Gender, spousal caregiving, and depressive symptoms among Chinese older adults: does work status matter?

OBJECTIVES: This study aims to examine the impacts of spousal caregiving on caregivers' depressive symptoms, and how work status and gender mitigate the relationship. METHOD: We used four waves' data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018, N = 20,213) with linear mixed-effect models to investigate the association between providing instrumental activities of daily living (IADL) and activities of daily living (ADL) assistance to a spouse and spouse caregivers' depressive symptoms. We further examined the moderating effect of work status. Analyses were stratified by gender. RESULTS: As main effects, respondents who provided ADL assistance to their spouse had significantly higher depressive symptoms than non-spousal caregivers, and the association was particularly stronger for women than for men. However, we did not find significant difference of depressive symptoms between IADL spousal caregiver and non-spousal caregivers. Working while ADL spousal care further exacerbated caregivers' depressive symptoms for both genders, whereas working full-time while providing IADL spousal care is only associated with elevated depressive symptoms for women. Interestingly, we found that providing IADL assistance is associated with lower depressive symptoms while they were not working. CONCLUSION: The relationship between spousal caregiving and depressive symptoms differed significantly by the type of care and was also moderated by work status, and female caregivers on average have worsened depressive symptoms than male caregivers. Future research on caregiving needs to consider the types of care and other social roles that caregivers also take on. Lastly, more affordable eldercare facilitates need to be built to alleviate the burden among spousal caregivers, especially when they are working.

Which wound cuts deeper: loss of an only child or loss of a spouse? An examination of bereavement in older adults within a Chinese cultural context.

OBJECTIVES: This study aimed to examine whether the loss of spouse had similar impacts on psychological well-being as the loss of the only child, and whether the presence of one mitigated the absence of the other. METHODS: We used data from a 2013 survey conducted in Shanghai, China. The sample included 1,200 older adults aged 60+, and 200 adults aged 45+ who lost their only child. Psychological well-being consisted of three dimensions: depression, loneliness, and life satisfaction. We applied logistic regression models to assess the impact of loss of spouse or children on psychological well-being. We further tested whether the impact differed by gender and whether social support mediated the relationship. RESULTS: Participants who have at least one living child but lost their spouse had less psychological distress than those who have a living spouse but lost their only child. This effect appeared to be stronger in women than in men. Social support mediated the relationship between bereavement and loneliness among women. CONCLUSION: The findings suggested the loss of the only child is a more devastating event than the loss of spouse in Chinese adults. The loss of the only child is a major chronic stressor that has cumulative negative effect on psychological well-being.

The mixed blessing of living together or close by: Parent-child relationship quality and life satisfaction of older adults in China.

BACKGROUND: Geographic proximity between parents and children is increasingly recognized as an alternative measure to coresidence as a gauge for intergenerational support in China. The quality of intergenerational relationships is another important dimension of intergenerational ties that is often underexplored. OBJECTIVE: We examine the association between parent-child proximity and life satisfaction of older adults and how it interacts with the quality of intergenerational relationships, particularly for vulnerable subpopulations. METHODS: We use data from the China Longitudinal Aging Social Survey (CLASS 2014). We use ordered logit models to predict life satisfaction scores (ranged 1 to 4). RESULTS: Our analyses show that parent-child relationship quality is strongly associated with life satisfaction, regardless of living proximity, in our full sample analysis. For those who have a lower-quality relationship with their children, coresidence or close-distance living does not enhance life satisfaction and they indeed have lower life satisfaction than those parents who have all children living farther away but maintain a high-quality relationship with them. At the same time, for those who have a high-quality relationship with their children, we find that close proximity provides added benefits for the subpopulations who are socioeconomically or physically disadvantaged, that is, female, urban, unmarried, and disabled (in terms of being capable of activities of daily living, or ADL) older adults. CONCLUSIONS: We recognize the interdependence of the quality of the intergenerational ties and parent-child proximity in promoting life satisfaction, particularly for subpopulations who are in stronger need of support from adult children. CONTRIBUTION: Our study clearly points to the importance of extending the research on intergenerational relationship beyond the boundary of the household and of paying close attention to the affective dimension of intergenerational ties.

