Gender Differences in Activity of Daily Living of the Elderly in Rural China: Evidence from Chaohu

ABSTRACT

Using data from a sample survey, “Well-being of the elderly in Anhui province, China,” this paper studies the effects of health, economic and family factors on the activities of daily living (ADLs) as measures of disability for elderly men and women. The objective is to explore reasons for gender differences in ADLs in rural China. Our results suggest that higher incidence rates of chronic diseases, lower cognitive ability, as well as heavier household and daily care burdens of females, are the main factors leading to a higher prevalence of ADL disability for the female elderly.     

中国老年人的生活自理能力状况与变化

本文利用2004年全国人口变动抽样调查数据对中国老年人的生活自理能力进行了分析,又与1994年老年人生活自理能力进行了对比。分析结果表明,2004年我国老年人中有8.9%生活不能自理,由此推算全国生活不能自理的老年人已经超过1200万人。分年龄、性别和城乡的老年人生活自理能力存在明显差别,年龄越大生活自理能力越差、女性不能自理比例高于男性、农村比城市差、中西部地区生活不能自理比例远高于东部地区。与1994年相比,中国老年人的生活自理能力总体上略有下降,需要进一步关注老年人的生活质量。     

Trends in late-life disability in Taiwan, 1989-2007: the roles of education, environment, and technology

This analysis offers the first strong evidence of trends in late-life disability in an emerging economy. For the population of Taiwan aged 65 and older, consistent measures of limitations in seeing, hearing, physical functions, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) were available for three to six survey waves, depending on the outcome, from 1989 to 2007. Limitations in seeing, hearing, and IADLs declined substantially, but trends were mixed for physical functions and flat for ADLs. The remarkable reduction in difficulty telephoning, an IADL, may reflect changes in telecommunications infrastructure and highlights the roles of environment and technology in disability outcomes. Trends for urban residents were more advantageous than those for rural residents for seeing and hearing, but less so for physical functions and IADLs. Were it not for the substantial increase in educational attainment, trends in all outcomes would have been less favourable.     

Modeling Disability Trajectories and Mortality of the Oldest-Old in China

This article uses a group-based modeling approach to jointly estimate disability and mortality trajectories over time based on data from the population aged 80 and older in China, and explores relations of demographic, socioeconomic, and early-life characteristics to membership in gender-specific trajectory groups. A three-group model best fits the data for both males and females. For most groups, predicted numbers of limitations in activities of daily living (ADLs) increase with age, but the pace is gradual in some cases and rapid in others. For each gender, the estimated mortality probability trajectories for the three groups follow a hierarchy that is related to the predicted ADL counts at age 80. Only a few characteristics predict trajectory-group membership. Prior nonagricultural occupation is associated with less favorable disability trajectories for both genders. For females, rural residence, a greater number of children ever born, and having a father who did not work in agriculture are associated with more favorable trajectories. For a small group of males who received education, disability is moderate but changes little with age. Findings may reflect heterogeneity of survival among the least advantaged, as well as a possible expansion of morbidity among a small advantaged group.     

1992~2002年中国老年人生活自理能力变化研究

基于1992年中国老年人供养体系调查和2002年中国老年人健康长寿第三期调查,本文对中国老年人1992~2002年生活自理能力的变化进行了探讨。结果显示1992~2002年十年间中国老年人生活自理能力失能率平均年下降l%。其平均年下降率具有如下特点:高龄老人高于中低龄老人;城镇老人高于农村老人;男性老人高于女性老人;非文盲老人高于文盲老人;有配偶老人高于无配偶老人。     

中国老年人临终前 生活自理能力的衰退轨迹

本文以老年人为研究对象,以基本生活自理能力(ADL)为测量指标,使用"中国老年健康长寿影响因素跟踪调查"(CLHLS)数据,分析在1998-2014年期间去世的老年人群临终前的生活自理能力的变化轨迹。作者利用组基轨迹模型对男性和女性老年人的生活自理能力变化过程分别进行拟合,发现老年人在临终前的生活自理能力存在显著差异并归纳出三种变化轨迹:生活自理能力完好型、快速发展型和缓慢下降型。研究发现生命历程早期阶段的经历、所处的社会经济状况、年龄效应和队列效应都会对生活自理能力的衰退轨迹产生显著影响。增龄带来的生活自理能力下降使老年人临终前的失能风险及其持续时间增加,而较晚的出生队列在临终前出现长时间失能的可能性较低。在三类轨迹中,自理能力缓慢下降型轨迹受到各种因素的影响最为显著,而该类型的出现概率是影响失能老年人照料负担的主要因素,由此也证明了除去年龄效应与性别差异之外,由社会经济状况、健康行为习惯、生活环境等因素合力产生的健康保护作用将会在失能老年人照料负担增长过程中发挥主导作用。研究还发现老年女性在临终前会面临更高的失能风险和更长时间的失能存活期,其生活自理能力变化过程受到更多因素的影响。     

Analysis on the Make-up of China＇s Disabled Seniors and the Demand for Long-term Care

