44,886 observations, to investigate the association between doctor‐diagnosed chronic diseases (DCDs) and socioeconomic status at both individual and province level by multilevel logistic models. Results showed that higher socioeconomic status at both individual and regional level (measured as urbanisation) were associated with higher odds of diagnosed chronic diseases among older people in China. This study also found a "convergent" effect on DCDs between individual income and urbanisation. Meanwhile, older people who can receive adequate medical support and who cannot receive adequate medical support have a "divergent" effect on DCDs by urbanisation. Additionally, older people with different types of public health insurance have a "paralleled" effect on DCDs by urbanisation. The implications of this study may be that chronic disease among older people in lower socioeconomic status was substantially underdiagnosed. Investment in primary health care could be a cost‐effective way to reduce the inequalities of diagnosed chronic diseases. [ABSTRACT FROM AUTHOR]

This study explores the moderating influence of perceived and objective community environments on the relationship between older adults' home‐ and community‐based care (HCBC) needs and their actual utilisation of such care. We selected 5,668 older adults in two cities in China and adopted latent class analysis to descriptively explore the patterns of their HCBC need and utilisation. Structural equation modelling was used to determine factors related to the patterns of need and utilisation of HCBC services, and to explore the moderating roles that the perceived and objective community environments had on the effect of long‐term care need on its utilisation. The results descriptively showed that older adults' patterns of HCBC need and utilisation appear to be embedded within two broader latent categories: a high‐need/use group and a low‐need/use group. Among participants who were satisfied with their community or who lived in areas with high accessibility to HCBC services, HCBC need could predict HCBC use. Our integrated conceptual framework proved to be applicable, thus enriching the theoretical models in explaining HCBC‐related behaviours. The results have strong implications for urban planners, policymakers, and programme managers who seek to support older people and provide elderly care services in communities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to estimate the prevalence of unintentional injuries and to identify factors mediating the risk of unintentional injuries among internal migrant children in southern China using self‐reported data collected between April 2016 and March 2017. Logistic regression models were used to identify significant risk factors for unintentional injuries among the internal migrant children. The prevalence of self‐reported unintentional injuries among internal migrant children in this study was 19.15%. Internal migrant children exhibiting antisocial (antisocial behaviour vs. no behaviour problems, OR = 2.162, 95% CI: 1.194–3.915, p =.011) and neurotic behaviours (neurotic behaviour vs. no behaviour problems, OR = 2.064, 95% CI: 1.098–3.880, p =.024) were more likely to report unintentional injuries. There was a positive correlation between the number of risk behaviours and the prevalence of unintentional injuries among non‐migrant and internal migrant children. Children's behavioural problems were closely related to unintentional injuries and may be useful as predictors of unintentional injuries in children. [ABSTRACT FROM AUTHOR]

Mental health problems are prevalent among migrant workers in China. The present study examined the prevalence of mental health problems (depression, anxiety and suicidal ideation) among migrant workers in China, and identified the work‐related factors associated with their mental health problems based on the Demand‐Control and Effort‐Reward Imbalance Model. A total of 807 migrant workers were recruited from three factories in Shenzhen using stratified randomized sampling. The prevalence of moderate‐to‐severe anxiety, mild‐to‐severe depression and suicidal ideation in the past year was 17.8%, 60.3% and 4.8% respectively. Results from stepwise regression analyses reported that role conflict and effort were risk factors, whereas utilization of job skills and reward were protective factors for anxiety and depression. Social support was also associated with lower level of depression. Effort was the only factor associated with suicidal ideation in the stepwise analysis. Interventions to improve their mental health are warranted and they should work to reduce their role conflict, improve effort–reward balance, promote utilization of skills and increase social support. [ABSTRACT FROM AUTHOR]