The Emergence of Educational Hypogamy in India.

With rising education among women across the world, educational hypergamy (women marrying men with higher education) has decreased over the last few decades in both developed and developing countries. Although a decrease in hypergamy is often accompanied by increasing homogamy (women marrying men with equal levels of education), our analyses for India based on a nationally representative survey of India (the India Human Development Survey), document a considerable rise in hypogamy (women marrying partners with lower education) during the past four decades. Log-linear analyses further reveal that declining hypergamy is largely generated by the rise in education levels, whereas hypogamous marriages continue to increase even after marginal distributions are taken into account. Further multivariate analyses show that highly educated women tend to marry men with lower education but from more privileged families. Moreover, consanguineous marriages, which exemplify strong cultural constraints on spousal selection in certain parts of India, are more likely to be hypogamous than marriages not related by blood. We argue that the rise in hypogamous marriage by education paradoxically reflects deep-rooted gender scripts in India given that other salient social boundaries are much more difficult to cross.

Moving beyond living arrangements: the role of family and friendship ties in promoting mental health for urban and rural older adults in China.

Objective: This study examines the interplay among living arrangements, social networks, and depressive symptoms among Chinese older adults.Methods: Data are derived from the 2014 baseline survey of the China Longitudinal Aging Social Survey (CLASS), which provides a sample of older Chinese who had been married and had children (N = 7,662). This study examines the association between living arrangements and depressive symptoms (measured as CES-D scale, 0-18) of older adults, and addresses the moderating role of social networks (measured as family ties and friendship ties, 0-15) on this perceived association.Results: Our results show that older adults who live both with a spouse and adult children report superior mental health than those living alone (ß = 1.240, p < 0.001), but no differences are seen from those living only with a spouse or children. Older adults living alone in rural areas are also more disadvantaged in comparison to those living alone in urban places (ß = 0.535, p < 0.05). However, we find that the undesirable consequences associated with depression of older adults living alone can be reduced or even eliminated when older adults have strong friendship ties in rural China (ß = -0.145, p < 0.01). We also find that for rural older adults living only with children, their mental health is highly contingent on their family ties, that is, they are extremely disadvantaged when having weak family ties, but benefit most significantly from strong family ties (ß = -0.137, p < 0.05).Conclusions: Associations between living arrangements and mental health in later life are contingent on older adults' social networks, and these moderating effects vary between rural and urban China.

Fathers' Migration and Nutritional Status of Children in India: Do the Effects Vary by Community Context?

BACKGROUND: Due to international and internal migration, millions of children in developing countries are geographically separated from one or both of their parents. Prior research has not reached a consensus on the impacts of parental out-migration on children's growth, and little is known about how community contexts modify the impact of parental out-migration. OBJECTIVE: We aim to assess the overall impacts of fathers' previous and current migration experiences on children's nutritional status in India and how the impacts are shaped by community socioeconomic contexts and community gender norms. METHODS: Using data from the Indian Human Development Survey collected in 2011-2012, we estimated community fixed-effect regression models predicting the nutritional status of children (ages 10-15) and examined the interactions among fathers' migration, child's gender, and community contexts. RESULTS: The results showed that children of returned migrants had lower height and Body Mass Index (BMI) than children of non-migrants. Fathers' current absence was associated with lower height and BMI for adolescents in communities with high levels of socioeconomic development but not for those in communities with low levels of development. Fathers' current absence due to migration was especially harmful for girls in communities with strict norms of female seclusion. CONTRIBUTION: Our findings highlight that the effects of father's out-migration on children are conditioned by the level of communities' socioeconomic development and community gender contexts, which helps to reconcile the previously mixed findings on the effects of parental migration on child outcomes.

Spousal migration and married adults' psychological distress in rural China: The roles of intimacy, autonomy and responsibility.

