Elderly parent health and the migration decisions of adult children: Evidence from rural China

Recent research has shown that participation in migrant labor markets has led to substantial increases in income for families in rural China. This article addresses the question of how participation is affected by elderly parent health. We find that younger adults are less likely to work as migrants when a parent is ill. Poor health of an elderly parent has less impact on the probability of employment as a migrant when an adult child has siblings who may be available to provide care. We also highlight the potential importance of including information on nonresident family members when studying how parent illness and elder care requirements influence the labor supply decisions of adult children.     

与收入相关的老人健康不平等及其分解——基于中国城镇和农村的经验研究

本文使用“中国老年人健康长寿影响因素调查”（CLHLS）数据,测度了中国老人健康不平等程度,重点计算了收入、婚姻状况、居住安排等因素对健康不平等的贡献。回归基础上的集中系数及其分解结果显示：我国存在亲富人的健康不平等,高收入人群的健康状况更好;城镇地区,健康不平等主要的贡献因素为收入、婚姻状况、医疗保险、经常锻炼,居住安排对健康不平等的贡献为负。农村地区,收入因素对于健康不平等的贡献最大,这就意味着消除农村健康不平等的关键是要降低收入不平等。在城镇和农村地区医疗保险的不平等程度更甚,进一步强化了健康不平等。因此如果政策想要降低健康不平等,首先要降低穷人获得医疗保险的经济门槛,增加医疗保健服务的可及性。     

Unhealthy Weight in Indian Families: The Role of the Family Environment in the Context of the Nutrition Transition

India faces a dual burden of increasing obesity and persistent underweight as it experiences the nutrition transition—the dietary and lifestyle changes that accompany globalization, economic development, and technological change. Yet, the nutrition transition is not solely a top-down process; rather, global forces converge with local practices at multiple levels of the social ecology. The family environment, a key site for the transmission of local customs and norms, remains largely unexplored in India. We examined the extent to which opposite-gender siblings and mother–child pairs were concordant or discordant in body weight, and whether domains of the family environment, specifically, food practices, food-related gender norms, and household resources, were associated with patterns of unhealthy weight within and between families. Multilevel dyadic analysis and logistic regression were conducted using survey data from a representative sample of 400 families in a Southern Indian city. We identified substantial clustering of weight among opposite-gender sibling pairs (ICC = 0.43) and mother–child pairs, as well as important patterns of discordance, including 11% of families experiencing a dual burden of underweight and overweight. Household resources, including mother’s education and income, were salient in explaining the distribution of body weight within and between families. Importantly, less examined domains of the family environment were also relevant, including food practices (e.g., grocery shopping frequency), and food-related gender norms (e.g., mother’s control of food served at home). Continued exploration of how global and local practices converge in households will be necessary to develop programming that effectively addresses India’s dual burden of unhealthy weight.     

The heterogeneous impact of pension income on elderly living arrangements: evidence from China’s new rural pension scheme

This paper investigates the impact of pension income on living arrangements of the elderly. Taking advantage of a unique opportunity due to the recent establishment and expansion of the New Rural Pension Scheme in China, we explicitly address the endogeneity of pension status and pension income through a fixed-effect model with instrumental variable approach by exploiting exogenous time variation in the program implementation at county level. We find an overall positive effect of pension income on independent living as well as considerable heterogeneity. The positive income effects of the NRPS are concentrated among the elderly with adult children living nearby, of higher socio-economic status, and with better health at baseline; for other groups, the effects are insignificant. We also find that more generous programs exhibit larger effects. Our results highlight that living arrangement is multidimensional in rural China.     

Variations in nutritional risk among black and white women who receive home-delivered meals

The maintenance of good nutritional status is a cornerstone of health, function, and quality of life. To assess indicators and correlates of high levels of nutritional risk, sociodemographic, functional status, and nutritional data were collected from a diverse sample of 729 older women. Results from ordered logit analysis indicated that being Black, having an income < or = 125% of the federal poverty level, living alone, and being in the younger-old age group (ages 60 to 74 years) were associated with moderately high and very high levels of nutritional risk. An examination of individual and multiple nutritional risk indicators suggested a heightened vulnerability of Black women to inadequate dietary intake, even net of income and other influential variables. With demographic projections of an increasingly numerous and diverse older population who may face health and nutritional challenges, researchers must strengthen efforts to assist policymakers and service providers to properly target nutrition services.     

