[The impact of demographic aging on the pension systems.]

This article discusses the economic consequences of demographic aging. The relevance of this topic is substantiated. The research problem of this article is to assess the strength of the influence of demographic aging on the financial condition of the pension system in the world. Abstracts of the «macroeconomics of aging¼ theses are reviewed with respect to the financial condition of pension systems with an increase in the share of people over working age. A geographical analysis of deviations of the place of countries in the rating of sufficiency of retirement income and the rating of the Melbourne mercer global pension index from the place of countries in the ranking of demographic aging is carried out. The retirement income sufficiency rating for 48 countries, the Melbourne mercer global pension index rating for 25 countries and the UN developed Old age dependency ratio (OADR) are used as the information base. It is concluded that there is no significant correlation between the aging of the population on the one hand and the financial condition of pension systems on the other. Additionally, it was concluded that there is a certain pattern between the strength of the influence of demographic aging and the economic and geographical region. A possible theoretical justification of the thesis of the thesis «macroeconomics of aging¼ is given. Non-demographic factors of influence on the financial condition of pension systems are considered.

Challenges For Middle-Income Elders In An Aging Society.

The United States is becoming an "aging society," in which the number of people older than age sixty exceeds the number of those younger than age fifteen. This transformation has major implications for many aspects of American life. The fundamental challenge relates to our core societal institutions-education, work and retirement, health care, housing, and the like-which were not designed to support a population with our future age distribution. While the most disadvantaged are at greatest risk of losses in physical and emotional well-being and economic security, it has become apparent that middle-income elders will face formidable economic challenges, and related reductions in access to health care and secure housing, in the next ten years. Innovative private- and public-sector initiatives, including both specific public policies as well as individual programs targeting access to health care, housing, and economic security, are needed to support this very large group. For the past decade the Research Network on an Aging Society, an interdisciplinary group of scholars, has been working to identify the critical elements of successful adaptation and to formulate strategies to develop the policies and programs referred to above and assess their effectiveness. Here I present an overview of such policy development and assessment strategies, with a special focus on the housing and other needs of the large older middle class of the future.

Old Age Care Preferences Among Chinese Middle-Aged Single-Child Parents and the Related Policy Implications.

We contrast rural and urban single-child parents' old age care preferences and factors determining their preferences. The results show that single-child parents are more likely to report specific old age preferences than parents with multiple children; urban single-child parents are also more likely to have specific old age care preferences than their rural counterparts. Pension/social insurance is most preferred by urban single-child parents; whereas the preferences of rural single-child parents are more diverse. The most significant rural and urban differences lie in the effects of social and medical insurance on the respondents' selection of care sources. Policy implications are discussed in the end.

Quality of Life in Australian Adults Aged 50 Years and Over: Data Using the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW).

OBJECTIVES: This study explored unique and personal domains associated with quality of life (QOL) in 153 mid-aged and older Australian adults over age 50, using an innovative measure of individualized QOL, the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW). METHODS: Demographic measures as well as the SEIQOL-DW were administered. The qualitative responses on this scale were analyzed by Leximancer, a text analysis program that extracts semantic meaning and relational information automatically from text. RESULTS: For the sample as a whole, the most important QOL domain was found to be Relationships, followed by Family, Health, Activities, Community, Security, Beliefs, Independence and finally Wellbeing. When the sample was broken down into age bands for analysis, the most important domain theme was Family (50-59 year olds), Relationships (60-69 year olds), Relationships (70-79 year olds), and Health (80+ year olds). CONCLUSIONS: The wide range of concepts elicited in each domain via Leximancer underscores the argument for analyzing QOL in an individualized way, as it was clear from these concepts that different domains had unique meanings to each person. CLINICAL IMPLICATIONS: Understanding QOL at the level of which domains in an individual are important to QOL in later life is critical to providing services to both healthy aged as well as those with health and mental health needs. The SEIQOL-DW affords clinicians a unique tool with which to describe an individual's unique and relevant quality of life areas, and affords a way to measure change in these areas as a result of interventions.

Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services.

Despite being one of the world's wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants' photographs and narratives. The shifting of the participants' financial care expectations from informal to formal sources in changing family and sociocultural contexts indicated that older people are in urgent need of policy reform from a needs-based to rights-based approach to foster empowerment and fulfill older people's rights of financial security, dignity and participation. Improving the retirement protection system should go hand in hand with encouraging family support and caregiving and creating age-friendly working environment for older residents. The findings of this study may have crucial policy implications for Hong Kong and other aging societies, especially those that share similar filial piety values and have seemingly ungenerous welfare systems.

Super-aging and social security for the most elderly in China.

