Preventing Economic Hardship Among Chinese Elderly in Hong Kong

Abstract

Over the next 20 years, Hong Kong will face a rapidly aging population as the number of older adults aged 65 or above increases to approximately 1.4 million by 2021, that is, 17% of the total population. In 2001, there were 1.2 million adults aged 45-59. To assess the differences between these middle-aged adults and the current cohort of older adults, we identified the challenges that Hong Kong society will face in meeting the financial needs of older adults in the coming two decades. In this paper, we examine the retirement economic status of three groups of older adults: those who are financially independent, those who are financially supported by their adult children or children-in-law, and those who are receiving welfare assistance. We describe the current situations of these groups, prevailing social policy, future trends, and recommend policies for tackling problem areas.     

Cross-border retirement migration plan in Hong Kong middle-aged adults

The purpose of this study was to determine factors affecting cross-border retirement migration plans in Hong Kong using a life-course model as the framework. Data were based on a representative random sample of 1867 adults aged between 45 and 59, who were interviewed in person in 2001. About 6.7% of these respondents planned to migrate to Mainland China after retirement or when they become older. Those who planned to migrate to Mainland China (n=126) were more likely to be male, to be employed in white-collar occupations, to have attained higher levels of education, and to possess non-self-occupied properties, but less likely to live with adult children than those who did not plan to migrate at all (n=1699). The Government must examine and anticipate the socio-economic impact of this future retirement migration on Hong Kong and formulate measures to effectively reduce its negative consequences.     

Age-Friendly Neighbourhoods as Civic Participation: Implementation of an Active Ageing Policy in Hong Kong

In response to challenges brought by population ageing, Hong Kong has adopted an active ageing policy framework and built age-friendly neighbourhoods to encourage the participation of older people. This article distinguishes between the civic and political participation and emphasizes active involvement in community and neighbourhood activities as a way to encourage the civic engagement of older adults. The promotion of age-friendliness is set at two levels: concerning policy and practical/operational issues, both of which are interrelated with the purpose of offering civic engagement opportunities for older people. The experiences of Hong Kong reflect both top-down and bottom-up approaches, where civic participation is promoted by encouraging life-long learning and developing caring communities, as well as carrying out a variety of neighourhood programmes. It is suggested that different stakeholders, such as older adults, NGOs and other social organizations, shall all be included and play important roles in promoting civic participation of the elderly through creating a conducive environment. The initiatives, whether these are in policy or at operational levels, should be integrated into actions that are aimed to enhance quality of life for all residents and create a more age-friendly neighbourhood.     

“Aging males” symptoms and general health of adult males: a cross-sectional study

A cross-sectional study was conducted to explore the prevalence and severity of health-related complaints perceived by adult males of Hong Kong by using the Hong Kong Traditional Chinese versions of the Aging males’ symptoms (AMS) scale and the 5-dimensional and 3-level European Quality of life (EQ-5D-3L) questionnaire. A total of 825 adult males aged 40 years or above were surveyed, and observed that 80% of the population was living with little-to-mild levels of aging symptoms with mean total scores ranged between 26.02?±?7.91 and 32.99?±?7.91 in different age groups. Such symptoms were correlated with age, especially for the somato-vegetative and sexual symptoms. The most severe AMS symptoms were observed in the oldest age group at 70 years or above, with 76%, 34% and 70% living with moderate-to-severe levels of somato-vegetative, psychological and sexual symptoms, respectively. The result was highly correlated with the EQ-5D-3L questionnaire. Secondly, the Hong Kong Aging males’ symptoms (AMS) scale was shown to have good reliability with test–retest coefficient at 0.79 (ranged 0.66–0.87) and Cronbach’s alpha coefficient at 0.88 (ranged 0.70–0.84). In summary, the population of Hong Kong male adults was commonly living with little-to-mild levels of aging symptoms, whereas their severity was correlated with age.     

Employer Policy and Practice Toward Older Workers in Hong Kong: The Role of Shifting Intergenerational Dynamics

Many governments are seeking to encourage the extension of working lives to counteract potential labor market shortages that might result from population aging. Nevertheless, research shows that older workers continue to face a range of barriers to their labor market participation. However, this research has not tended to take a holistic view of the factors shaping employer policy and practice or acknowledge that older workers’ experiences are embedded within broader social structures and age dynamics. This article reports on exploratory qualitative research undertaken in Hong Kong. It demonstrates how employer policy and practice toward older workers are shaped by intergenerational dynamics and by the social responsibility that employers feel toward different generations. It is argued that in order to more fully understand employer policy and practice toward older workers, an approach that acknowledges the social context and position of different age groups is required.     

