Unanswered Questions and New Directions in Research on Elderly Migration: Economic and Demographic Perspectives

The availability of data from the 1990 Census and the Retirement and Health Survey will afford researchers an unparalleled opportunity to study elderly migration from several perspectives. This article focuses on economic and demographic issues. Census data will continue to serve the role of providing small area data on flows and will permit further disaggregation of behavioral differences according to age, marital status, and household relationship. They will also permit disaggregation according to the economic status of individuals and their households which, coupled with aggregate data on places of origin and destination, will facilitate comparison between such areas. The RHS data will go a long way to investigate questions thought to lie at the heart of migration behavior of older persons, but which have been difficult or impossible to study. Central to such questions will be the availability of a migration history, which will permit research on the interaction of migration behavior with critical life-course events such as retirement and the loss of a spouse.     

Unanswered questions and new directions in research on elderly migration: economic and demographic perspectives

The availability of data from the 1990 Census and the Retirement and Health Survey will afford researchers an unparalleled opportunity to study elderly migration from several perspectives. This article focuses on economic and demographic issues. Census data will continue to serve the role of providing small area data on flows and will permit further disaggregation of behavioral differences according to age, marital status, and household relationship. They will also permit disaggregation according to the economic status of individuals and their households which, coupled with aggregate data on places of origin and destination, will facilitate comparison between such areas. The RHS data will go a long way to investigate questions thought to lie at the heart of migration behavior of older persons, but which have been difficult or impossible to study. Central to such questions will be the availability of a migration history, which will permit research on the interaction of migration behavior with critical life-course events such as retirement and the loss of a spouse.     

Using census data to study elderly migration: problems and possibilities

Although the elderly are the fastest growing of all age groups in developed countries, their migration remains little studied. Elderly migration differs in several fundamental ways from that of other age groups, but many of the data collection and analysis procedures, as well as basic concepts used in censuses, have been developed with the working population in mind and are of limited utility in studying elderly migration. This article discusses some of the problems using census data to identify movers among the elderly population, and to analyze the characteristics of movers and the causes of migration. The author concludes that it is clear that what is needed with respect to census data on elderly migration is not necessarily new questions to be included. Instead, more appropriate decisions need to be made at the stages of deciding what variables to code and what categories are to be included. In addition, at the stage of determining tabulation programs there needs to be greater sensitivity to finer age breakdowns among elderly migrants and to the selection of cross-tabulation variables which are more relevant to issues and problems of the aged. Hugo suggests that an authoritative agency convene a working group to establish guidelines which address the following issues. 1) What are appropriate age breakdowns? 2) What are appropriate variables for detailed cross-tabulations? 3) Exactly what is an appropriate form for migration data to be prepared for multi-regional analysis? 4) What is the most appropriate way of formatting public use sample tapes to make analyses for assisting in the study of elderly migration? 5) How should the institutional population among the aged be dealt with? Another recommendation which arises out of the issues raised here is that, analysts should give a clear indication of what movers are actually missed by census data and which types of movers are included. Awareness of the limitations of particular data sources is of critical significance to meaningful interpretation of results if one is seeking a better understanding of the causes and consequences of important social phenomena.     

Status variations in stress exposure: implications for the interpretation of research on race, socioeconomic status, and gender

Life events checklists have been the predominant method for estimating variations in stress exposure. It is unknown, however, whether such inventories are equally meaningful for estimating differences in exposure between men and women, African Americans and whites, and those in lower and higher socioeconomic categories. In this paper, we employ a wider range of measures of stress--recent life events, chronic stressors, lifetime major events, and discrimination stress--to examine the extent to which these dimensions collectively yield conclusions about status variations in stress exposure that are similar to or different from estimates based only on a life events checklist. Our analyses of data collected from 899 young men and women of African American and non-Hispanic white ancestry suggest that status differences in exposure to stress vary considerably by the measure of stress that is employed. Although women are more exposed to recent life events than men, males report more major events and discrimination stress than females. Our results also reveal that life event measures tend to substantially under-estimate differences between African Americans and non-Hispanic whites in exposure to stress. A similar pattern also holds for socioeconomic status. When stress is more comprehensively estimated, level of exposure profoundly affects ethnic differences in depressive symptomatology, accounting for almost half of the difference by socioeconomic status but contributing little to the explanation of the gender difference in distress. The implications of these findings for the debate over the relative mental health significance of exposure and vulnerability to stress are discussed.     

