Changes in functional limitation and survival among older Taiwanese, 1993, 1996, and 1999

Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties in walking and climbing stairs, tasks that represent basic lower-body movements less likely to be influenced by changes in environment and social roles than are activities and instrumental activities of daily living. Results are shown for unadjusted prevalence rates and rates adjusted for changes in population composition. The findings indicate that Taiwan does not appear to be experiencing the improvements in functioning witnessed recently in the United States. Prevalence of functional limitation increased between 1993 and 1996 and between 1996 and 1999. One possible reason is the change in old-age survival, which appears to have benefited those who have functional limitations, especially in a severe form. The Universal Health Insurance programme, established in 1995, may have increased access to care and thus the survival of those in poorest health.     

Educational attainment and transitions in functional status among older Taiwanese

Despite considerable research examining the influence of socioeconomic status on health, few studies have considered this relationship as it pertains to older adults in non-Western societies. We attempt to ascertain the influence of education on changes in physical functioning in a rapidly developing country. Data come from the 1989 Survey of Health and Living Status of the Elderly in Taiwan and a follow-up interview in 1993 (N = 4,049, age = 60+). Individuals are conceptualized to be in a state of functional independence or functional limitation at the time of origin, based on their ability to perform three physical functioning tasks. The outcome at the follow-up interview is categorized as functionally independent, limited, or dead, allowing for six probabilities, one from each state of origin to each outcome. These are calculated using a multinomial logit model, controlling for other factors often thought to be associated with health transitions. High levels of educational attainment result in a decreased incidence of functional limitation for those originating in a state of independence. Contrary to expectations, however, education has little influence on those who originate functionally limited. Thus, higher education plays a substantial role in primary prevention of morbidity, delaying the onset of disability, but other factors are more important once limitations begin. We speculate on the reasons behind these findings, including that the results may be culturally dependent.     

Changing chronic disease rates and longterm declines in functional limitation among older men

Functional limitation (difficulty walking, difficulty bending, paralysis, blindness in at least one eye, or deafness in at least one ear) in the United States fell at an average annual rate of 0.6% among men aged 50 to 74 from the early twentieth century to the early 1990s. Twenty-four percent of this decline is attributable to reductions in the debilitating effects of chronic conditions, 37% is attributable to reduced rates of chronic diseases, and the remainder is unexplained. The findings have implications for theories of the impact of declining mortality rates on the health of elderly people.     

中国人口转变与消费制度变迁

从抑制消费到刺激消费是中国消费制度的重大变革。本文运用新制度经济学和人口经济学理论,论证了中国人口转变通过人口增长的迅速下降,人口年龄结构的变化及其带来的人口红利对消费制度变迁的影响:死亡率下降主导的初期阶段,人口转变固化了抑制消费的制度,出生率下降主导阶段,人口转变与改革开放条件下的高速经济增长相叠加加剧了原有消费制度的不均衡。通过实证分析,揭示出消费率在人口转变过程中下降的必然性和中国保持适度人口增长的必要。     

Below-replacement fertility in Thailand and its policy implications

The fertility transition in Thailand has been one of the most rapid among Asian countries that are yet to attain newly industrialized country status. In the early 1960s, the total fertility rate exceeded six births per woman; currently, it stands at 1.9 or slightly below replacement level. At present, it is hard to predict the future trend in fertility as this involves several factors that need much closer study, in particular, fertility preferences, changes in marriage patterns and the wider effects of the current economic crisis in Thailand. Rapid declines in fertility and mortality have had a profound effect on the age structure of the population, notably the increasing elderly proportion. Thailand now faces new challenges and priorities for population policy. Policy responses to concerns arising from below-replacement fertility will be much more complex and involve greater government activism, improved institutional capacities and more resources than in the past. This paper reviews the fertility transition in Thailand and looks at some consequences and policy implications of low fertility, with special reference to the family and the elderly population. National Statistical Office     