Overeducation,Skills and Wage Penalty: Evidence for Spain Using PIAAC Data

Despite well documented high levels of socioeconomic inequalities, health gradients by socioeconomic status (SES) in contemporary China have been reported to be limited. Using data from the 2010–2012 China Family Panel Studies, we reexamine associations between three sets of SES—human capital, material conditions, and political capital—and self-rated health among Chinese adults 18–70 years old, capitalizing on anchoring vignette data to adjust for reporting heterogeneity. We find strong evidence of substantial variations in reporting behaviors by education, cognition, and family wealth but not by family income or political capital. Failing to correct for reporting heterogeneity can bias the estimates of SES gradients in self-rated health as much as nearly 40 %. After vignette adjustment, we find significantly positive associations of education, family income, wealth, and political capital with self-rated health. Individuals’ cognitive capacity, however, does not predict self-rated health.     

Does Subjective Social Status Predict Self-Rated Health in Chinese Adults and Why?

A positive relationship between subjective social status (SSS) and health has been documented in many countries, however, many studies rely on non-representative, cross-sectional samples. Potential mechanisms underlying the association between SSS and health have been proposed but empirical investigation remains scarce. Capitalizing on nationally representative data from the 2010–2016 China Family Panel Studies (CFPS), this study examines the longitudinal association between SSS and self-rated health in Chinese adults 20–70 years old. Estimates from lagged dependent variable models confirm a linear relationship between current SSS and self-rated health two years later over a 6-year follow-up period, after adjusting for education, occupation, income, and other demographic controls. This relationship remains robust after adjusting for additional indicators of objective socioeconomic status (SES) including household wealth, education of the spouse, parental literacy, and political capital. Mediation analysis shows that a large proportion (about 60%) of this association can be explained by such psychosocial factors as future prospects, life satisfaction, and mental illness. For Chinese adults, SSS is an important predictor of health not because it is a comprehensive measure of multidimensional SES, but because of a salient psychosocial pathway.

     

女性丧偶老年人的养老保障状况分析①

女性丧偶老年人是老年人口中的双重弱势群体。利用中国老龄科学研究中心2006年“中国城乡老年人口状况追踪调查”数据以及对18位女性丧偶老年人的深度访谈资料．发现我国女性丧偶老年人普遍存在着经济收入低、保障水平差、自评经济状况“困难”比例大的特点。此外,女性老年人在丧偶之后的生活质量、身心健康以及对生活状况的主观评价也会发生重大变化。在完善社会保障制度的过程中强调性别平等观念,建立遗属养老金制度,是解决女性丧偶老年人经济、生活困难的一个主要措施。     

Income inequality and self-rated health status: Evidence from the european community household panel

We examine the effect of income inequality on individualś self-rated health status in a pooled sample of 11 countries, using longitudinal data from the European Community Household Panel survey. Taking advantage of the longitudinal and cross-national nature of our data, and carefully modeling the self-reported health information, we avoid several of the pitfalls suffered by earlier studies on this topic. We calculate income inequality indices measured at two standard levels of geography (NUTS-0 and NUTS-1) and find consistent evidence that income inequality is negatively related to self-rated health status in the European Union for both men and women, particularly when measured at national level. However, despite its statistical significance, the magnitude of the impact of inequality on health is very small.     

Life Satisfaction of Middle-Aged and Older Chinese: The Role of Health and Health Insurance

