Childlessness and vulnerability of older people in China.

Zhixin Feng

doi:10.1093/ageing/afx137

Abstract

Backgroundthe number of childless older people is increasing in China, but relatively little is known about the role of childlessness in health outcomes. This study investigates the relationship between childlessness and three health outcomes: difficulty with Instrumental Activities of Daily Living (IADLs), self-rated health and depression.Methodsthis study includes 13,171 individuals aged 50 and above from national survey data of the second wave of the China Family Panel Study (2012). Binary/multinomial logistic and ordinary least squares regression models are presented.Resultschildless individuals whose children have all died exhibit worse health outcomes than individuals with children, but this effect is influenced by demographic characteristics, socio-economic status and social security. On the other hand, individuals who are childless due to other reasons (involuntary or voluntary) are less likely to report difficulty with IADLs and to report depression than older people with all children alive after controlling for demographic and socio-economic and social security factors.Conclusionsthe death of a child has an adverse effect on people’s health for both childless people whose children have all died and those who have lost a child but have other children alive. These two groups are in the most vulnerable position, which could also suggest that their children have died because they grew up in a vulnerable family. The government needs to improve the social security for these two groups and provide social services (particularly mental health services) to older people who have lost a child; these could contribute to alleviating some of the adverse effects of the death of a child.

Highlights

Along with an increasing ageing population, the number of childless older people in China has increased
Older people whose children have all died and those who have lost a child but still have at least one living child are more likely than their counterparts with all their children alive or people who are childless due to other reasons to report difficulty with IADLs, poor self-rated health (SRH) (Pearson chisquared
Older people whose children have all died and those who have lost a child but still have at least one living child are in the most vulnerable position, as they are older, live in rural areas (75% and 80%, respectively), have a lower level of education (68% and 69%, respectively, are illiterate/semi-literate), are less likely to have an income (70% and 80%, respectively) and are less likely to receive a pension after retirement age, compared with older people with all children alive and those who are childless for other reasons

Summary

Introduction

Along with an increasing ageing population, the number of childless older people in China has increased. From a sociological and economic perspective, involuntary and voluntary childlessness could have positive effects on peoples’ health status if individuals have enjoyed a higher personal consumption (i.e. healthcare) and less pressure to earn an income due to not devoting a significant portion of their income to support children, and avoiding stressors or health issues associated with parenting [6]. Childless persons may have more assets and a higher disposable income, which allows them to afford better health care and health insurance, and can more pay for household services in old age than their counterparts with children [7, 8]. Childless older people have been found to have worse health behaviours

Objectives

Methods

Results

Conclusion