中国的家庭结构转变--来自居住方式与人口因素的作用

基于历次人口普查数据,利用SOCSIM微观模拟方法将家庭转变的关键影响因素分解为人口因素和居住方式因素两个方面,并进一步将人口因素分解为人口惯性、生育率、死亡率和结婚率四个层面进行计量分析.结果发现,当前人口变动相对稳定,较小的波动使其在家庭转变中的贡献率相对较小,而居住方式的影响相对较大;对人口因素的进一步分解还发现,人口惯性及生育率水平的作用相对更大,生育率水平、结婚率水平带来的影响与人口因素的总影响方向是一致的,均提高了一人户、一代户、二代户的人口比重,降低了三代及以上户的人口比重.与之相反,死亡率的影响与人口因素的总影响方向是相反的.     

基于调研数据的总和生育率发展趋势及影响因素分析——来自湖北鄂州、黄石、仙桃的调查数据

文章基于5490份有效问卷的调查数据对湖北省总和生育率（TFR）进行分析。结论表明,自1985年以来年龄别生育率下降主要原因是计生政策严格控制生育数量,而非生育行为的推迟。TFR呈现先快速下降后缓慢上升的趋势,其变化与高生育水平育龄妇女占比无关。与政策生育率变化有关。通过对湖北省总出生人数进行估算和分析,结论表明1985—2008年总和生育率对总出生人数的影响程度要大于高生育水平育龄妇女占比的影响;外推预测表明2009～2014年出生人数趋势稳定,2015年以后呈下降趋势。利用Logit模型对实际生育水平的影响因素进行分析,发现有显著影响的因素为：受访者文化程度、户口性质、出生年代、工作状态、丈夫工作状态、放宽的计生政策和奖励少生的计生政策。     

生育转型、性别平等与香港生育政策选择

香港是世界上生育率水平最低的超低生育率地区之一。低生育率现象是个体导向的社会机制所倡导的两性平等与家庭导向的社会机制在事实上的性别不平等之间强烈冲突的结果。“有偿养育计划”也许是刺激那些有多生倾向的家庭把生育意愿转变为实际生育行为的有效途径。     

Modelling period fertility: Schooling and intervals following a birth in Eastern Africa

We describe a regression-based approach to the modelling of age-, order-, and duration-specific period fertility, using retrospective survey data. The approach produces results that are free of selection biases and can be used to study differential fertility. It is applied to Demographic and Health Survey data for Ethiopia, Kenya, Tanzania, and Zimbabwe to investigate differential trends in fertility by education. Parity progression fell and the intervals following each birth lengthened between the 1970s and 2000s in all four countries. Fertility fell most among women with secondary education. In contrast to other world regions, postponement of successive births for extended periods accounted for much of the initial drop in fertility in these African countries. However, family size limitation by women with secondary education in Ethiopia and Kenya and longer birth spacing in Zimbabwe also played significant roles. Thus, birth control is being adopted in Eastern Africa in response to diverse changes in fertility preferences.     

Subjective Well-Being,Poverty and Ethnicity in South Africa: Insights from an Exploratory Analysis

South Africa has one of the highest inequality levels in the world. In 1993, nearly half of the population were considered poor. These poverty and inequality levels were and still are a legacy of South Africa’s colonial and apartheid past. Since the end of apartheid, there has been a strong governmental effort to combat poverty and in this light a ‘social indicators movement’ has emerged. The aim of this article is to contribute to the South African social indicators research in three ways: Firstly, this article introduces ethnicity as a unit of analysis in the context of poverty and well-being. It is argued that racial categorisations are not justifiable and in the case of South Africa hide valuable insights. The results of an exploratory analysis suggest that ethnicity allows a more insightful analysis of poverty and well-being than race. Secondly, this article introduces a multiple correspondence analysis (MCA) in the context of subjective well-being research. Many studies regarding subjective well-being in South Africa use ordered probit regression models. It is argued here that these models are based on false assumptions and that a MCA can be seen as a suitable alternative since it constitutes an assumption free model. Lastly, the insights gained from the exploratory analysis are discussed. The MCA seems to show that subjective well-being can be regarded as an outcome measure. Furthermore, it is argued that there are cultural differences (between the ethnic groups) regarding subjective well-being. It seems that the ethnic groups in South Africa have different conceptions of well-being and that different factors influence their subjective well-being assessments. This work is partly based on a Master thesis from 2004 at the Institute for Development Policy and Management at the University of Manchester. I am grateful for the intellectual guidance, the constant support and encouragement by Wendy Olsen and for the comments on earlier drafts from Peter Edward, David A. Clark and two anonymous reviewers.     

