Childhood Adversities and Unmet Needs of Older Chinese Adults: The Mediation Effects of Family Relationships.

Bo Hu,Mingyu Wei

doi:10.1177/01640275211048237

Abstract

Ensuring equality and adequacy of care for older adults is vitally important. This study investigates the relationships between childhood adversities and unmet long-term care needs of older adults in China and the mediation effects of family relationships. The data came from a nationally representative sample of older Chinese adults aged 60 and over with long-term care needs (N = 2186). We conducted mediation analyses and decomposed the total effects of childhood adversities on unmet needs into direct and indirect effects. The probability of unmet needs is significantly higher among older adults experiencing childhood adversities. Satisfaction with marriage mediates the association between childhood adversities and unmet personal care needs. Relationships with children mediate the association between childhood adversities and unmet domestic care needs. The causes of unmet needs can be traced back to early life, which underscores the importance of concerted efforts in family, education and long-term care policies to tackle unmet needs.

Highlights

Long-term care involves assistance and services that help people perform daily activities such as dressing, eating and cooking and is crucial for older adults who experience a loss of functional capability in later life
For married older adults with ADL care needs, more childhood adversities were significantly associated with a poorer relationship with their spouse (OR = 1.12, P-value = .025), and poorer relationships were significantly associated with a higher probability of unmet needs (OR = 1.27, P-value = .028)
We found that even after we control for those factors, the association between childhood adversities and unmet needs remain statistically significant

Summary

Introduction

Long-term care involves assistance and services that help people perform daily activities such as dressing, eating and cooking and is crucial for older adults who experience a loss of functional capability in later life. Due to global population ageing, demand for long-term care is set to rise rapidly worldwide. In the case of China, there are currently 250 million older adults aged 60 and over, accounting for 18% of the total population. Chinese society faces a plummeting supply of care from family members as the impact of the one-child policy implemented in the 1980s starts to materialise and the average household size continues to decrease (Zeng et al, 2013). Ensuring the adequacy of longterm care for older adults is currently at the top of the Chinese government’s agenda (Peng et al, 2015)

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Conclusion