HIV/AIDS Orphans' Education in Uganda

Abstract

The HIV/AIDS epidemic in most sub-Saharan African countries has created a crisis in the African family structure. In Uganda, older people's roles have been reversed from being provided for to providers. Older people, who are already poor, face the loss of economic support from their adult children and unexpected social, psychological and economic burden due to the care-giving role they assume. In this study, we used cross-sectional data from Kayunga district in Central Uganda to examine the impact of HIV/AIDS on the role of older persons. We found that there were HIV/AIDS related deaths in 82.3% of the surveyed households. In almost 34% of the households, the care-givers of HIV/AIDS orphans were older people over 50 years old. Almost all households headed by older people (97.8%) had on average three school-going orphaned children living in the household.     

THE EFFECT OF NONCONTRIBUTORY PENSIONS ON SAVING IN MEXICO

This paper examines the effects of noncontributory pension programs at the federal and state levels on Mexican households' saving patterns using micro data from the Mexican Income and Expenditure Survey. We find that the federal program curtails saving among households whose oldest member is either 18–54 or 65–69 years old, possibly through anticipation effects, a decrease in the longevity risk faced by households, and a redistribution of income between households of different generations. Specifically, these households appear to be reallocating income away from saving into human capital investments, like education and health. Generally, state programs have neither significant effects on household saving, nor does the combination of federal and state programs. Finally, with a few exceptions, noncontributory pensions have no significant impact on the saving of households with members 70 years of age or older—individuals eligible for those pensions, plausibly because of their dissaving stage in the lifecycle. (JEL D14, J26, O12, H55)     

Pensions,poverty and wellbeing in later life: Comparative research from South Africa and Brazil

This paper draws on two linked studies of social policy and wellbeing in later life. The studies make comparisons between distinct groups of older people at the national and sub-national levels, as well as over time. The paper reflects on some of the main challenges for operationalising this complex design, as well as for interpreting findings and identifies lessons for other studies. The first study, conducted in 2002, included a questionnaire survey of around 2000 households containing at least one older person in South Africa and Brazil, supplemented by a set of in-depth qualitative interviews. Intriguingly, these countries had remarkably similar pension programmes, providing the majority of older people a reliable payment of roughly US$3 a day. This offered the prospect of exploring the effects of similar interventions in distinct developmental and cultural settings. In both countries, we found that these pensions had a substantial impact on the prevalence and depth of poverty in the study households, and were usually shared between older people and other family members. The second survey took place in 2008/9 and involved revisiting the households included in the 2002 survey, along with a separate set of in-depth interviews. This provided an opportunity for dynamic analysis of economic and wellbeing effects, against a backdrop of increased divergence in the wider national settings. Among other things, this revealed high and increasing levels of life satisfaction across all the study groups, although the extent to which this was directly related to generous pension provision cannot be ascertained.     

The Pension Reform Process in France

The French old age security system was constructed progressively following the end of the Second World War in response to the pressing problem of old age poverty. In 1945 less than 40% of old people (4.5 million in total) had a pension. This was despite the existence of some pension systems dating back to the end of the nineteenth century and the beginning of the twentieth century. Monetary depreciation also meant that the pensions of those who enjoyed such benefits were very low. Historical factors explain the current pension system's organization and institutional division favouring pay-as-you-go schemes. While the French pension system has been largely successful in eliminating old age poverty, it today faces new challenges and constraints that make reform necessary. The debate as how best to reform the pension system is a long and winding one. Change is slow and incremental. Ideological, social and cultural factors and their interrelations help explain the difficulties in effecting reforms.     