Additional Work,Family Agriculture,and the Birth of a First or a Second Child in Russia at the Beginning of the 1990s

At the beginning of the transition period, many Russian households faced substantial economic hardships and uncertainties. An economic downturn had become one of the major factors responsible for the significant and rapid decline of Russian fertility. However, many households tried to cope with this situation by engaging in multiple income generating activities and the cultivation of food on private plots of land. The question therefore arises whether these activities had a positive impact on fertility decisions. This paper explores the association between additional employment or subsistence measures (second jobs, part-time self-employment, and part-time family agriculture) and the probability to have a first or a second child in Russia during 1990 and the spring of 1993. Data from 966 respondents from the Russian component of the survey Social Stratification in Eastern Europe after 1989: General Population Survey show that activities that generate an additional income were positively associated with the birth of a second child. This is especially the case if these activities produce half of a respondent's or her household's income. The birth of a second child was also positively associated with the fact that a household consumed food that was cultivated by the household itself. However, none of these activities was significantly connected with the birth of a first child.     

The translocal villagers. Mining,mobility and stratification in post-apartheid South Africa

Internal labour migration from rural areas to urban centres has been and remains one of the dominant patterns of migration in South Africa. Based on data from ethnographic field research, this paper explores the mobility patterns and translocal relations of miners in the Northern Cape province of South Africa. By considering the tension between mobility and locality in a historical and political perspective, the concept of translocality helps to explain why miners try to expand their action space and, at the same time, why they are embedded in certain places. Thus, a translocal perspective enhances the interpretation of the spatio-temporal transformations in South Africa’s mining communities and beyond, as it sheds light on the agency of mine workers, superseding merely structuralist explanations.     

Stabilization,birth waves,and the surge in the elderly*

Substantial regularities characterize the transition to stability that follows a shift from one set of vital rates to another. The new vital, rates interact with the population's initial age composition and generate birth waves whose amplitude and attenuation depend on the ratio of ultimate to initial growth and on the new pattern of stable net maternity. A greater change in growth and a later stable net maternity pattern produce larger fluctuations in the number of births. Stabilization begins at the youngest ages and proceeds upward. Sixty years after the shift, the birth waves have largely disappeared and the proportion under age 15 approximates the stable level implied by the new rates. Those patterns are manifest in the stabilization of both observed and Coale‐Demeny model stable populations.

When fertility falls, the new stable population has a larger fraction at all ages above (approximately) 30, with greater changes characterizing the extremes of life. Fifteen years after the fall, there is a trough in the number at ages 0–14. Sixty years after the fall, when the largest pre‐decline cohort is age 60–74 and the smallest post‐decline cohort is age 45–59, there is a surge in the relative size of the elderly population. Thus after two generations, the birth waves produced by a rapid decline in fertility accentuate the effects of population aging.     

The role of intergenerational transfers,land, and education in fertility transition in rural Kenya: the case of Nyeri district

This qualitative study reveals how population pressures, land availability, inheritance norms, and educational opportunities intertwine to influence fertility decline in rural Kenya. Focus group discussions with men and women whose childbearing occurred both before and after the onset of rapid, unexpected fertility transition in Nyeri, Kenya allowed individuals who actually participated in, or witnessed, the fertility transition to “voice” their perceptions as to the mechanisms underlying the transition. Findings suggest that, since land inheritance is a cultural norm, land scarcity and diminishing farm size often influence fertility decision-making and behavior via preferences for fewer children. Further, education does not appear to be the driving cause of fertility behavior change, but rather is adopted as a substitute for land inheritance when land resources are scarce. These findings have implications for our understanding of fertility behavior as well as for improving predictions of fertility transition in other rural sub-Saharan African contexts.     

