老年失能的配偶溢出效应及性别差异研究

由于健康预期寿命增长滞后于预期寿命增长，中国老年失能问题严重，特别是女性老人的失能比例更高。但现有研究对老年失能性别差异的社会机制认识不足。家庭小型化、人口老龄化和年轻人口外流使越来越多的老年夫妻与子女分开生活。以往对失能老人的研究集中在个体或者代际层面，少有以老年夫妻为主体的研究，忽视了老年夫妻日常生活中可能存在的失能性别分化。本文利用中国健康与养老追踪调查2015年和2018年数据分析老人失能情况对其配偶存在的溢出效应以及该效应在机制和结果上的性别差异。结果表明丈夫失能会显著提高女性老人的失能风险，而男性老人的失能风险却未显著受到妻子失能的影响。受照料的性别文化影响，尽管女性老人失能比例更高，但其在失能配偶照料上投入的时间要比男性老人长。此外，丈夫失能会对老年夫妻家庭经济水平造成负面影响，妻子失能则没有显著影响。总体而言，性别要素贯穿老年失能分化过程中，并通过照料和收入两种社会机制导致女性老人比男性老人更易受到配偶失能的影响。因此，失能老人相关的家庭安排和政策设计有必要考虑老年夫妻间的依存关系，特别要关注老年女性可能因老伴失能而面临的一系列生存困境。建议以长期护理保险和家庭照料补贴...     

失能老人养老状况分析

文章基于2011年中国老年健康影响因素追踪调查数据,对失能老人的养老状况进行分析。研究发现,93%的失能老人都属于80岁及以上年龄组,女性失能老人的数量是男性失能老人的2倍,城镇失能老年人口比重高于农村地区。失能老人的主要生活来源来自子女供给的占66%,来自政府和社团支持的仅占6%,77%的失能老人表示能满足生活需求。失能老人的医疗保险覆盖率为79%,但养老保险仅占18%。在照顾主体方面,88%的照顾来自家庭内部,54%的失能老人表示现有的照顾能满足基本生活需要。在居住安排和居住意愿方面,87%的失能老人选择与家人同住,近60%的失能老人倾向于与子女一起居住,其居住意愿受失能老人的年龄、失能程度和婚姻状况的影响显著。     

中国老人丧偶与其死亡风险的关系分析——配偶照顾的作用

文章基于中国老人健康长寿影响因素研究数据(1998~2005),利用Cox比例风险模型考察了中国老人丧偶对其死亡风险的影响机制,并深入分析了配偶照顾因素在降低老人死亡风险中的作用。结果发现:丧偶与死亡风险具有显著的关系,一般而言,长期丧偶老人的死亡风险显著地高于长期有偶的老人。而且,除了高龄女性老人之外,老人在丧偶初期,其死亡风险会大大增加。在解释丧偶是如何影响老人的死亡风险时,配偶的照顾是一个非常重要的因素,在控制配偶照顾的条件下,丧偶者与有偶者的死亡风险差异会大幅下降,这说明来自配偶的生活照顾对于老人的寿命发挥着重要影响。此外,本研究也发现配偶照顾的作用具有显著的性别差异和年龄组差异。     

隔代照顾的生物社会学动因及影响分析

当前社会环境下,儿童照顾给工作和家庭平衡带来压力和挑战。隔代照顾成为缓解这一压力的流行方式而得到了广泛的关注,学术界产生了许多研究成果。其中,生物社会学视角在国外隔代照顾研究中有较多的应用。但是在国内采用这一视角进行的实证研究非常少。本研究以中国健康与养老追踪调查(CHARLS)2015年的数据为资料,通过生物社会学的视角并使用广义Logistic模型和广义线性模型对四类儿女双全的祖辈的隔代照顾的积极性进行分析。结果表明亲缘选择假设不能完全解释四类祖辈照顾孙辈的积极性的差异。虽然从整体上看女性祖辈比男性祖辈更积极地照顾孙辈,但是父系女性祖辈照顾孙辈的积极性并没有像亲缘选择假设所推断的那样显著低于母系女性祖辈。同时,分城乡的回归结果表明城镇地区四类祖辈的积极性没有显著差异,而在乡村地区父系女性祖辈的照顾强度显著高于其他三类祖辈。因此,亲缘选择理论可以解释照顾者性别差异的部分原因,而无法阐明父系和母系的宗族差异。此外,照顾者的工作状态、婚姻状态、受教育水平、子女的经济支持、子女的数量和子女的年龄都是影响隔代照顾积极性的显著因素。需要注意的是虽然生物社会学理论有其独特的价值,但是将它用于社会研究也有明显的局限性。因此,这一理论仍然有许多亟待探索和完善的空间。     