Qualitative perceptions of the meaning of “headship” and female-headed households in post-apartheid South Africa

The identification of one household member as the head of the household remains a feature of household surveys conducted by Statistics South Africa. While the analytical relevance of this practice has been critiqued and while many national statistics agencies have abandoned the concept of a household head altogether, researchers in South Africa often use the characteristics of the household head in order to classify households. In particular, recent research has documented a rise in female headship in South Africa and a growing gap in poverty risks between female- and male-headed households in the post-apartheid period. Some of this work has also shown that the increase in female headship is due to the growing incidence of women living in households without men. The way that headship is assigned and what it actually means, however, is something of a “black box” in social science research. This paper presents the findings from a qualitative investigation of headship in South African households. The results suggest that most respondents attach meaning to the notion of a household head but that, as expected, some clear contradictions in the way that headship is assigned were encountered in the data. The paper concludes with a discussion of the implications for using the characteristics of the head (and gender in particular) as a way to classify households and identifies some lessons for survey research protocols.     

Changing households in Britain: do families still matter?

The decline in traditional nuclear family households, and the marked increase in the proportion of people living alone, or alone with dependent children have led some to claim that individualism has replaced the importance of family life. In this paper we use data from a large household panel study of Britain to suggest that this is not true. Regardless of people's own household circumstances, family issues and events are clearly top of the agenda of what people consider matter most in their lives. Moreover, in talking about events that mattered, people are almost as likely to talk about something that happened to other family members, as they are to talk about themselves. Surprisingly, people living alone or alone with children are as likely to mention other family members as those who live in family households. Yet the importance of family does vary considerably by gender and age. Women give more importance to family events and events in the lives of other family members than do men. Young people are far more self-centred than older people but whether this is a generational or life-stage difference is open to question.     

Expenditure patterns of older Americans, 2001-2009

PRE- AND POSTRETIREMENT EXPENSES: Before retirement, people pay FICA taxes, incur work-related expenses, and set aside money for retirement. But after retirement, most people have different financial obligations, and, as a result, retirees may still be able to maintain their level of preretirement well-being with very different income levels. Studying income, expenditures, and wealth-holding patterns together provides a more complete idea of how people are doing in terms of being able to afford retirement than arbitrary estimates such as income replacement ratios. UNIQUE DATA: This Issue Brief examines the expenditure patterns of the older section of the population. It uses data from the Consumption and Activities Mail Survey (CAMS), a supplement to the Health and Retirement Study (HRS), conducted by the Institute for Social Research at the University of Michigan, contains detailed expenditure data on 32 categories, and follows the same group of individuals over eight years In addition, the income and wealth data available in the HRS are used to establish the financial standing of older households. DECLINING EXPENSES: Household expenses steadily decline with age. With the age 65 expenditure as a benchmark, household expenditure falls by 19 percent by age 75, 34 percent by age 85, and 52 percent by age 95. HOME EXPENSES: Home and home-related expenses remain the single largest spending category for older Americans. On average, those over age 50 spend around 40-45 percent of their budget on home and home-related items. RISING HEALTH CARE EXPENSES: Health-related expenses are the second-largest component in the budget of older Americans. It is the only component which steadily increases with age. Health care expenses capture around 10 percent of the budget for those between 50-64, but increase to about 20 percent for those age 85 and over. DEMOGRAPHIC GROUPS: Singles, blacks, and high school dropouts do not have a sound financial standing in retirement. Their expenditures exceed their income and they hold very little financial wealth. The bottom income quartile, which includes mostly these demographic groups, has the weakest financial standing in retirement. LONG-TERM CARE and PRIVATE HEALTH INSURANCE: Long-term care and some form of private health insurance coverage have a significant effect on increased spending by older households.     