The Chinese government has launched a series of health reforms to establish universal health insurance coverage, particularly for vulnerable groups, including middle-aged and older adults. However, the current public health insurance system is highly fragmented, consisting of different programs with different levels of premiums and benefits. We analyse whether the universal health insurance system increases the life satisfaction of middle-aged and older Chinese people and to what extent the type of health insurance affects the life satisfaction of this group. Our study is based on data from the China Health and Retirement Longitudinal Study, a nationally representative longitudinal survey of Chinese aged 45 and above, in 2011, 2013, and 2015. We find that the life satisfaction of middle-aged and older adults does not depend on having any health insurance coverage but varies with the type of health insurance coverage, controlling for potential confounding variables such as health status, occupation, hukou status, and other demographic variables. Individuals covered by the most generous program, the Government Medical Insurance, reported a higher life satisfaction. In comparison, individuals covered by the Urban Employee Medical Insurance, the Urban Resident Medical Insurance, and the New Rural Cooperative Scheme reported a lower life satisfaction by 0.155, 0.106, and 0.112 standard deviations, respectively. Our results suggest that establishing a more equitable health insurance system should be the next step in health reforms in China.

     

Family size and maternal health: evidence from the One-Child policy in China

In this paper, we examine the impact of family size on maternal health outcomes by exploiting the tremendous change in family size under the One-Child policy in China. Using data from the China Health and Nutrition Survey 1993–2006, we find that mothers with fewer children have a higher calorie intake and a lower probability of being underweight and having low blood pressure; meanwhile, they have a higher probability of being overweight. This would occur if a smaller family size increases the food consumption of mothers, leading underweight women to attain a normal weight and normal weight women becoming overweight. Robust tests are performed to provide evidence on the hypothesis that the tradeoff between children’s quantity and mother’s “quality” is through a budget constraint mechanism, that is, having more children decreases the resource allocated to mothers and affects their health outcomes.     

挤入还是挤出:社会保障对子女经济供养老人的影响——关于医疗保障与家庭经济供养行为

社会保障对子女经济供养老人的影响一直是学术界关注的热点问题。基于实地调研数据,控制其他变量基础上,重点分析社会保障对子女经济供养老人的影响,研究结果显示,社会保障总体上对子女经济供养老人的水平具有挤入效应,老年人获得社会保障总体上将提高子女对其经济供养水平。而解释机制分析则发现,原因在于医疗保障释放了老年人的医疗卫生服务需求,进而增加了相应支出,并最终导致子女增加了经济供养支出。进一步分析发现了该效应的群体差异性,而该效应实质是医疗卫生资源和服务分配的阶层性差异,根源在于现行医疗卫生制度存在的各种弊病。在研究结论基础上,提出了建立公平的健康保障与福利改进体系等思考。     

The synthesis economic fertility model: a latent variable investigation of some critical attributes

"This study uses Nicaraguan data to estimate a latent variable system of reduced-form demands for births, infant mortality, contraception, nutrition and breastfeeding. The estimates support some of the synthesis extensions to the standard fertility model, such as the concurrent increase of contraception, health, nutrition and fertility and decline in breastfeeding with income increases from initial low levels.... The initial stages of development may experience an increase in family size despite an increase in contraceptive use...as well as a profertility impact of reduced breastfeeding." Data are from a survey of women aged 15-45 that was conducted in Nicaragua from 1977 to 1978.     

中国农村老年人养老规划的现状及影响因素研究

制定养老规划是农村老年人积极应对养老风险的重要举措。利用中国老年社会追踪调查2018年数据,文章分析了农村老年人的养老规划现状及其影响因素,发现约34.6%的农村老年人实际有养老规划,约13.8%的老年人误判了自身的养老规划状况;现金储蓄是农村老年人的主要规划方式。相比农村居住的非留守老年人,农村留守老年人和进城农村老年人有养老规划的比例更高。农村老年人的经济收入对其是否做养老规划既存在显性影响,也具有通过养老观念的中介作用而表现出的显著的隐含影响。在养老责任观念的中介作用下,认同由政府和社会承担养老责任的养老观念会促使有劳动收入、子女给予经济支持和有新型农村养老保险的老年人做养老规划的可能性下降。     

Is the Relationship between Socioeconomic Status and Health Stronger for Older Children in Developing Countries?

Recent research on the relationship between child health and income in developed countries reveals a positive gradient that is more pronounced for older children, suggesting that the impact of income upon health accumulates. This article examines whether the same is true in a developing country. Using data from the Indonesian Family Life Survey on children aged 0 to 14 years, we find that although low income adversely affects health, its impact does not differ by age. This finding is robust to the use of both subjective and objective health measures, controlling for selective mortality, the use of alternative measures of households’ resources, and the inclusion of indicators of health at birth and parental health. One explanation for the constancy of the health-income relationship that we explore is the dominant role played by acute illness in determining the general health status of children in a developing-country context compared with the more central role played by chronic conditions in developed countries.     