异质性、家庭支持与中国高龄老人的死亡率:虚弱度模型的应用

本文通过虚弱度模型展示了中国高龄老人死亡率模式中的个体异质性,女性内部异质性远大于男性。在控制未观测异质性后,结果显示:男性和女性高龄老人的基准死亡率呈现交叉效应;配偶对男性高龄老人的存活存在显著的保护作用,已婚有偶的男性高龄老人死亡风险较之无偶的低22%(=1-e-0.253);除日常照料和精神慰藉外,子女对烟酒嗜好等不健康生活方式的监督,对男性高龄老人的存活也可能存在不可替代的保护作用。女性高龄老人在社会支持网络依赖、社会经济地位与健康生活方式上迥异于男性,使得配偶和子女以上支持作用并不显著。     

中国高龄老人自理能力的性别差异

本文利用<中国高龄老人健康长寿抽样调查>数据分析了高龄老人的健康、患病和自理状况,并重点从以下几个方面探究了高龄老人生活自理能力的性别差异.(1)不同性别高龄老人的健康质量,这是生活自理能力的前提;(2)高龄老人生活自理能力的丧失率性别差异;(3)高龄老人生活自理能力性别差异的影响因素.     

我国老年人口失能判别及其对健康预期寿命影响分析

老年人口失能水平对健康预期寿命的测算具有重要影响,而不同数据来源的老年人口失能水平存在着较大差异。本文以经过模型生命表调整的2015年1%人口抽样数据所计算的生命表为基础,以2010年人口普查、2015年1%人口抽样调查、2015年CHARLS数据和2014年CLHLS数据为资料来源,探讨老年人口分年龄失能状况及其对健康预期寿命测算结果的影响。老年人失能率较大程度地影响着健康预期寿命及其性别年龄模式。无论是失能的主观评价指标还是客观评价指标,不同数据来源的高龄老人失能率差别较大;CHARLS数据中高龄老人失能率偏倚原因可能产生于调查过程中的系统误差,而非样本规模较小;CLHLS和CHARLS中的问卷访题设计也是影响失能程度判别的重要因素。因此,在理论和应用层面上探讨我国老年人口特别是高龄老人失能水平的差异及其原因,逐步形成共识是学界亟待解决的重要问题。     

婚姻对中国高龄老人健康长寿影响的性别差异分析

文章利用中国高龄老人健康长寿纵向调查1998年基线数据和2000年跟踪数据,就婚姻对中国高龄老人健康长寿影响的性别作用差异进行了剖析。研究结果表明,婚姻状况对女性高龄老人健康的保护作用强于男性高龄老人,婚姻状况对男性高龄老人死亡风险的降低作用比女性高龄老人大,较高的婚姻满意度有利于高龄老人减缓健康状况的下降和死亡风险的下降,高龄老人近期丧失配偶对健康状况的下降有恶化作用并增加死亡风险,女性的这种作用强于男性。     

养老金性别差异影响因素分析——以上海城镇“老人”为例

为了了解养老金性别差异的影响因素及各因素的影响程度,通过对2003年上海市老年人口状况与意愿跟踪调查原始数据的多元线性回归分析,本研究发现：．女性城镇“老人”在受教育年限、退休年龄和退休前职业等方面较男性城镇“老人”均处于劣势：不同特征女性城镇“老人”养老金整体上低于男性城镇“老人”：退休年龄和受教育年限对养老金的性别差异有较强的解释力;退休年份越晚,养老金的性别差异由退休年龄和受教育年限解释的比重越高。     