动员效力与经济理性:农户参与新农保的行为逻辑研究——基于武汉市新洲区双柳街的调查

本文通过问卷调查发现,农户普遍了解新农保,参保积极,但缴费水平偏低;宣传动员有助于提升农户信息了解程度,从而提升农户参保广度,但对参保深度无显著影响。当信息充分时,农户参保行为是完全经济理性行为,情理动员无显著影响;当信息不充分时,农户参保行为是有限理性行为,情理动员可以提升参保广度,但参保深度不足。社会动员效力与特定社会背景下社会成员的价值理念相关。在当前经济理性主导下,社会动员必须符合农户的经济利益。作为后发展国家,社会成员对新制度的理解与接受能力有限,社会动员具有推动社会跨越式发展的功能。     

Lifecycle effects on consumer financial product portfolios in South Africa: An exploratory analysis of four ethnic groups

This paper assesses ownership of 16 financial products by households in different lifecycle stages amongst four ethnic groups (Africans, Coloureds, Asians, and Whites) in South Africa. The lifecycle hypothesis indicates younger households should own more debt-related financial products, whereas households in intermediate lifecycle stages should own more financial products to accumulate assets; both these claims are disconfirmed for all groups. However, White households in intermediate household stages own more financial products than younger and older households, consistent with previously reported lifecycle findings in Western countries. Consistent with the literature on innovation adoption we find that younger, affluent and highly educated households amongst the other three ethnic groups tend to own more financial products than older Africans, Coloureds and Asians. These results indicate that innovation adoption literature may better describe financial product ownership in developing countries than the lifecycle hypothesis.     

Aging With Rising Risk: Have Older Households Experienced Faster-Growing Risk Exposure Than Younger Ones Since the 1990s?

Financial markets have been characterized by boom and bust cycles since the 1980s, while the responsibility for managing retirement wealth has increasingly shifted onto individual households at the same time. Policy makers and experts have expressed concern over rising risk exposure among older householders, who appear to be increasingly exposed to the growing financial risks just as they near retirement. We consider household data from the Federal Reserve’s Survey of Consumer Finances from 1989 to 2010 to analyze the correlation between age and risk exposure. We test whether older householders’ risk exposure has indeed grown over time, whether it has increased more than that of younger householders, whether changes in the demographic composition of older householders have contributed to older households’ rising risk exposure, and the degree to which increases in risk exposure can be traced to a growing concentration of household assets held in stocks and housing and to rising householder indebtedness. Our results indicate that risk exposure has grown more for older householders than for younger ones, that demographic changes among older householders have contributed to additional increases in older householders’ risk exposure, and that the growth of older householders’ risk exposure is driven more by rising risky asset concentration and less by greater indebtedness.     

Changing Perception of the Rights and Responsibilities in Family Care for Older People in Urban China

As an ageing society, China has undergone various political and economic transitions since the 1980s, which has raised a series of social and policy concerns about the practicality of relying on family support in the care of older people. To understand the changing social expectations and the corresponding societal responses, the shifting perception of the rights and responsibilities associated with the family care of older people has to be comprehended first. Based on 39 qualitative interviews in two Chinese cities, Beijing and Guangzhou, this research contributes to an understanding of the pursuit of a “good life” by older people in contemporary urban China. It points to the argument that independence and autonomy in old age, as valued by the interviewees, will not be realised unless there is a shift in policy to recognise and respect the individuality of older people and facilitate their life choices.     

Policy Shift: South Africa’s Old Age Pensions’ Influence on Perceived Quality of Life

Noncontributory pensions serve as an important resource for poverty-affected households in low- and middle-income countries. This study explores how a recent policy change to pension receipt influences perceived quality of life among older South Africans. We use survey data from the longitudinal World Health Organization Study on global AGEing and adult health and from the Agincourt Health and Socio-Demographic Surveillance System census. We find pension receipt to have a positive impact on both men’s and women’s perceived quality of life. These findings hold when controlling for prior well-being status. We find a significant moderating factor of physical limitations on the relationship between pension receipt and quality of life. Individuals reporting the highest levels of physical limitation report a larger increase in their quality of life upon pension receipt than those with less severe physical limitations. We conclude that despite the well-documented household income-pooling in this population, pension receipt still leads to a significant positive impact on pensioners’ perceived quality of life.     