营养健康水平对农民工工资收入影响的调查研究

利用北京地区的调查数据,对农民工这一特殊群体的营养和健康状况进行详实的统计分析,集中反映出营养和健康水平、社会保障和工作环境现状对农民工收入的影响。结果发现,农民工收入与其营养和健康水平存在正相关关系,即营养水平越高,身体越健康,健康意识越强烈的农民工其收入水平也越高。这一观点的提出丰富了有关农民工研究的成果,对制定旨在提高农民工社会福利水平,实现城乡和谐发展的决策具有重要的参考价值。     

The Benefits of Educational Attainment for U.S. Adult Mortality: Are they Contingent on the Broader Environment?

The growing recognition that educational attainment is one of the strongest preventive factors for adult health and longevity has fueled an interest in educational attainment as a population health strategy. However, less attention has been given to identifying social, economic, and behavioral resources that may moderate the health and longevity benefits of education. We draw on theories of resource substitution and multiplication to examine the extent to which the education–mortality association is contingent on other resources (marriage, employment, income, healthy lifestyles). We use data on adults aged 30–84 in the 1997–2006 National Health Interview Survey Linked Mortality File and estimate discrete-time event history models stratified by gender (N = 146,558; deaths = 10,399). We find that the mortality benefits of education are generally largest for adults—especially women—who have other resources such as employment and marriage, supporting the theory of resource multiplication. Nonetheless, our results also imply that other resources can potentially attenuate the mortality disadvantages (advantages) associated with low (high) levels of education. The findings suggest that efforts to improve population health and longevity by raising education levels should be augmented with strategies that assure widespread access to social, economic, and behavioral resources.     

城市社区养老服务需求及影响分析——以长春市的调查为例

老年人社区养老服务需求主要包括经济需求、健康医疗需求和休闲娱乐需求等方面,但是对于不同地区、不同老年人,影响需求的因素存在一定的差异。"我国老年人生活状况及养老公共服务需求调查"对长春市社区老年人生活状况及养老服务需求进行调查分析,结果显示,居住类型对老年人经济方面的需求有显著影响,性别和居住类型对老年人医疗健康方面的需求有显著影响,在影响老年人休闲娱乐的诸多因素中,代际关系和受教育程度的影响最为显著。     

中国农村收入、收入差距和健康

本文利用2004年和2006年中国9个省份的家庭调查面板数据,研究收入、相对收入和农村居民健康之间的关系。发现健康状况随着个人收入的增加而改善,呈现出明显的非线性关系;收入差距对健康的滞后影响,呈现倒U型关系。此外,当基尼系数在0.387以下时,农村居民健康水平将会随着基尼系数的扩大而改善,当收入差距进一步扩大时,健康水平将受到损害。而数据显示68%的农村居民在倒U右侧,健康正受到扩大的收入差距侵蚀。     

生活满意度与养老院需求意愿的影响研究——江苏农村老年人的调查

在城镇化快速推进和家庭养老支持力弱化的背景下,农村老年人对养老院人住意愿也在发生变化。以人口老龄化严重、农村社会养老保险实现全覆盖的东部沿海经济发达省份江苏为例,运用Logistic旧归模型对农村老年人养老院的需求意愿进行实证分析。研究表明,农村老年人晚年生活满意度对养老院需求意愿存在负相关关系,即生活满意度低的老年人相比生活满意度高的老年人更倾向于选择入伟养老院。另外,农村老年人对养老院的需求意愿还受年龄、个人年收入、健康状况、存活儿子数和存活女儿数的影响。本研究的政策启示是,整合村组或社区中的多种力量,为农村老年人构建一个包含生活照料、精神慰藉等多方面的社会支持网络;科学预测农村人口老龄化水平和养老院的需求意愿,稳步推进农村地区养老机构事业发展;从农村地区实际出发,合理引导农村养老机构的资源配置和功能定位。