Gender differences in the associations of self esteem, stress and social support with functional health status among older adults with heart disease

This study explored and compared the role of self esteem, stress and social support in maintenance or improvement in physical and psychosocial functioning over 12 months in older men and women with cardiovascular disease. Data from 502 adults over 60 years of age showed that self esteem and stress were both significantly associated with functioning when demographic and clinical factors were controlled. Men were significantly more likely than women to maintain or improve in functioning. Self esteem, stress, compliance with medication regimens, and marital status were significantly associated with maintenance or improvement of functioning among women. Only age and stress were significantly associated with maintenance or improvement in functioning among men. Findings indicated that: (1) stress and self esteem were stronger predictors of functioning, especially among women, than demographic and clinical factors; and (2) women in the highest quartile of the self esteem distribution were approximately five times as likely to maintain or improve their functioning as women in the lowest quartile.     

Reported excellent health among men in same-sex and mixed-sex couples: Behavioral Risk Factor Surveillance System, 1993-2010

Self-reported excellent health was examined across sexual orientation among male adult couples using 18 years of data from the Behavioral Risk Factor Surveillance System. Men in same-sex couples were more likely to report being in excellent health (28.7%) than men in unmarried and married mixed-sex couples (20.4% and 23.2%). After adjusting for other demographic and health factors, men in same-sex couples remained more likely to report excellent health than men in unmarried mixed-sex couples, but not than men in married mixed-sex couples. Reporting only adverse health disparities provides a partial picture of sexual minority health, and discounts the role of resilience and other health promoting factors in these populations.     

The Best and Worst Times of Life: Narratives and Assessments of Subjective Well-Being by Anamnestic Comparative Self Assessment (ACSA) in the Eastern Cape,South Africa

The Anamnestic Comparative Self Assessment (ACSA) measure of subjective well-being (SWB) aims to reduce the problems of cultural bias and relativity to external standards by allowing people to define the endpoints or ‘anchors’ of the measurement scale. In medical terminology anamnestic denotes ‘based on memory’. The ACSA uses subjects’ memories of the best and worst periods in their lives to define the anchors of the scale. They then assess their current quality of life relative to these personal anchors. The South African pilot study tested the match between self-assessment of SWB with ACSA and the conventional single-item measures of life satisfaction and happiness used in the South African Quality of Life Trends Study and analysed the narratives of the best and worst times of life. The quota sample of 46 consisted of 26 residents of Makana district in the Eastern Cape Province, South Africa, and 20 patients undergoing treatment in the local TB hospital. Mean SWB ratings with all three measures of life satisfaction, happiness and ACSA were between 5 and 6 on a 0–10-point scale. Ratings on all three scales were positively correlated. However, on ACSA the TB patients rated their current SWB 1.84 points lower than the community respondents, suggesting a greater sensitivity of this measure. It was observed that the starting points of the life stories produced by respondents to define the anchor periods for ACSA were related to their current assessment of SWB. A typology was developed that combined the starting point of the life stories with current SWB. The majority of community respondents matched the ‘Achiever’ type who scored positively on ACSA (i.e., above the mid-point of the scale) and whose life stories started with the worst period of their lives and proceeded to the best period. The TB patients were the only respondents to represent the ‘Survivor’ type whose morale had recovered after misfortune in life. ‘Survivors’ started their narratives with the best period in their lives, then moved to the worst (often health-related) one, and gave positive ACSA ratings. Based on the qualitative analysis of narratives, it is concluded that ACSA is a sensitive measurement instrument and therefore particularly useful for monitoring the effects of treatments and social interventions in longitudinal studies. However, further research is required to verify its cross-cultural validity.