Socio-economic and other variables affecting maternal mortality in Sierra Leone

This study identifies socioeconomic and health care variables affecting maternal mortality in 12 villages in Gbendembu Ngowahun Chiefdom in Sierra Leone. Data were obtained from Bombali district in the Northern Province. The villages include about 245,000 people. Analysis is based on interviews, participant observation, and health records from primary health care (PHC) centers and peripheral health units (PHUs). Interviews were conducted among 400 households and among 31 traditional birth attendants (TBAs) and PHC staff during November 1989 to February 1990. Findings indicate that high parity was related to early marriage. Over 40% of women were married by the age of 15 years. About 85% of women aged 45-49 years had 6 or more children. 55.1% had 9 or more children. Localized areas within the Chiefdom had even higher fertility. Fertility was somewhat lower among women living beyond a 3-mile radius of the PHUs. Most of the women had never had any formal primary education, particularly older women. More people were Christians than Muslims. About 80-90% of the population was composed of very poor subsistence farmers. During the rainy season people went hungry. Few could afford health care. About 69.5% of deliveries in the prior 24 months occurred at home, 21.5% were performed at a health center, and about 9% occurred in the hospital. The health units were located in Gbendembu and Kalangba. One aide per unit was assigned to maternal and child health services. The program aim--to reduce maternal mortality by 30% by the year 2000--is unattainable. Many factors are constraints to quality health care. Facilities were inadequate, prices were high, and nurses were unfriendly. Over 70% of deliveries within 3 miles of PHUs and over 90% of outside deliveries were performed by TBAs. Over 60% of TBAs were untrained and did not use sterile supplies.     

Grandparenting and age identity

This study examines multiple dimensions of age identity, including how old people feel, how old people want to be, how old people hope to live to, and how old is old. We pay particular attention to the influence of the grandparent role and the timing of the transition to grandparenthood. We use data from a Midwestern sample of 666 elderly Americans included in the Iowa Youth and Families Project (IYFP). The analysis suggests that older people who enjoy being grandparents feel younger, believe that people become old at older ages, and hope to live longer than those who do not enjoy grandparenting. In addition, those who became grandparents at younger ages feel older than those who enter this role “on time.” While becoming a grandparent at a young age may in a sense accelerate aging, positive interaction with grandchildren can lead to a younger age identity.     

Health care,social care or both? A qualitative explorative study of different focuses in long-term care of older people in France,Portugal and Sweden

Challenges with an ageing population are increasingly becoming a reality in the Western world. Since cognitive impairment increases with age, we can expect an increasing number of older people in need of care. The aim of this article is to describe, analyse and compare different focuses on care of older people with dementia, using examples from France, Portugal and Sweden. The questions are principally focused on the participants’ view about their tasks, the organisation of work, the professional role and cooperation with other professions. Everyday care was studied through observations and participant observations and the staff's opinion was explored by means of interviews. Twenty-two care settings for older people were included. The findings showed that France provided mainly ‘health care’, Sweden ‘social care’ and Portugal an integrated ‘health care and social care’. In a comparative perspective the Portuguese general care of older people, which focuses on integration of health care, social care and social work, also seems to provide care for older people suffering from dementia which best corresponds to the previously developed group living model.     

Is Swedish pension reform the right medicine for aging Europe?

Following the Second World War, the idea of the life course with distinct periods of education, work, and retirement became popular as a result of the alliance of interests of unions and management, with politicians seizing the opportunity to accommodate them. These "social partners" implemented benefit rules and created practices for using old age and disability to ease the exit of older workers. Although justifiable at the time, now those rules and practices hinder individual and employer incentives to invest in human capital and work environments that enable older workers to remain in the workforce. The article argues that the workforce environment of the coming half-century, which is relevant for persons born around 2000, is much different from that a hundred years earlier, which determined the opportunities for people born around 1900. People are healthier and live much longer and work environments are friendlier. The article argues that it is no longer justifiable to subsidize exit from the workforce around the age of 60 for healthy workers, especially in view of the coming labor shortage in Europe. It also argues that the introduction of the principles of the Swedish NDC pension reform in Europe would provide possibilities for flexible exit from the workforce and remove impediments to labor mobility in Europe, which are embedded in many of Europe's present pension arrangements.     