高龄失能老人居住方式及影响因素的实证研究

高龄失能老人居住方式直接影响到长期照护服务质量,通过对211位高龄失能老人的调查,发现他们理想的居住方式与现实的居住方式之间存在很大差异,大多数高龄失能老人理想的居住方式是与家人同住,而现实的居住方式则是入住养老机构比例在大幅度提高。经济与社会支持因素对高龄失能老人理想居住方式有较大影响,而居住地、婚姻状况、儿女数量等多因素阻碍他们实现理想的居住方式,使他们不得不居住在养老机构。在研究的基础上,提出社区应整合社会多方资源将照护服务递送到居家高龄失能老人身边,同时提高机构照护服务质量,使身居养老机构的高龄失能老人在接受专业化照护服务的同时感受到居家的温馨,以实现高龄失能老人理想的居住方式,满足他们对长期照护服务的需求。     

Mental health differences between men and women caregivers,BRFSS 2009

This study uses data from the 2009 Behavioral Risk Factors Surveillance System (BRFSS) to examine differences between male and female caregivers by demographics, health-related quality of life (HRQOL), and the effect of social support on HRQOL. Roughly two-thirds of caregivers were women, and demographic characteristics differed among men and women caregivers. Women caregivers reported significantly more mentally and physically unhealthy days than men, but there were no differences between men and women in general health or life satisfaction. Men were significantly more likely to report that they rarely or never received social support. Despite this, the effect of social support on HRQOL was stronger in men than in women. Implications of these findings for caregiver support programs are discussed.     

The Psychological and Health Consequences of Caring for a Spouse With Dementia: A Critical Comparison of Husbands and Wives

Caring for someone with dementia can be demanding, particularly for spouses living with the care recipient. The main goal of this study was to clarify differences in the experience of caregivers who were husbands and wives with respect to burden, health, healthy behaviors, presence of difficult care recipient behaviors, social supports, and the quality of the premorbid relationship. The results of this study support research demonstrating a difference between the caregiving experiences of women and men. It is becoming increasingly apparent that female gender is a marker that places them at increased risk of high burden and less support.     

The Influence of Health Promoting Practices on the Quality of Life of Community Adults in Hong Kong

The importance of a healthy lifestyle is receiving increasing attention due to its impact on health and well-being. However, very few studies have been done on health promoting practices of the general public in Hong Kong. The present study aimed to identify the patterns of health promoting practices of the general public in Hong Kong, to compare health promoting practices across gender and education levels, and to examine the relationship between health promoting practices and quality of life. A total of 941 community adults were recruited using a randomized household survey design. Results revealed that a large proportion of participants reported practicing various types of health promoting behavior related to healthy food choice, engaging in stress management strategies, and refraining from health compromising behavior such as smoking and drinking excessively. Female participants were more likely to choose healthy food, refrain from smoking and drinking alcohol excessively, and take vitamin supplements, whereas male participants were more likely to exercise regularly. Both men and women with higher levels of education were more likely to report not smoking, not drinking alcohol excessively, and participating in social activities. Women with higher levels of education were also more likely to engage in relaxing activities but less likely to report exercising regularly and sleeping sufficiently. Hierarchical regression analyses revealed that stress management and social relations significantly predicted better quality of life for both male and female participants, and types of preventive health behavior were significant predictors of quality of life for female participants only. Results highlighted the importance of advocating health promoting practices among the general public in Hong Kong. Implications for future practice were discussed.     

Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.     