Intergenerational Coresidence and Nearness in Korea and Japan: Unbalanced Aspects of Family Changes

Abstract  This study aims to explain similarity and difference in geographic proximity between elderly parents and their children in Korea and Japan. Using data sets from two nationally representative surveys conducted in Korea and Japan, this study examines the extent to which needs and kinship of elderly parents and regional constraints influence intergenerational coresidence and nearness.
Results highlight a complex feature of intergenerational relationship in Korea and Japan. Advanced economic and health conditions of Korean elderly parents increase the likelihood of living with children. For Japanese elderly parents, however, coresidence with children is significantly likely to occur in response to their disadvantaged economic status. These results suggest that the elderly Korean are more likely than the elderly Japanese to lack not only economic and health resources but also opportunities in obtaining family support in a time of need.
Characteristics of children, however, show a similar trend between the two societies. Both societies maintain a strong son preference for extended family living arrangement. Eldest children in both societies are more likely than their siblings to live with or near elderly parents. However, children of younger cohorts in both societies are significantly more likely than those of older cohorts to maintain a disperse geographic network indicating a significant change in family attitude among different cohorts.
Finally, this study finds a more disperse family network among rural elderly parents than urban elderly parents in both societies reflecting the fact that massive rural-to-urban migration of young population has contributed to geographic segregation of kinship in these societies.     

Demographic and socioeconomic aspects of elderly migration in the 1980s

The availability of data from the Current Population Survey for each year makes it possible to monitor the migration behavior of the population on a year-to-year basis and facilitates efforts to detect changes in long-standing patterns of behavior. The data used in this article come from the published reports summarizing the results of the March administration of the Current Population Survey over a decade, and, in general, deal with the movement of persons during the 12-month interval immediately preceding the survey. Trends and changes in some of the principal aspects of migration behavior among the elderly are reviewed and summarized, focusing on the demographic, social, geographic, and economic dimensions. Also considered are differences in migration behavior along these dimensions from a temporal perspective as well as in comparison to the migration behavior of the younger population. When possible, the article provides insight on behavioral differences among the various age categories within the older population, differentiating between the youngest and oldest components of the group and recognizing the striking differences between the youngest and oldest members of the older population in nearly all aspects of the migration process.     

Age Differences Between Spouses: Sociodemographic Variation and Selection

Throughout the world, marriages in which the husband is older than his wife are more common than same-age and women-older marriages. Yet there is surprisingly little systematic knowledge about within-country variation in spousal age differences. This study used comprehensive Swedish register data to investigate how age differences in newly married couples were associated with spouses' age, gender, education, income, and birthplace. Among both women and men, small age differences were most common among the highly educated, high-income earners, and native Swedes, whereas persons with low education, low income, and non-Swedish origin more often entered marriages with large age differences, particularly men-older marriages. Findings are discussed in relation to theoretical attempts to explain spousal age differences and sociodemographic selection into couples with different age relationships.     

Old and Female: Testing the Double Jeopardy Hypothesis*

A double jeopardy hypothesis argues that the combined negative effects of occupying two stigmatized statuses are greater than occupying either status alone. Applying this framework to elderly persons, it can be argued that being female and “old” elderly has more negative consequences than being male and “old” elderly, male and “young” elderly or female and “young” elderly. An empirical test of this hypothesis, using both an objective (mental health status) and a subjective (perceived well-being) indicator as the dependent variable, reveals a confirmation of double jeopardy using the objective quality of life indicator, but not the subjective indicator. Additional analyses of the factors affecting each of the dependent variables, adds further support for the uniqueness of old, elderly women as a social category.     

Demography of Indian aging, 2001-2051

India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001, compared to China's 127 million. One of the objectives of this paper is to assess the emerging scenario of elderly for the first half of the 21st century. According to projections, the elderly in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and further to 301 million in 2051; in the case of those 70 years and older, they are projected to increase from 27 million in 2001 to 132 million in 2051. Among the elderly persons 80 and above, they are likely to improve their numbers from 5.4 million in 2021 to 32.0 million in 2051. The increasing number and proportion of elderly will have a direct impact on the demand for health services and pension and social security payments. Mobilizing resources for geriatric care and providing sufficient maintenance for the elderly will emerge as a major responsibility for heath-care providers and pension economists.     

Meeting the mental health needs of elderly clients

1. Older individuals in both community and institutional settings have traditionally underused mental health services. Providers of such care devote a minimum of their professional time to those over 65 years of age. 2. Ageism and difficulty with diagnosis are the most frequent explanations for inadequate mental health care to the elderly. This study found that lack of referrals and failure of the aged to seek services partially accounted for underuse. 3. Legislative changes mandating that aged persons be screened for and receive appropriate mental health services will increase the demand for qualified providers. 4. Nursing's approach to care of the older adult, which focuses on both physiological and psychological needs, can facilitate the delivery of comprehensive effective mental health interventions in and out of the institutional setting.     