Spousal separation due to migration is a prevalent phenomenon in the developing world, but its psychological consequences for left-behind partners are largely understudied. Using data from 2010, 2012 and 2014 China Family Panel Studies (CFPS), this paper first examined whether spousal migration causes rural married adults any psychological distress; this finding was then advanced by testing the mechanisms that could potentially explain the linkage between these two variables. Inverse Probability Weighting (IPW) for multivalued treatment effect models and paired Propensity Score Matching (PSM) have been used to correct the potential selection bias of spousal migration. The results show that prolonged spousal separation through migration increases the depressive symptoms of married adults in rural China, and the detrimental effects on left-behind spouses' psychological well-being can be explained by the reduced level of emotional intimacy between husband and wife, and partially by women becoming the master of the household. Considering that being the master of the household is accompanied by elevated stress levels associated with increasing family responsibilities, further examination showed that economic resources can buffer the negative effect associated with being the master of the household when the spouse migrates. However, we did not find that time use is an effective mechanism to link spousal migration and left-behind spouses' well-being.

Mothers' work patterns and Children's cognitive achievement: Evidence from the India Human Development survey.

As female labor force participation increases globally, the relationship between maternal employment and children's development remains unclear. Using data from the India Human Development Survey (2005), we investigate the link between maternal employment and children's arithmetic and reading achievement. We develop a work pattern typology that goes beyond standard measures of employment and captures work intensity and its compatibility with child-rearing in a transitional economy. We find that the relationship between maternal employment and children's outcomes is not unidimensional. For example, children of self-employed mothers are not disadvantaged compared to those with stay-at-home mothers, but maternal employment in salaried jobs or wage work outside the home is negatively associated with cognitive skills in children. However, this negative association is reversed at higher levels of maternal education, suggesting greater access to resources and flexibility associated with better jobs mitigate the negative aspects of maternal employment posed by time constraints. Additionally, maternal employment is associated with maternal involvement in schoolwork and financial investment in academic activities, providing evidence that both time and resources devoted to children's education are significant.

Women's employment trajectories during early adulthood in urban China: A cohort comparison.

This study uses retrospective work history data from CGSS 2008 and employs group-based trajectory analysis to model the diverse employment trajectories of cohorts of urban Chinese women (born in the 1940s-1970s) during young adulthood (age 20-35). We identify ideal-types of urban women's employment trajectories and explore traits associated with each group type. In particular, we examine whether and how the timing of marriage and fertility as well as socioeconomic background help to distinguish patterns of women's labor force attachment in young adulthood. We also examine how these patterns change across cohorts given China's rapid social transformations in the past few decades. We find that delaying family formation is generally associated with more consistent work attachment, but this relationship is also largely associated with one's socioeconomic background. Our results reveal significant cohort variations in the shape of women's employment trajectories and we discuss how institutional and cultural contexts of different historical periods could have shaped family formation and employment processes differently. Our findings highlight the heterogeneity of urban women's work and family formation patterns in the context of rising gender inequalities and rapid socioeconomic transformation over time.

Functional limitation trajectories and their determinants among women in the Philippines.

BACKGROUND: Limited evidence exists regarding how functional limitation patterns of women in developing countries unfold through midlife and into old age, a critical period during which the tendency to develop severe problems is fomented. OBJECTIVE: Functional limitation prevalence and patterns through midlife into early old age, and their determinants, are examined among women in the Philippines. METHODS: Data from the Cebu Longitudinal Health and Nutrition Study are monitored from 1994 to 2015. Patterns are categorized using group-based trajectory modeling. Predictors of group membership are modeled. RESULTS: About half responding to all survey waves report functional limitation at least once over the study period. Movements in and out of functional limitation states are common. Between age 30 and 70, trajectories are categorized into four groups: 1) robust, 2) late onset, 3) early onset, and 4) recovery. Being married, living in a nuclear household, higher successful birth ratio, and higher education associate with favorable trajectories. More births, higher age at first birth, wealth, and urbanicity associate with less favorable trajectories. CONCLUSION: Many possible routes into and out of functional limitation exist. The manifold patterns can be grouped into common trajectories. A number of earlier life characteristics associate with these trajectories. CONTRIBUTION: This is the first analysis to ascertain common functional limitation trajectories and earlier life predictors among women as they age in a high fertility developing country setting. Recognizing these is an important step toward understanding global health given aging of the population and the likelihood of functional problems developing in women as they move into old age.

For Better or Worse: The Health Implications of Marriage Separation Due to Migration in Rural China.

