The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

Yazhen Yang,Maria Evandrou,Athina Vlachantoni

doi:10.1017/s0144686x21000702

Abstract

AbstractResearch to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

Highlights

Population ageing is one of the most significant trends and challenges of the 21st century
Older people in rural areas were more likely to co-reside with their adult children compared to their urban counterparts, whilst the proportion of older people living near adult children did not show significant differences
The results show that the direction of the association between the living arrangements with adult children and the exchange of economic and social support was similar for older people in rural and urban areas (Figure 3a)

Summary

Introduction

Population ageing is one of the most significant trends and challenges of the 21st century. China is a unique context for studying population ageing, characterised by the largest absolute number of older people in the world, a massive rural to urban migration trend, and its Confucius culture and family-centred traditions (Ao et al, 2016; Ministry of Civil Affairs, 2018). 250 million people were aged 60 or over by the end of 2018, which accounted for 17.9 per cent of the total population in China (NBS, 2019). Another characteristic of China lies in the remarkable rural and urban differences in terms of economic and cultural development, employment opportunities and public facilities (The Statistics Portal, 2015). Since the reform and opening-up policy in 1979, the urban areas of China have accumulated greater wealth, capital, innovative enterprises and public services, and have attracted a better-educated and -trained labour force than rural areas, as the former are influenced by higher levels of economic growth, and by a more enhanced process of social development and city strategy (Qiu et al, 2013)

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