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.     

Negotiating multiple boundaries: diasporic Hong Kong identities in the United States

The 1997 return of the British colony Hong Kong to mainland China has prompted the largest exodus of Hong Kong migrants to western countries such as Australia, Canada and the United States in the 1980s and 1990s. While the transnational capital accumulation and life strategies of Hong Kong business elites has been well documented, little has been written on pre-1997 Hong Kong immigrants who are from non-elite backgrounds. Based on ethnographic research in Chicago, this article explores the flexibility and multifarious nature of identity construction among two generations of Hong Kong immigrants: those who arrived in the United States during the 1960s-1970s and those who did during the 1980s -1990s. I identify class positioning in the Chinese disaporic community and racialization experience in the larger U.S. society as two important factors in mediating the boundary making strategies of different groups of Hong Kong immigrants.     

Resource Accessibility and Walkability Among Older Adults in Extended-Stay Hotels

Older adults represent a large and growing population group in the United States. This population cohort is projected to grow to 72.1 million, or 19% of the total population, by 2030, up from 40 million in 2010 (Administration on Aging, 2011; Federal Interagency Forum on Aging-Related Statistics, 2012). Despite reported decreases in the proportion of older adults living in poverty in recent years, inequities prevail. Approximately 40% of older American households reported housing cost burdens¹Cost burdens are expenditures on housing and utilities that exceed 30% of household income. (Federal Interagency Forum on Aging-Related Statistics, 2012). Many of these low-income older adults live in socially and economically marginalized positions, and housing them remains a major challenge complicated by (a) limited affordable housing options and (b) chronic health conditions that seriously undermine long-term health and mobility. In a study on the impacts of public housing transformation in Atlanta, Oakley, Reid, & Ruel (2011) reported that 26% of seniors entered public housing because of a health condition or disability. According to Smith (2006), seniors in public housing are in worse health than other older Americans, even other poor older Americans suffering from such chronic health conditions as hypertension, diabetes, arthritis, and asthma. Despite these realities, Ball (2012) has noted that older adults receive little attention in comprehensive development planning beyond specialized age-segregated retirement and care communities. Salkin (2009) echoes similar concerns about the tendency toward housing initiatives and designs for more affluent older adults. She commented that most states have focused attention on programs that are best suited for seniors who do not have the same income limitations as those who are truly on fixed incomes and living close to the poverty level (Salkin, 2009). While public housing remains the predominant affordable housing option for low-income older adults, such housing is out of reach for many low-income older adults who find themselves displaced and homeless. As a result, some of these adults move into extended-stay hotels to remain sheltered.     

Lessons on social and health disparities from older lesbians with alcoholism and the role of interventions to promote culturally competent services

ABSTRACT

Older adults who are lesbian, gay, bisexual, or transgender (LGBT) face greater health risks and possibly more costly care because of their reluctance to seek out health and long-term care services because of limited cultural sensitivity of service providers. This is particularly evident in older lesbians who face substantial risk of health problems associated with alcoholism and are less likely to be open with health care providers because of stigma combined with feelings of alienation, stress, and depression. An estimated 4.4 million older adults are predicted to have problems with alcohol by 2020, and the rates of alcohol-related hospitalizations are similar to those for heart attacks, creating exorbitant medical costs. More culturally competent health and long-term care may reduce health care costs by effectively addressing the dynamics of alcoholism, aging, and lesbian culture. Training initiatives such as those developed by the National Resource Center on LGBT Aging have begun to address the need of a more culturally competent aging services network. This article provides exemplars from empirical data on older lesbians with alcoholism to highlight some of the health, economic, and social disparities experienced in the aging LGBT community. Current interventions in the form of cultural competence training for service providers are presented as a potential step toward addressing health disparities among LGBT older adults.     