This article is dedicated to an under-researched area, the demographic development and social welfare for the most elderly (aged ≥80 years) in The People's Republic of China. Based on national censuses conducted over the last six decades in China this study examined the development of the most elderly population in comparison with groups of younger elderly people. It is argued that population growth among the most elderly in China has occurred with unparalleled speed, a phenomenon referred to as second order aging. This study demonstrated that the proportion of individuals aged ≥80 years has increased more rapidly than any other age group among elderly people. Particular attention has been given to the issue of social security and social welfare for the most elderly based on the non-contributory old age allowances provided by various regions and provinces. A national unified program of social security for the most elderly in the population is still not in sight.

Origins and consequences of technology acquirement by independent-living seniors: towards an integrative model.

BACKGROUND: Living independently can be challenging for seniors. Technologies are expected to help older adults age in place, yet little empirical research is available on how seniors develop a need for technologies, how they acquire these technologies, and how these subsequently affect their lives. Aging is complex, dynamic and personal. But how does this translate to seniors' adoption and acceptance of technology? To better understand origins and consequences of technology acquirement by independent-living seniors, an explorative longitudinal qualitative field study was set up. METHODS: Home visits were made to 33 community-dwelling seniors living in the Netherlands, on three occasions (2012-2014). Semi-structured interviews were conducted on the timeline of acquirements, and people and factors involved in acquirements. Additionally, participants were interviewed on experiences in using technologies since acquirement. Thematic analysis was employed to analyze interview transcripts, using a realist approach to better understand the contexts, mechanisms and outcomes of technology acquirements. RESULTS: Findings were accumulated in a new conceptual model: The Cycle of Technology Acquirement by Independent-Living Seniors (C-TAILS), which provides an integrative perspective on why and how technologies are acquired, and why these may or may not prove to be appropriate and effective, considering an independent-living senior's needs and circumstances at a given point in time. We found that externally driven and purely desire-driven acquirements led to a higher risk of suboptimal use and low levels of need satisfaction. CONCLUSIONS: Technology acquirement by independent-living seniors may be best characterized as a heterogeneous process with many different origins, pathways and consequences. Furthermore, technologies that are acquired in ways that are not congruent with seniors' personal needs and circumstances run a higher risk of proving to be ineffective or inappropriate. Yet, these needs and circumstances are subject to change, and the C-TAILS model can be employed to better understand contexts and mechanisms that come into play.

Cohort Differences in Received Social Support in Later Life: The Role of Network Type.

OBJECTIVES: The objective is to assess cohort differences in received emotional and instrumental support in relation to network types. The main guiding hypothesis is that due to increased salience of non-kin with recent social change, those in friend-focused and diverse network types receive more support in later birth cohorts than earlier birth cohorts. METHOD: Data from the Longitudinal Aging Study Amsterdam are employed. We investigate cohort differences in total received emotional and instrumental support in a series of linear regression models comparing birth cohorts aged 55-64, 65-74, 75-84, and 85-94 across three time periods (1992, 2002, and 2012). RESULTS: Four network types (friend, family, restricted, and diverse) are identified. Friend-focused networks are more common in later birth cohorts, restrictive networks less common. Those in friend-focused networks in later cohorts report receiving more emotional and instrumental support. No differences in received support are evident upon diverse networks. DISCUSSION: The increased salience of non-kin is reflected in an increase in received emotional and instrumental support in friend-focused networks in later birth cohorts. The preponderance of non-kin in networks should not be perceived as a deficit model for social relationships as restrictive networks are declining across birth cohorts.

Increasing pension age - Inevitable or unfeasible? Analysing the ideas underlying experts' arguments in the UK and Germany.

Based on interviews with German and British experts from major political parties, government departments, employer confederations, trade unions and special interest organisations, we investigate the chains of arguments that these experts advance in favour of or against increases in state pension age. In this way, we add to the explanation why very similar reforms could be enforced in the very different pension systems of Germany and the UK. The chains of arguments deployed are surprisingly similar between the two countries: Whereas the proponents of reform stress its necessity in the context of pension spending and see older people as being able to work longer, opponents and sceptics of the increase doubt most older people's ability to work longer and thus the feasibility of the reform. The proponents prioritise ideas of intergenerational justice and meritocratic justice based on individual performance, and underline pension-related interest oppositions between age groups and cohorts. By contrast, opponents and sceptics tend to focus on needs-based justice and social inequalities within age groups. Concomitantly, the actors have different ideas on how a flexible transition to retirement could be organised, with country differences being more pronounced here.

Impact of a guaranteed annual income program on Canadian seniors' physical, mental and functional health.