Shidu parents (parents who lost their only child) experience poor mental health, and social support is expected to alleviate mental stress and facilitate mental adaptation of bereaved parents. However, the literatures on the effects of social support on mental health of bereaved parents have yield mixed outcomes, and the relationship between social support and mental health among Shidu parents has been unexplored in China. The purpose of this study was to examine the relationship between social support and mental health among Shidu parents in China. Multistage stratified random sampling was conducted to collect data in 2017, and a total of 1,750 Shidu parents were employed as the analytical sample. The Ordinary Least Squares Model and Instrumental Variables (IV) Method were both employed. The variable of community services for the aged provided by the market was employed as the IV of the study considering death taboo inveterately rooted in philosophies and religions in Chinese culture. The results indicated that there was a positive relationship between social support and mental health among Shidu parents, specifically, objective social support and social support utilisation were significantly related to mental health of Shidu parents, while subjective social support was not. Implications of the study include the following: First, it is crucial to help spouse and friends gain appropriate social support skills. Mutual associations can be an important source of social support. Second, objective social support should be given a top priority, and suitable amount, timing, source and structure of social support should be paid more attention to strengthen the 'goodness of fit' between the needs of Shidu parents and support provided. Third, some other social services such as community care, social work services and professional consulting services can be appropriate alternatives to alleviate mental stress of Shidu parents. [ABSTRACT FROM AUTHOR]

Previous research has found a negative linkage between neighbourhood social participation and depressive symptoms in Western countries, but the cross‐sectional design of these studies limits the ability to infer causality. Little attention has been paid to socio‐psychological pathways linking neighbourhood social participation to depressive symptoms among older adults in China. This study aimed to examine the impact of neighbourhood social participation on depressive symptoms among older adults in China. It also further explored the mediating roles of physical activity, social contact among neighbours, and contact with own children in the relationship between social participation and depressive symptoms. Data obtained through three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study were used. The sample consisted of 10,105 individuals aged 60 and above and 24,623 person‐year records captured during these three waves. Depressive symptoms were assessed using the Center for Epidemiology Studies of Depression scale. Results showed that respondents' depression decreased with an increasing level of neighbourhood social participation, more time spent on physical activities, and a higher frequency of contact with neighbours and with own children. These factors were found to partly mediate the relationship between neighbourhood social participation and depression. The negative relationships between social contact and depression and contact with own children and depression were both strengthened by neighbourhood social participation. In conclusion, physical activity, social contact among neighbours and contact with own children are mechanisms through which neighbourhood social participation lowers the risk of depression among older adults in China. [ABSTRACT FROM AUTHOR]

International migrants experience first-hand differences between countries in terms of the social meanings, spatial regulation and prevalence of smoking. This research centred on the smoking-related perceptions, experiences and behaviours of recent migrants from China to Canada. Eight focus groups were held in Edmonton, Alberta, in July-October 2013 to explore migrants' understandings of the practices and meanings of smoking in both countries. There were 58 participants (37 non-smokers and 21 smokers), most of whom were international students. Qualitative content analysis of focus group transcripts was undertaken to identify key themes. Participants observed that smoking remains almost ubiquitous in China due to ineffective spatial restrictions and the social importance of smoking among men. By contrast, smoking bans in Canada were perceived as effective due to widespread compliance and expectations of enforcement. They were conscious that male smoking was both less prevalent and less socially valued in Canada; conversely, female smoking was perceived as more accepted in Canada than in China. There was broad agreement that smoking was tolerated in Canada, provided it occurred in appropriate places. Complying with widespread spatial restrictions brought about changes in smokers' behaviours: they smoked less often, and consumed fewer cigarettes. Because smoking was more difficult to perform, participants thought the Canadian context supported quitting. Non-smokers were enthusiastic about smoke-free environments in Canada, and had become acculturated to air that did not smell of smoke. These findings affirm the importance of comprehensive smoking bans, backed by enforcement, in contributing to the denormalisation of smoking and the protection of non-smokers. [ABSTRACT FROM AUTHOR]