Social gerontology in developing countries. A report by participants in the International Short Term Course on Social Gerontology organised by the International Institute on Aging (United Nations,Malta), 17-29 February 1992

Prior to the International Short Term Course on Social Gerontology, organized by the International Institute on Aging in Malta, participants filled in a brief questionnaire regarding their personal views on the socioeconomic situation of the elderly. The questions dealt with: the definition of the elderly as understood by the respondents; availability of statistical data on the elderly regarding gender, marital status, location, immigration, industrialization, and the impact of urbanization; existing training facilities in gerontology in their countries; old age as perceived by the elderly population; socioeconomic problems faced by the elderly; degree of participants' involvement in working with the elderly. An attempt was made to quantify the views expressed by the participants. Countries with more than one representative--Argentina (2), China (4), Jamaica (2) and Malta (13)--each had their responses summarized as one contribution to this survey. The participants' replies were represented by a frequency distribution of 16 countries. In 9 out of 16 responses, elderly was defined as a chronological age. Females were almost always described as the majority gender represented in old age (13 out of 16). The state was identified as the greatest provider of special services, with the exception of religious organizations in only 2 of the countries. The most difficult problems of the elderly were defined as a lack of economic support, ill health, and social isolation. 8 out of 16 respondents described being active as the most important for the elderly. Governments are urged to provide for their senior citizens and their care-giving members who, in turn, are encouraged to support more elderly persons in developing countries.     

Migration and health

Investigation of migration and health often forces us to acknowledge that the types of migration (international, internal, and residential) interact with each other as well as other population parameters such as the age/sex structure, sexual activity, fertility, mortality, and family structure. Research on migration is often obscured by these interactions. In fact, the adoption of a health perspective in the design of migration research represents a substantial improvement over traditional approaches that are based on distinctions among the various types of population movement. This is because a health perspective treats population movement as a dynamic process by which individuals are related to specific locations by reason of their participation in human networks. In other words, migration is regarded as a human process rather than a discrete event, and accordingly, it becomes less important to describe the individual's involvement with human networks and the institutions sustaining them. The use of a health perspective in migration research often calls our attention to the ways in which the types of migration are interconnected. For example, a migrant from Mexico might exhibit considerable internal mobility and may circulate between Mexico might exhibit considerable internal mobility and may circulate between Mexico and the US over several years until he develops enough contacts in the US to settle in a particular community in which his personal contact with human networks and place-specific institutions are conducive to settlement. Through him, family members may attach to the community. In the process, they all encounter health risks, make demands on the health care system, change the demographic/health characteristics of both sending and receiving places, sometimes act as transmitting agents of disease to those with whom they interact and, undergo changes in their levels of personal development and well-being. A research perspective that investigates these processes will consider all of the types of movement and characterize them as dynamic processes rather than as discrete events. The articles in this issue all touch on the ways in which migration can affect the health of migrants, and show the circle range of ways migration and health are interrelated. A special introductory note also suggests Acquired Immunodeficiency Syndrome (AIDS) should receive special attention in the study of this interrelationship. The uneven distribution of AIDS is heightening concern about the health implications for receiving countries.     

Demography of Indian Aging, 2001-2051

Summary

India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001, compared to China's 127 million. One of the objectives of this paper is to assess the emerging scenario of elderly for the first half of the 21st century. According to projections, the elderly in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and further to 301 million in 2051; in the case of those 70 years and older, they are projected to increase from 27 million in 2001 to 132 million in 2051. Among the elderly persons 80 and above, they are likely to improve their numbers from 5.4 million in 2021 to 32.0 million in 2051. The increasing number and proportion of elderly will have a direct impact on the demand for health services and pension and social security payments. Mobilizing resources for geriatric care and providing sufficient maintenance for the elderly will emerge as a major responsibility for heath-care providers and pension economists.     

State and Regional Policy Implications of Elderly Migration

This paper uses the 1980 Census data to estimate the size of the economic transfers associated with the 1985 to 1990 interregional migration of older persons. Total economic transfers are estimated by multiplying interregional migration flows of older persons by the average income of older persons in each migration stream. Assuming an average life expectancy of 15 years for elderly migrants and an expenditure multiplier of 2, the total redistribution of income as a result of 1985 to 1990 elderly migration is estimated to be over $600 billion. The South Atlantic and Mountain regions are the recipients of the largest positive net transfers; the East North Central and West North Central regions have the largest negative net transfers.     