Massive rural-to-urban migration in China has led to spatial separation of millions of married couples. In this article, we examine the question of whether the well-documented health benefits of marriage extend to left-behind individuals in rural China who are spatially separated from their spouses. Using longitudinal data that span 16 years (China Health and Nutrition Survey 1991, 1993, 1997, 2000, 2004, 2006), we compare the self-reported health trajectories of adults across different marital statuses while taking into account the physical location of their spouses. Our results suggest a clear health disadvantage of married individuals whose spouses are absent compared with those whose spouses are living in the same household. Further, longer spousal absence is more harmful to an individual's health. Finally, spousal absence and longer physical separation from their spouses induce stronger health deficits for married men than for married women, suggesting that a gendered process is at work.

Reconfiguring Social Disconnectedness and Its Link to Psychological Well-Being among Older Adults in Rural China.

Using data from 2015 to 2018 waves of the Longitudinal Study of Older Adults in Anhui Province, China, this study investigated associations between different forms of social disconnectedness (social isolation, loneliness, living alone) and psychological well-being of older adults longitudinally. The results showed that social isolation and loneliness were independently associated with psychological well-being, whereas living alone was not. Different forms of social disconnectedness had additive and interactive effects on psychological well-being of older adults. Those who were exposed to all three forms of social disconnectedness suffered from the lowest level of psychological well-being. Moreover, the adverse effects of social disconnectedness on psychological well-being were found to be stronger for older women than for older men. The results underscore the necessity to consider multiple forms of social disconnectedness as well as their different combinations in explaining psychological well-being in later life.

Intergenerational Caregiving Patterns, Living Arrangements, and Life Satisfaction of Adults in Mid and Later Life in China.

While the health implications of intergenerational caregiving have been broadly investigated in the aging literature, less is known about caregivers in four-generation families and their living arrangements. Using 2011 and 2013 waves of China Health and Retirement Longitudinal Study (N = 12,914 obs.), we document enhanced life satisfaction of grandchild caregivers and sandwich caregivers caring for both grandchildren and parents than non-caregivers. When further taking living arrangements into consideration, we find that parent caregivers also benefit from care provision when not living with their parents and sandwich caregivers only have an advantage when co-residing with care recipients with adult children present in households. By contrast, grandchild caregivers living with grandchildren show substantially higher life satisfaction no matter adult children are present or not. The subgroup comparison suggests that females and rural residents enjoy psychological advantages over their male counterparts and urban counterparts in grandparenting within skipped-generation households and sandwich caregiving.

What Could Interfere with a Good Night's Sleep? The Risks of Social Isolation, Poor Physical and Psychological Health among Older Adults in China.

This study provides one of the first population-based investigations of the longitudinal association between social isolation and sleep difficulty among older adults in China. We analyzed three waves of longitudinal data from the China Longitudinal Aging Social Survey (2014-2018), in which 8456 respondents contributed 16,156 person-year observations. Results from multilevel logistic regression models showed that social isolation was related to a higher risk of sleep difficulty. We also found that socially isolated older adults were more likely to report higher levels of depressive symptoms, a greater prevalence of loneliness and pain, and more chronic diseases compared to their socially integrated counterparts, which in turn increased their risks of sleep difficulty. Moreover, socially isolated older adults with chronic diseases were particularly vulnerable to the risk of sleep difficulty. These findings provide helpful guidance for policymakers and practitioners to design effective intervention strategies to help older adults with sleep problems.

Negative Life Events, Social Ties, and Depressive Symptoms for Older Adults in China.

Although it is widely acknowledged that older adults who have gone through negative life events are more likely to develop depression, there is limited evidence on whether and which type of social ties moderate this perceived relationship. Based on 2016 and 2018 waves of Chinese Longitudinal Aging Social Survey (4,466 individuals, 8,932 observations), we apply linear fixed effects models and confirm that negative life events are associated with depressive symptoms for older adults (Coef. = 0.35; 95% CIs 0.11-0.61), and social ties are negatively associated with depression (Coef. = -0.08; 95% CIs -0.10 to -0.07). Our study further suggests that the association between negative life events and depressive symptoms is significantly moderated by friendship ties (Coef. = -0.18, 95% CIs -0.30 to -0.07), rather than family ties (Coef. = -0.03, 95% CIs -0.09 to 0.15). Moreover, the buffering effects of friendship ties are more prominent for the less resilient and less privileged groups, namely male, rural, and less educated older adults. Our findings point to the importance of expanding and strengthening social networks for Chinese older adults in promoting their psychological health.