According to Chinese Food Safety News, China Food and .Drug Administration has organized and formulated the Provisions on Food and Drugs Administrative Penalty Procedure （Hereinatter referred to as ＂the Provisions＂） to regulate tbod and drug administration departments toCarry out the administrative ptinisbment authority;     

Research on Health Status and Health Care of the Elderly in China

The issue of health status and care for the elderly in urban and rural areas is becoming increasingly serious in the rapid context of population aging in China.The paper analyzed the health status of urban and rural elderly in China in the two-week morbidity rate,prevalence rate of chronic diseases, disability status,self-rated health and healthy life expectancy of the elderly using the data from the 2006 Sampling Survey on the Status of Urban/ Rural Aged Population in China,the Fourth National Health Service Survey and the 2006 Second China National Sample Survey on Disability,to explore the current provision of sources of care for the elderly and try to make some policy recommendations about to improve the health and care for the elderly population facing the crisis of population aging.     

Trends in health of older adults in the United States: Past,present, future

The decline in late-life disability prevalence in the United States was one of the most important developments in the well-being of older Americans in the 1980s and 1990s, but there is no guarantee that it will continue into the future. We review the past literature on trends in disability and other health indicators and then estimate the most recent trends in biomarkers and limitations for both the population aged 65 and older and those aged 40 to 64, the future elderly. We then investigate the extent to which trends in education, smoking, and obesity can account for recent trends in limitations and discuss how these three factors might influence future prospects for late-life health. We find that improvements in the health of the older population generally have continued into the first decade of the twenty-first century. The recent increase in the proportion of the younger population needing help with activities of daily living is concerning, as is the doubling of obesity in the last few decades. However, the increase in obesity has recently paused, and favorable trends in education and smoking are encouraging.     

中国老年人带残预期寿命及疾病影响的城乡差异分析

为了明确各种疾病对我国城乡老年人残疾以及带残预期寿命的影响,本文基于第二次全国残疾人抽样调查数据,首先对残疾现患率进行归因分析,得到分疾病的残疾现患率,然后结合死亡率数据,利用苏利文方法计算分疾病的带残预期寿命。结果显示,在60岁时,城市男性预期将有4.08年(城市女性:4.95年)生活在残疾状态中,低于农村男性的4.72年(农村女性:5.46年)。老年性耳聋、白内障、脑血管疾病、骨关节炎和未分类的伤害是老年人的最重要的5种致残疾病。而且,各种疾病对老年人的残疾现患率和带残预期寿命的影响存在明显的城乡差异。本研究为政府在城乡老年人中提出具有针对性的残疾预防战略提供了实证支持。     

Was there compression of disability for older Americans from 1992 to 2003?

Medical advances and the growth of the elderly population have focused interest on trends in the health of the elderly. Three theories have been advanced to describe these trends: compression of morbidity, expansion of morbidity, and dynamic equilibrium. We applied multistate life table methods to the Medicare Current Beneficiary Survey to estimate active and disabled life expectancy from 1992 to 2003, defining disability as having difficulty with instrumental activities of daily living or activities of daily living. We found increases in active life expectancy past age 65 and decreases in life expectancy with severe disability. These trends are consistent with elements of both the theory of compression of morbidity and the theory of dynamic equilibrium.     

中国老年人口健康预期寿命差异的分解研究

健康预期寿命是反映人群健康长寿的重要指标,健康预期寿命差异反映了一个国家或地区的健康不平等状况。利用多状态生命表分析了中国老年人口健康预期寿命在过去十余年间的趋势与变动,并通过夏普利值分解法测算了人口社会学等11类因素对老年人口健康预期寿命差异的具体贡献值。得到以下四项重要研究结论:第一,从2005年到2018年,中国老年人口健康预期寿命差异的程度略有增加,女性、农村群体相比对应群体差距始终较高;泰尔指数分解发现,组内不平等(而非组间不平等)是造成上述差异的主要原因;老年人口健康预期寿命的性别差异呈现出高龄老人缩小而低龄老人扩大的趋势。第二,婚姻状况是健康预期寿命变动最重要的影响因素,但影响程度呈现逐年下降趋势,反之,受教育程度的影响在逐年上升;进一步将11类影响因素归类后发现:"个体特征"是最重要的影响因素,"经济因素"和"行为因素"的重要性次之,"环境因素"的影响最小。第三,上述影响因素对中国老年人口健康预期寿命的影响总体呈上升趋势,分城乡、分性别后依然呈现出相同的特征。最后,各因素在不同城乡、性别、婚姻状态的群体中的影响存在异质性。     

老年人长期照护需求现状及趋势研究

伴随人口老龄化的加剧,老年人照护问题逐渐成为社会关注的热点。国内学者关于长期照护的研究大多是以失能老人为基础的,对失智者的研究较少涉及。本研究依照老年人的功能状态,将照护需求评估建立在对失能老人和失智老人分析的基础之上,分析我国老年人的长期照护需求及未来的变化趋势,以期对今后长期照护政策的制定提供参考。     