Aging in Asia: A cultural,socio-economical and historical perspective

Asia has about 60% of the world population and population aging is occurring more rapidly in Asia than in Western countries. The group aged 65 years and above will increase from 207 million in 2000 to 857 million in 2050, a staggering increase of 314%. The diversity in economic, demographic, religious, cultural and geo-political factors in Asia is unparalleled by any other continent, and is, in part, contributory to the rapid rise in population aging. By 2050, those under 15 years old will have shrunk from 30% in 2000 to 19%, while those aged 65 years and above will increase from 6% to 18%. In addition, the gender divide still persists with 100 elderly women to 70 elderly men. These projected demographic changes pose three major challenges: 1) how best to address the rising population of the group aged 65 years and above, 2) how to address the shrinking population of the young as well as the working adults, and 3) how to address the problems arising from the disproportionate increase in older women than men. From now to 2050, it will be expeditious for each country in Asia to look into ways of reversing the decline in total fertility rates (TFRs) and restore to replacement levels. If not, at least introduce measures to halt its free fall. Due to the complexity of factors that have influenced the fall in TFRs in Asia, it will be a daunting task to reverse this fall. There is no “single size fits all” solution to this complex problem. Research work in this short-term strategy in addressing the aging population is urgent. In the longer term, the East-West Centre have suggested four modalities, 1) establish policies and programmes that enhance traditional Asian systems of family support for the elderly; 2) introduce policy reform that encourages the elderly who are still capable of remaining in the work force; 3) create institutions and systems that support high levels of personal saving; and 4) formulate public programmes, including pension schemes and national healthcare systems. We need to work while there is time.     

Neighborhood disadvantage and anger among older adults: social comparisons as effect modifiers

Using data from a sample of 1,136 adults ages 65 and older in the District of Columbia and two adjoining counties in Maryland, we examine the association between neighborhood structural disadvantage and levels of anger. In addition, we test whether subjective financial comparisons with neighbors modify those effects differently for elders at different levels of income. We find that the association between neighborhood disadvantage and anger is positive among lower-income elders who feel financially advantaged relative to their neighbors. In contrast, the association between neighborhood disadvantage and anger is positive among higher-income elders who feel financially disadvantaged relative to their neighbors. Irrespective of income, neighborhood disadvantage is unrelated to anger among people who feel financially similar to their neighbors. We discuss the implications of our findings for the study of neighborhood context and health, underscoring interrelationships among inequality, social comparisons, and the stress process.     

An exploration of older Hong Kong residents’ willingness to make copayments toward vouchers for community care

Because of its rapidly aging population, Hong Kong faces great challenges in the provision and financing of long-term care (LTC) and needs to explore sustainable funding mechanisms. However, there is a paucity of research on older people’s willingness to pay (WTP) for LTC services in Hong Kong. This study utilizes data collected in Hong Kong in 2011 (N = 536) to investigate older people’s receptivity to this financing mode by assessing their co-payments for a community care service voucher scheme and then testing how potential factors affect respondents’ amount of co-payment. Results show that respondents’ WTP was positively associated with family financial support, financial condition, and positive attitudes toward this novel policy and negatively associated with family caregiving support. Direct and moderating effects of family financial support on WTP were found. The policy-related implications of LTC financing to improve older people’s acceptance of co-payment mechanisms, financial condition, and shared responsibility of care are discussed.     

Teaching pedagogies enhancing social work students’ perceptions and attitudes toward older age in an undergraduate course on working with older people

Approximately threefold increases in older age population groups (+65 years) are projected in the next 15 years. Demographic changes in society will mean greater numbers of older adults in proportion to the younger generation. In the current policy on older age groups, emphasis is placed on healthy aging warranting a multidisciplinary workforce to work with older people. Despite this need and increased demand in the aged care sector, a fewer social work students are willing to undertake aged care placements or to choose it as a career option.

An innovative teaching and learning pedagogy was used in designing the course curriculum titled ‘Social Work with Older People’, including the input of invited specialist guest speakers, an on-campus interactive workshop with older guests, and an assessment designed to evaluate the learning related to the workshop content. The paper reports changes in the attitudes of students studying gerontological social work after the course delivery, evaluated through an online survey with the purpose of improving the learning outcomes in the course and to gauge students’ interest, experiences, attitudes and motivation to work in the aged care sector. The paper contributes to building knowledge in addressing the needs of the changing social demographic.     

The effects of environmental stressors on the mortality of the oldest old male population in Hong Kong, 1977–2006

Although age–sex-specific mortality rates were decreasing over the years, such a trend was not observed for the male population aged 85 or above (the oldest old) in Hong Kong. Despite literature suggesting that environmental stressors were associated with higher mortality, the adverse effects of socioeconomic and political events were seldom included. Hence, this study explored the relationship between environmental stressors covering adverse weather conditions as well as key socioeconomic and political events and fluctuations in the oldest old mortality rates in Hong Kong during the period 1977 to 2006. The oldest old mortality rates in Hong Kong were observed to have a likelihood of being associated with these environmental stressors. Furthermore, men appeared to be more susceptible to these risk factors than did women. More care and attention should be given to the oldest old men, in particular, during periods of socioeconomic or political upheavals. A cohort study would be useful to study these stressors in greater detail.     