Social Change and Socioeconomic Disparities in Health over the Life Course in China: A Cohort Analysis.

This article examines social stratification in individual health trajectories for multiple cohorts in the context of China's dramatically changing macro-social environment. Using data from the China Health and Nutrition Survey, we find significant socioeconomic status (SES) differences in the mean level of health and that these SES differentials generally diverge over the life course. We also find strong cohort variations in SES disparities in the mean levels of health and health trajectories. The effect of education on health slightly decreases across successive cohorts. By contrast, the income gap in health trajectories diverges for earlier cohorts but converges for most recent cohorts. Both effects are more pronounced in rural areas. Given that these cohort effects are opposite those reported in recent U.S. studies, we discuss China's unique social, economic, and political settings. We highlight the association between SES and health behaviors, China's stage of epidemiologic transition, and the changing power of the state government and its implications for health care.

Living Arrangements, Offspring Migration, and Health of Older Adults in Rural China: Revelation From Biomarkers and Propensity Score Analysis.

Objective: We examine the combined effects of living arrangements and outmigration of adult children on rural older adults' health profiles, measured by biomarker data from the China Health and Retirement Longitudinal Study 2011. Method: We employ biomarker data and propensity score analysis which allows us to effectively deal with selection issues that are commonly observed in the literature. Results: We show complex health implications of living arrangements and offspring migration. Living in a traditional multigenerational household has limited health benefits to older adults. However, older parents of migrants who live in a multigenerational household have better fitness in blood pressure. Their advantage over parents of migrants in other living arrangements suggests added benefits of the presence of grandchildren. Discussion: This study bridges the living arrangement and migration literature on health by showing that health effects of adult children's migration on older adults are contingent upon their living arrangements.

Family division in China's transitional economy.

Using a longitudinal data-set (the China Health and Nutrition Survey) we explored the effect of various economic factors, including household wealth, employment sector, and involvement in a household business on the division of extended families in China's transitional economy. Results from event history analyses suggest that these economic factors act as either a dividing or a unifying force on the extended family. Household wealth reduces the risk of family division, but the effect is weaker for families in which parents have upper secondary education. In addition, an extended family is more likely to divide when married children work in the state sector. Further, the probability of family division is higher in families where daughters-in-law work in the state sector than in those with sons in this sector. Finally, involvement in a household business for married children increases family stability.

Allocation of Eldercare Responsibilities between Children and the Government in China: Does the Sense of Injustice Matter?

China's large aging population poses grim challenges to eldercare provision. Against the background of withering traditional kinship-based eldercare and the increasing significance of government-sponsored support programs, this study draws on data from the 2013 Chinese General Social Survey to investigate not only the correlation between the sense of social injustice and the preference to allocate eldercare responsibilities between public and private agents but also how this correlation varies between urban-versus-rural regions. We find that perceived social injustice is significantly correlated with the odds of designating the government, instead of family members, to shoulder eldercare responsibilities. Further mediation analysis suggests that this correlation is mediated through concerns about eldercare. On average, the link between perceived social injustice and the preference for eldercare duty allocation is weaker in rural China than in urban China. Theoretical and policy implications are discussed.

Which Child Is Parents' Preferred Caregiver/Listener in China?

Adult children are an important source of care providers for parents in a rapidly aging Chinese society, but we know little of which particular child is preferred by parents in time of need. Using the China Longitudinal Aging Social Survey, we investigate the factors associated with parental preference of caregivers and listeners among all his or her children. With children nested within each parent, we fit the conditional (family) fixed-effect fractional logit model. The main results for both caregivers and listeners suggest a preference for the unmarried, the oldest or the youngest, and children who have provided them with support before. Coresident children are favored in rural but not urban China. We did not find preference for sons over daughters. Neither did we find any effect of prior transfers from parents to children. Our findings shed light on the changing norms of eldercare provision in a transitioning society.