OBJECTIVE: Although there is widespread recognition that poverty is a key determinant of health, there has been less research on the impact of poverty reduction on health. Recent calls for a guaranteed annual income (GAI), defined as regular income provided to citizens by the state regardless of work status, raise questions about the impact, relative to the costs, of such a population health intervention. The objective of this study was to determine the impact of Canadian seniors' benefits (Old Age Security/Guaranteed Income Supplement, analogous to a GAI program) on the self-reported health, self-reported mental health and functional health of age-eligible, low-income seniors. METHODS: We used the 2009-2010 Canadian Community Health Survey to examine unattached adult respondents with an annual income of $20,000 or less, stratified by seniors' benefits/GAI eligibility (55-64 years: ineligible; 65-74 years: eligible). Using regression, we assessed self-reported health, selfreported mental health and functional health as measured by the Health Utilities Index, as outcomes for seniors' benefits/GAI-eligible and -ineligible groups. RESULTS: We found that individuals age-eligible for seniors' benefits/GAI had better health outcomes than recipients of conditional income assistance programs. Eligibility for seniors' benefits/GAI after age 64 was associated with better self-reported health, functional health and self-reported mental health outcomes, and these effects were observed until age 74. CONCLUSION: Using seniors' benefits as an example, a GAI leads to significantly better mental health and improved health overall. These improvements are likely to yield reduced health care costs, which may offset the costs associated with program expansion.

A cost of living longer: Projections of the effects of prospective mortality improvement on economic support ratios for 14 advanced economies.

The economic implications of increasing life expectancy are important concerns for governments in developed countries. The aims of this study were as follows: (i) to forecast mortality for 14 developed countries from 2010 to 2050, using the Poisson Common Factor Model; (ii) to project the effects of the forecast mortality patterns on support ratios; and (iii) to calculate labour force participation increases which could offset these effects. The forecast gains in life expectancy correlate negatively with current fertility. Pre-2050 support ratios are projected to fall most in Japan and east-central and southern Europe, and least in Sweden and Australia. A post-2050 recovery is projected for most east-central and southern European countries. The increases in labour force participation needed to counterbalance the effects of mortality improvement are greatest for Japan, Poland, and the Czech Republic, and least for the USA, Canada, Netherlands, and Sweden. The policy implications are discussed.

Fragmentation in social security old-age benefit provision in China.

Currently, in many countries most workers are covered by a national social security benefits program that applies equally in all parts of the country. In China, however, social security old-age benefits are provided in a highly fragmented manner. This article documents the high degree of fragmentation. It discusses both why that has occurred and the effects of the fragmentation on participants. It examines effects of the fragmentation on benefit levels, focusing on variations in the generosity of benefit formulas but also considering other measures of benefit adequacy. Fragmentation is seen to cause differences in benefit levels even within a single city. While the new National Rural Pension Scheme is a major improvement in the provision of retirement security for rural workers, important differences still exist in the social security programs for urban and rural workers.

Elderly care and the one-child policy: concerns, expectations and preparations for elderly life in a rural Chinese township.

Several studies have looked at the effect of the one-child policy on elderly care in China. This study compares the differences in concerns, expectations and preparations for elderly life of parents of reproductive age between one- and two-child families in a rural Chinese village. With support from the Bill and Melinda Gates Institute for Population and Reproductive Health, 800 one- and two-child families were surveyed from 2009 to 2010. The data showed that the parents of one-child families were significantly more concerned about being abandoned in old age. There was a discrepancy between parents' preferences and expectations for elderly care: while many parents "preferred" to live with their children in old age, only a small percentage "expected" to co-reside with their adult children. Some elders even preferred to live in elderly care institutions, indicating a change in the perception and accessibility of these institutions, which have historically been stigmatized and heavily restricted. As China's population ages, there is increased need for expanded services and alternatives to the traditional model of co-residence for the rural elderly.

Family, welfare state generosity and the vulnerability of older adults: A cross-national study.

The availability of family can be considered a protective factor for aging well. In this article, we examine to what extent the family situation of older people creates vulnerability with respect to their quality of life. Because not everyone is vulnerable to the same degree, we try to identify the conditions under which older people benefit more from having family resources. Based on the resources perspective, we argue that the impact of family resources on life satisfaction is stronger for older people with fewer resources at both the individual level (material, physical and non-familial social resources) and the country level (welfare state services targeted at older adults). To test our hypotheses we make use of the fourth wave of the European Values Study, and the MULTILINKS Social Policy Indicators database. In general our data offer support for the idea that the presence of intimate family ties (with partner and children) can be considered an important resource for achieving psychological well-being, whereas their absence or loss may act as a constraint. Our vulnerability argument is partly supported by the findings. Partner resources are more important for the life satisfaction of older people with a low education and health problems. Similarly, having children only improves the life-satisfaction of lower educated older adults. However, family resources are not more important for older people with fewer material resources or for older people living in countries with low services levels targeted at older adults.