State and regional policy implications of elderly migration

This paper uses the 1980 Census data to estimate the size of the economic transfers associated with the 1985 to 1990 interregional migration of older persons. Total economic transfers are estimated by multiplying interregional migration flows of older persons by the average income of older persons in each migration stream. Assuming an average life expectancy of 15 years for elderly migrants and an expenditure multiplier of 2, the total redistribution of income as a result of 1985 to 1990 elderly migration is estimated to be over $600 billion. The South Atlantic and Mountain regions are the recipients of the largest positive net transfers; the East North Central and West North Central regions have the largest negative net transfers.     

Nursing home admissions and long-stay conversions among persons with and without serious mental illness

The appropriateness of nursing homes for individuals with serious mental illness remains a controversial issue in long-term care policy more than a decade since the landmark U.S. Supreme Court Olmstead decision in 1999 , which affirmed the rights of persons with disabilities to live in their communities. Using national nursing home Minimum Data Set assessments from 2005, the authors compared the demographic, clinical, and functional characteristics of persons with and without serious mental illness newly admitted to nursing homes. They found that newly admitted people with serious mental illness were younger and more likely to become long-stay residents than those admitted with other conditions, despite a higher proportion of residents with serious mental illness, including the elderly, classified as low-care status. The most substantial and clinically significant difference for rates of low-care status 90 days after initial admission are for persons younger than 65 with serious mental illness versus those younger than 65 without serious mental illness (33% vs. 8.5%, or 3.9 times greater). There is a notable difference in low-care status between persons aged 65 and older with serious mental illness and those aged 65 and older without serious mental illness (14% vs. 6.6%, or 2.1 times greater). These results suggest that a substantial number of adults with serious mental illness residing in nursing homes may have the functional capacity to live in less restrictive environments.     

The consequences of international migration for the status of women: a Turkish study

As part of a larger inquiry into the consequences of international migration for those who remain in the country of origin, 234 adults in four Turkish provinces were interviewed concerning matters (mostly opinions) pertaining to the status of women. Three migrant-status categories were defined; (a) Returned migrants, (b) Non-migrant close kin or friends of migrants, and, as a control group, (c) All others. Controlling for age, sex, urban-rural residence, and schooling, group (a) was the most likely to express "non-traditional" views, and group (c) the least. Group (b) was in between.
Of the two possible explanations for such a pattern – recruitment and socialization – we found recruitment highly significant. The evidence for socialization, however, was decidedly mixed. Some of the considerable diversity of viewpoints pertaining to the status of women found in this inquiry are doubtless causally associated with the experience of migration, whether direct or indirect. But there is also evidence here of a society in the process of rapid change; and it is these more general social changes, not migration as such, that would appear to be more likely to affect the status of women.
There is little support for the contention that the type of international migration that has involved so many Turks these past three decades – migration that has for the most part been temporary and economically motivated and has consisted of movements from relatively poor agricultural or but slightly industrialized areas to rich, highly industrialized ones characterized by marked differences in language, religion, and overall culture – is going to result in moving the status of women from a more to a less "traditional" plane.     

Client satisfaction with live-in and live-out home care workers in Israel

In an era of globalization where the migration of longterm care workers is common, foreign live-in home care workers can compensate for the unavailability of family members and, perhaps, even substitute for institutional care in the provision of long-term care services to disabled older persons. This study examines differences in home care satisfaction between disabled older persons in Israel with "live-in" home care workers and those with "live-out" workers, and explores some differences in sociodemographic and personal characteristics between these two groups. Face-to-face interviews were held with a random sample of 93 older persons in Beer-Sheva. Older persons with live-in home care workers were more satisfied with their home care service than those with live-out workers. Those with live-in workers were more severely disabled, tended not to have any children living in close proximity, although an adult child was available as an informal caregiver. Communication difficulties between the elderly persons and their home care workers were found not to affect negatively the satisfaction with the service.     

Family Therapy with the Elderly

This article outlines health and lifestyle challenges to elderly persons and associated changes in their family systems. Flexibility, related to attachment patterns, is considered central to healthy adaptation. Family therapy approaches and relevant systemic and cultural factors influencing psychotherapy with the elderly are discussed. Key family therapy concepts and strategies (genograms, transmission of family histories and circular patterns of interaction), are reviewed and exemplified. Four types of family therapy presentations are elucidated by composite case examples. Firstly, the elderly person can be the identified patient. Secondly, another family member can seek help for him/herself in relation to the elderly person. Thirdly, another family member can be the identified patient without direct reference to the elderly person. Finally, the wider health care system involved with the elderly person and family can be the focus of therapy. Family therapy offers important conceptual and strategic advantages in working with the elderly and their systems.