Planning and development control through lease conditions

The Hong Kong government has pledged to deal with the imbalance between supply and demand of housing. Given the innate constraints of limited land resources in Hong Kong and the extensive and expedient control enforced through lease conditions, the Hong Kong government can alleviate the long-recognized problem of housing shortage by modifying specific development conditions. Therefore, the supply of housing units can be changed at a faster pace to satisfy the requirement of private dwellings. Other factors affecting the property market in Hong Kong include land supply, economic issues, population growth, and income growth. Many studies, for example, Hui et al. (Monograph, Department of Building and Real Estate, Hong Kong Polytechnic University and Hong Kong Government (Study of Housing Demand, Hong Kong Government Printer, Hong Kong and Study of Housing Demand Model, Hong Kong Government Printer, Hong Kong), have investigated in detail the impacts of these factors on the property market. However, little or nothing is known about the planning and development control through lease conditions. Therefore, this study particularly attempts to examine how the Hong Kong government exerts its influence in the local private residential market through changing the development conditions. These conditions will be studied separately and distinctively in order to capture their unitary effects upon the local private residential real estate market. Section 1 looks at Hong Kong's tenure system, followed by the deliberation of how planning and development control is done through lease conditions (in Section 2). 3 and 4 set out the analytical framework and report on the findings of how lease conditions affect property supply. The concluding section gives out recommendations.     

Foreign retirement income among new older immigrants in the United States

Older adults make up an increasing share of new legal immigrants to the United States. These immigrants are often financially dependent on family since they are often barred from receiving several US support programmes and are less likely to receive US retirement benefits than natives. However, little information exists as to whether they receive retirement income from abroad. Using the New Immigrant Survey (N=2,150), we find that only 8.1 per cent of older recent immigrants report receiving foreign retirement income. In logistic modelling, older immigrants from Asia and Latin America were less likely to receive retirement income from abroad than those from Europe (Odds ratio = 0.50, p<0.05; Odds ratio = 0.22, p<0.001, respectively). Results suggest that newly admitted older immigrants from Asia and Latin America face an additional economic disadvantage compared with older Europeans that cannot be attributed to their demographic and migration characteristics.     

Seeking identity: the transborder lives of mainland Chinese families with children born in Hong Kong

Between 2001 and 2013, Hong Kong regulations permitted pregnant women from mainland China to travel to Hong Kong to deliver their babies. In this article, based on 30 in‐depth interviews, I explore the transborder lives and identities of these mainland Chinese families who, motivated by cost considerations, citizenship and anticipated benefits for their children, chose to give birth to their babies in Hong Kong. In some cases, family networks providing flexible residential practices and family care, supported these transborder activities. However, the complexities of transborder life reveal the diverse ‘identifications’ within Hong Kong society and mainland families. Because neither administration totally accepts them, they are not full members of either society and so the identities they form are both plural and fragmented.     

Defining child abuse in Hong Kong

Definitions of child abuse are culturally driven. Hong Kong, with a predominantly Chinese population, has managed to eradicate much of the societal abuse that children suffer elsewhere in Asia. Professional and government attention has now shifted to child abuse and neglect within the family. The paper, based on interviews with key professionals. analysis of policy documents and practice records examines traditional Chinese parent-child relationships. the status of parental authority and corporal punishment and changes in contemporary Hong Kong family life. It goes on to outline the development of responses to child abuse in Hong Kong, some of the dilemmas that professionals face in defining abuse and areas for future research.     

Indonesian Chinese in Hong Kong: re-migration,re-establishment of livelihood and belonging

This paper describes the re-migration and adjustment of Indonesian Chinese to living in Hong Kong and their cultural belonging to Hong Kong, China, and Indonesia. Known in China as guiqiao or ‘Returned Overseas Chinese’, these were Chinese who re-migrated from Indonesia to mainland China in the 1950s and 1960s. By the early 1970s, many were allowed to migrate to Hong Kong. Although arriving with very little money, many have succeeded in establishing a fairly good life in Hong Kong, although there are also many who survive on low incomes. This paper discusses the experiences of the Indonesian Chinese in relation to local and transnational belonging, the perception of homelands, and the re-establishment of a Southeast Asian lifestyle in Hong Kong.