Trends in Functional and Activity Limitations among Chinese Oldest‐Old, 1998 to 2008

China has the world's largest oldest‐old population, but information on trends in late‐life disability is lacking. We use data from the Chinese Longitudinal Healthy Longevity Survey for 1998 to 2008 to determine whether prevalence of limitations with physical functions and daily activities has changed recently among the Chinese population aged 80 to 105 and, if so, to investigate the factors associated with the change. We find that prevalence of need for assistance with activities of daily living and inability to independently conduct instrumental activities of daily living declined substantially. Males did not experience improvement in ability to carry out underlying physical functions over the same period, but females did. Variables associated with trends in one or more of these outcomes were adequacy of medical care as a child, childhood hunger, father's occupation in agriculture, main occupation before age 60 in agriculture, adequacy of current medical care, and body weight.     

The Research of Long-Term Care Needs Condition and Tendency of the Elderly

With the acceleration of Chinese aging of population,the issue of Long-Term Care became the hot spots in society.The studies of our country are based on disabled elderly,but they are rarely related to Alzheimer’s disease patients who need care similarly.According to function of the elderly,care demand assessment is based on analysis of the elderly with disability and Alzheimer’s disease.To discuss Long-Term Care demand and change tendency of the elderly in China aims to offer references for policy making in the future.     

Health expectancies in Japan: gender differences and policy implications for women

Based on prospective observation of elderly people in the community in Japan, we compared the time-course of development and progression of physical disability between women and men. Men experienced disability at a younger age and at a faster rate than did women. The duration of time spent with disability in women was twice as long as in men. Consequently, women consume about two-thirds of the total resources of formal caregiving services in Japan. Women in Japan are increasingly educated, postponing marriage to higher ages, and less likely to care for parents in the home. Given these changes in family structure and social norms, the capacity for informal family caregiving has decreased dramatically. A recently enacted national long-term care insurance system may further change the picture of caregiving.     

Trends in old-age functioning and disability in Japan, 1993-2002

Disability is a burden to individuals and society. Population ageing, combined with the fact that disability is most common among the elderly, has focused attention on trends in old-age disability. This study estimates trends in functioning and disability among Japanese elderly from 1993 to 2002 and contrasts the patterns with those found in the USA. Japan is an especially interesting country because its age structure is relatively old, and it currently has the highest life expectancy in the world despite the fact that just 50 years ago its life expectancy was in the bottom half of all countries. As in the USA, disability rates have fallen. If it were not for the gains in disability between 1993 and 2002, there would have been 1.1 million more disabled elderly in 2002. The reductions were experienced broadly across socio-demographic and economic groups. Increases in education across cohorts are associated with the declines in disability.     

中国老年人参与互联网金融影响因素研究——以理财产品为例

互联网金融是老年人减少金融排斥,享受普惠金融的重要途径。但是目前我国老年人对互联网金融的优点认识不足,参与率过低。为探究中国老年人参与互联网金融的影响因素,基于中国家庭金融调查2017年数据,从个人禀赋、家庭支持和区域发展三个角度构建了多维解释模型,使用分层Logit模型进行验证。研究结果显示:第一,受教育程度高和金融素养高的老年人参与互联网金融可能性更大;第二,家庭总收入越高、与子女同住和与孙辈同住均可提高老年人参与互联网金融的比例;第三,信息社会化指数越高省份的老年人越容易参与互联网金融。第四,随着年龄的增大,老年人个人禀赋的影响减小,而家庭支持和区域发展的影响始终显著。根据上述研究结果,本文提出了有针对性的建议。     

旅游和健身锻炼与健康长寿关系的定量研究

基于中国老年人口健康纵向调查2002年和2005年数据,运用实证方法对影响我国65岁及以上老年人旅游和健身锻炼的相关因素以及旅游和健身锻炼对健康长寿的影响进行定量分析。研究显示在控制诸多干扰因素下,城镇老人、汉族老人、那些具有较高社会经济地位和较多医疗资源以及经常参与闲暇活动老人的外出旅游和参与健身锻炼的比例较高;宗教活动增加出游比例;出游比例具有随龄下降趋势。研究还发现出游和参与健身锻炼有利于健康长寿。     

劳动力迁移过程中的农村留守老人照料问题研究

随着大量农村劳动力人口的外出务工,农村留守老人照料问题日益突出,2004年7月中国人民大学老年学研究所组织了大型“农村流出人口对老年人生活影响”的调查,以此为基础,探讨农村青年劳动力人口外流对农村老年人生活照料的影响。一方面照料提供者的减少,农业劳动、家务劳动等负担的增加加剧了农村留守老人的健康和日常生活照料问题;另一方面社会照料网络如农村基层组织、农村社区、志愿者等为留守老人提供的照料体系还不完善。随着社会的发展,社会网络对老年人提供的照料必将发挥越来越大的作用。我们不能因为农村劳动力外流弱化了家庭照料老人的功能而忽略了其对社会照料体系构建的作用。