Racial differences in physician usage among the elderly poor in the United States

Despite the rapidly growing ranks of the elderly in America, the increasing racial and ethnic diversity of this population, and the large number of seniors who are poor, there are relatively few systematic investigations that examine the causes of racial differences in health care use specifically among elders living in poverty. This article addresses this issue by examining differences in patterns of having and using a physician among the elderly poor, the role that race plays and what might explain it. We demonstrate that even within this disadvantaged and medically engaged population there are persistent and significant racial differences in having and using a doctor. Specifically, we show: (1) Whites and women are more likely to have a regular doctor than men and African Americans; (2) Among those who have a doctor, whites and women also visit the doctor with greater frequency than other groups even at the same levels of health or illness; (3) After accounting for the varying levels and effects of social connectedness, racial differences in having a doctor essentially disappear; and (4) While differences in having a regular doctor can be accounted for using measures of social connectedness, substantial and robust racial and gender differences in doctor use remain. In the end, we provide an analysis that examines typical factors known to influence health care use, and find that while need, structural factors, perceptions of care, and social connectedness have a powerful effect on doctor visits, the racial variation in using a doctor cannot be explained away with the available measures.     

中国老年人隔代照料与 健康后果的实证研究及政策思考

在中国家庭代际关系的研究中,隔代照料这一选题极为重要,隔代照料也是老年和家庭福利政策制定的重要影响因素。老年人隔代照料与健康问题日益受到国内学者的关注,但对两者相关性的深入实证考察较少,仅有的研究也未就隔代照料产生的健康后果达成共识,政策应对亦存局限。为此,本文基于2014年中国老年社会追踪调查(CLASS)截面数据,探讨中国老年人照料孙子女对自身健康产生的后果及几个主要变量之间的交互作用,对其进行量化研究并通过稳健性检验。研究得出三项基本结论:隔代照料的健康后果受到照料强度、子女特征、居住模式及老年人自身罹患慢性疾病状况的影响,在不同的特征状况下呈现不同的健康结果;照料者受教育程度、照料者性别、健在子女数等变量间的交互作用对被解释变量(照料者健康)产生了不同程度的调节作用,成年子女向上的代际支持也对老年照料者的健康发挥了调节作用;使用工具变量(照料者是否享受老年优待政策)进行因果识别在一定程度上克服了解释变量与被解释变量间的内生性问题。最后,本文基于上述实证研究的结果从代际关系视角、社会性别视角和老年婚姻社会功能等方面提出公共政策的应对思考,以期为制定相应的老年和家庭福利政策提供策略和依据。     

Discriminating positive and negative aspects of pet interaction: Sex differences in the older population

Although pet interacters from a sample of 250 persons over 50 years of age generally report receiving more intense uplifts than hassles from their pets (Chi Square = 26.7, p<0.001), there are also differences seen within this group. More specifically, differences are seen in regard to relationships between reported hassles and uplifts from pets, and socializing, life situation, and gender. For example, pet interacters who report a great deal of uplift from pets also report doing things with friends more frequently than do interacters who report only slight uplift from pets (t=2.38, p<0.05). Importantly, pets also appear to serve different roles for female and for male pet interacters, and for pet interacters in different circumstances. Uplifts from pets are associated with leisure and lack of psychological pressure for females, but are related to hassles with social interactions, time, and money for males. Contrastingly, females who report hassles from pets report hassles in the areas of free time, money, and health, but uplifts from social interactions. Human interactions with pets frequently contribute to quality of life and these interactions merit further study.     

农村老年人老化态度变动轨迹:基于积极老龄化框架的实证考察

基于积极老龄化理论框架和“中国老年健康影响因素跟踪调查”面板数据,文章从积极和消极两个维度对农村老年人老化态度问题进行实证考察。研究发现,两种老化态度均以2008年为重要转折点,女性老化态度比男性更具多样性和多变性。健康、社会参与和保障都能引起老化态度的积极变动,但社会适应、子女经济支持和社区照料三个因素对消极老化态度有正向影响,而生产活动降低了积极老化态度水平。从贡献率看,健康因素对老化态度差异贡献最大,其次是保障因素、社会参与因素,健康因素更能解释积极老化态度的变化,社会参与因素对消极老化态度的贡献率更高,二者分别在女性和男性老年人群体中表现得更为明显。贡献率排在前四位的因素是精神健康、子女经济支持、医疗可及性和身体健康。用积极老龄化的观点帮助庞大的农村老年人口建立正确的老化态度将有益于养老问题的解决。