Trends in the Economic Status of the Aged and the Implications for State Policy

This paper examines recent trends in the economic status of the elderly. Particular attention is given to shifts in the income composition of older households and why these shifts have taken place. It is shown that most of these shifts are attributable, either directly or indirectly, to Social Security and private pension policies. The data also reveal that the income mix of poor older households differs greatly from that of more affluent older households. This has implications for the formulation of policies to improve the economic status of the elderly in poverty. Unfortunately, the current policy environment, characterized by large federal deficits, places severe constraints on developing federal programs to aid poor older persons. Thus, it is likely that state governments will need to take increasing responsibility for programs targeted to the aged poor. The paper concludes by considering the potential effectiveness of such programs.     

Future of Long-Term Care Financing for the Elderly in Korea

ABSTRACT

With rapid aging, change in family structure, and the increase in the labor participation of women, the demand for long-term care has been increasing in Korea. Inappropriate utilization of medical care by the elderly in health care institutions, such as social admissions, also puts a financial burden on the health insurance system. The widening gap between the need for long-term care and the capacity of welfare programs to fulfill that need, along with a rather new national pension scheme and the limited economic capacity of the elderly, calls for a new public financing mechanism to provide protection for a broader range of old people from the costs of long-term care. Many important decisions are yet to be made, although Korea is likely to introduce social insurance for long-term care rather than tax-based financing, following the tradition of social health insurance. Whether it should cover only the elderly long-term care or all types of long-term care including disability of all age groups will have a critical impact on social solidarity and the financial sustainability of the new long-term care insurance. Generosity of benefits or the level of out-of-pocket payment, the role of cash benefits, and the relation with health insurance scheme all should be taken into account in the design of a new financing scheme. Lack of care personnel and facilities is also a barrier to the implementation of public long-term care financing in Korea, and the implementation strategy needs to be carved out carefully.     

Inequality of Pension Arrangements Among Different Segments of the Labor Force in China

Social security for older people in China today has been established institutionally. However, there are substantial problems such as coverage, affordability, fund management, and corruption. This paper aims to provide a general picture of China's social security system for older people and to argue that the inequality of pension arrangements among different segments of the labor force is one of the most conspicuous problems challenging the Chinese government. Four unequal aspects of the pension system concerning the financing resources and pension levels are examined in this paper: (1) unequal institutional arrangements among different sectors, (2) unbalanced governmental expenditure in pension provision, (3) an increasing gap in pension levels between urban and rural areas, and (4) uncovered groups such as the unemployed and self-employed. Historical, economic, and political reasons all contribute to this unequal institution under transition from socialism to a market-oriented economy. At present, it is urgent for the central government to take measures to integrate the various pension arrangements into the unified Old Age Insurance and to reduce the gaps among different regions.     

Nursing Home Ownership

Abstract

Following the Second World War, the idea of the life course with distinct periods of education, work, and retirement became popular as a result of the alliance of interests of unions and management, with politicians seizing the opportunity to accommodate them. These “social partners” implemented benefit rules and created practices for using old age and disability to ease the exit of older workers. Although justifiable at the time, now those rules and practices hinder individual and employer incentives to invest in human capital and work environments that enable older workers to remain in the workforce. The article argues that the workforce environment of the coming half-century, which is relevant for persons born around 2000, is much different from that a hundred years earlier, which determined the opportunities for people born around 1900. People are healthier and live much longer and work environments are friendlier. The article argues that it is no longer justifiable to subsidize exit from the workforce around the age of 60 for healthy workers, especially in view of the coming labor shortage in Europe. It also argues that the introduction of the principles of the Swedish NDC pension reform in Europe would provide possibilities for flexible exit from the workforce and remove impediments to labor mobility in Europe, which are embedded in many of Europe's present pension arrangements.