Lessons from history: Surviving old age during The Great Depression in the United States.

This paper focuses on 30 couples who received a pension and other services from two private trusts in Detroit, Michigan beginning in 1929 or 1930. Results of the qualitative analysis of case files, which contain notes recorded chronologically for 17 of the couples and then surviving spouses, provide a portrait of older couples' lives prior to a partner's death, circumstances surrounding the death, and changes in the social support systems of widows and widowers until their deaths. Close examination of the experiences of these couples is a reminder of how old age and widowhood were experienced prior to the enactment of public pensions and health insurance in the United States.

Old age security in rural China: there is a long way to go.

OBJECTIVE: We aimed to examine the current developments and challenges confronted by old age security in rural China. DATA SOURCES: This study is based on the data from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese. STUDY SELECTION: Articles were selected with the search terms "rural", "China", "old", "older", or "elder", "elderly", or "aged", "aging", "security", "culture", "value", "medical insurance" or "community based medical insurance" or "cooperative medical scheme". Related websites and yearbooks were searched as well. RESULTS: The socio-economic development has made the burden of traditional care for the rural elderly heavier than ever, and new challenges are emerging in rural communities, such as poor economic, deteriorating natural environment and health crisis. CONCLUSIONS: The governments should improve the scale and caliber of rural old age security and strengthen regulations with great efforts in developing the rural economy and protecting the natural environment of rural communities.

Effectiveness of the National Program of Complementary Feeding for older adults in Chile on vitamin B12 status in older adults; secondary outcome analysis from the CENEX Study (ISRCTN48153354).

BACKGROUND: Older people are at increased risk of vitamin B12 deficiency and the provision of fortified foods may be an effective way to ensure good vitamin B12 status in later life. AIM: To evaluate the effectiveness of a vitamin B12 fortified food provided by a national program of complementary food for older people on plasma vitamin B12 levels. SUBJECTS AND METHODS: A random sub-sample of 351 subjects aged 65-67 y from a large cluster randomised controlled trial provided blood samples at baseline and after 24 months of intervention. The intervention arm (10 clusters 186 participants) received a vitamin B12 fortified food designed to deliver 1.4 µg/day, while the control arm did not receive complementary food (10 clusters, 165 participants). Serum vitamin B12 and folate levels determined by radioimmunoassay were used to estimate the effect of intervention on vitamin B12 levels, adjusting for baseline levels and sex. RESULTS: Attrition at 24 months was 16.7% and 23.6% in the intervention and control arms respectively (p = 0.07). Over 24 months of intervention, mean (95% CI) serum vitamin B12 decreased from 392 (359-425) pmol/dL to 357 (300-414) pmol/dL (p < 0.07) in the intervention arm and from 395 (350-440) pmol/dL to 351 (308-395) pmol/dL in the control arm. There was no significant effect of the intervention on folate status. DISCUSSION: Our findings suggest that foods fortified with 1.4 µg/daily vitamin B12 as provided by Chile's national programme for older people are insufficient to ensure adequate vitamin B12 levels in this population. Chile has a long and successful experience with nutrition intervention programs; however, the country's changing demographic and nutritional profiles require a constant adjustment of the programs.

Experience of socioeconomic-related inequality in dental care utilization among Thai elderly under universal coverage.

AIM: To assess the socioeconomic-related inequality in dental care utilization among Thai elderly and to determine factors associated with the observed inequality after the country achieved universal coverage. METHODS: The data were taken from the nationally representative Thailand Health & Welfare Survey 2007. Data of 10,096 Thai elderly (aged over 60 years) were selected. Descriptive analyses of the features of dental care utilization among Thai elderly were carried out, in addition to the concentration index (Cindex ) being used to quantify the extent of socioeconomic-related inequality in dental care utilization. Logistic regression was used to determine factors associated with inequality in dental care. RESULTS: Socioeconomic-related inequality in dental care utilization among Thai elderly was shown. Also, utilization was more concentrated among wealthier older adults, as shown by the positive value of Cindex (equals 0.244). The poor elderly, however, were more likely to utilize dental care at public facilities, particularly primary care facilities. Multivariate analysis showed that certain demographic, socioeconomic and geographic characteristics were particularly associated with poor-rich differences in dental care utilization among Thai elderly. CONCLUSIONS: Although socioeconomic-related inequality in dental care utilization among Thai elderly exists, the pro-poor utilization at public facilities, particularly primary care facilities, substantiates the concerted effort to reducing inequality in dental care utilization for Thai elderly.