Jung-Hwa Ha Seoul National University. Presentation at NYU Aging Incubator November 8, 2018

Similar documents
Facts and trends in sexual and reproductive health in Asia and the Pacific

UNIVERSITI TEKNOLOGI MARA ELECTRICITY CONSUMPTION AND ECONOMIC GROWTH IN ASEAN COUNTRIES

Illicit drug markets in Asia: Focus on East and SE Asia

Towards an ASEAN Community Guest Lecture

JOINT STATEMENT OF ASEAN PLUS THREE HEALTH MINISTERS SPECIAL MEETING ON EBOLA PREPAREDNESS AND RESPONSE Bangkok, Thailand, 15 December 2014

THE MACAO OUTCOME DOCUMENT

Southeast Asia and China FMD Campaign

The Relationships between Temperature, Rainfall and the Incidence Rate of Malaria in South East Asia: A Panel Data Analysis

Progress, challenges and the way forward in ASEAN Member States

Health Security. Supamit Chunsuttiwat Ministry of Public Health

ASEAN and the Changing Geopolitics of Southeast Asia

The Trilateral FTA: A Pillar of Trilateral Cooperation and East Asia Economic Integration

Initiatives of ASEAN in Promoting an Active Ageing Society. Edgar Gonzales Pato ASEAN Secretariat Tokyo, Japan December 3-5,2013

SECTOR ASSESMENT (SUMMARY): HEALTH

aids in asia and the pacific

Gender Equality and the Sustainable Development Goals in Asia and the Pacific

14 th International Conference of Drug Regulatory Authorities : Progress report from the Western Pacific Region

Nutritional interventions for the prevention of cognitive impairment and dementia in East Asia. A systematic review (and meta-analysis)

ASEAN Declaration of Commitment on HIV and AIDS: Fast-Tracking and Sustaining HIV and AIDS Responses To End the AIDS Epidemic by 2030

Chapter 6 Facilitating the Movement of Qualified Dental Graduates to Provide Dental Services Across ASEAN Member States

AIDS Funding Landscape in Asia and the Pacific

Asia s Diabetes Challenge

FMD Control in South East Asia: science based approach to development of roadmaps and PVS Tools to support capacity building.

Cross-Border Cooperation in the Global Fight against Communicable Diseases

Dengue Situation Update Number Update on the Dengue situation in the Western Pacific Region

ASEAN+3 FETN. ASEAN Plus Three Field Epidemiology Training Network

What is the status of child obesity worldwide and in the South East Asia Region?

Overview of ATS trends in East and Southeast Asia

Toshihiko Osawa World Customs Organization

Professor Glen Mola Head of Reproductive Health, Obstetrics and Gyneology School of Medicine and Health Sciences, UPNG

Trends in Second-Hand Tobacco Smoke Exposure Levels at Home among Viet Nam School Children Aged and Associated Factors

Dengue Situation Update Number Update on the Dengue situation in the Western Pacific Region

Overview of ATS trends in East and Southeast Asia

Update on the Dengue situation in the Western Pacific Region

TB Disease Prevalence Survey - Progress Report

Executive Board of the United Nations Development Programme and of the United Nations Population Fund

SEACFMD ACTIVITIES FOCUS ON

Leaving no one behind in Asia and the Pacific. Steven J. Kraus Director UNAIDS Regional Support Team, Asia and the Pacific 28 th January 2015

This presentation discusses

HIV / AIDS & HUMAN RIGHTS

South East Asia and China FMD Campaign

Health Behavioral Patterns Associated with Psychologic Distress Among Middle-Aged Korean Women

Population Geography Class 2.2

Global and Regional Strategies for HPAI and CSF

A/P Regional Capacity Building Approach Overview

The Global S.M.A.R.T. Programme: Synthetics Monitoring: Analysis, Reporting and Trends. ATS trends, programme progress and planned expansion

Regional Cooperation Initiatives: FAO Updates Food and Agriculture Organization of the United Nations Regional Office for Asia and the Pacific

Perspective from ASEAN: WHO support activities. Health and Communicable Disease Division, ASEAN Secretariat

MALARIA INFECTION AMONG THE MIGRANT POPULATION ALONG THE THAI-MYANMAR BORDER AREA

TB Disease Prevalence Survey - Overview and Introduction of the TF

Update on the Dengue situation in the Western Pacific Region

Framing ASCC Post-2015

ASEAN Mental Health Task Force (AMT)

The role of diet on nutrient bioavailability: Issues for habitual diets of Asian countries

Estimating Incidence of HIV with Synthetic Cohorts and Varying Mortality in Uganda

Update on the Dengue situation in the Western Pacific Region

6 July 2012, Phuket, Thailand

Democracy & Gender in Asia. Kuniko INOGUCHI, Ph.D. Minister of State for Gender Equality and Social Affairs, Japan

Asia: Portrait of a Changing Region

Mekong Basin Disease Surveillance (MBDS) Network

Extended Abstract: Background

The EAP Umbrella Facility for Gender Equality: Approach and Activities

ASEAN+3 Countries Field Epidemiology Training Network. 24 th January 2011 Holiday Inn, Bangkok, Thailand

Depression and Factors Associated with the Quality of Life among the Elderly in Numpong and Somsoong District, Khonkean Province, Thailand

Dengue Situation Update Number 534. Update on the Dengue situation in the Western Pacific Region

Antibiotic use in Southeast Asia: Research experiences of a social scientist

Update on the Dengue situation in the Western Pacific Region

Professor Claire Wallace Professor Pamela Abbott

Every year, on average, the ASEAN region experiences losses related to natural disasters estimated at US$ 4.4 billion*

Globalization & its Impact on Youth Health in Asia. Cai Cai Social Affairs Officer Health and Development Section Emerging Social Issues Division

Report of the Study Group for Japan s International. Contribution to Active Aging. (Original in Japanese) Summary. March 2014

Essential Medicines. WHO

Strengthening Veterinary Services in Asia

HIV Resource Allocations using AEM

Preventing HIV Transmission in Intimate Partner Relationships

Ending the AIDS epidemic by 2030

Disparities in access: renewed focus on the underserved. Rick Johnston, WHO UNC Water and Health, Chapel Hill 13 October, 2014

N. BUNYAPRAPHATSARA. ASEAN Harmonization on Traditional Medicine and Health Supplement Registration Requirement

The impact of economic crisis on suicide in Asia and other regions.

Update on the Dengue situation in the Western Pacific Region

How Does Women s Empowerment Affect Fertility Preference? A Cross-Country Study of Southeast Asia

Thailand and Family Planning: An overview

Loneliness in Older Adults

SDG Target 16.1 Measuring the prevalence of physical, psychological and sexual violence

The Western Pacific Region faces significant

General Information Booklet on the ASEAN Harmonised Cosmetic Regulatory Scheme

Getting to zero HIV new infections in Asia and the Pacific region: Possible or impossible dream?

Meeting the chronic disease challenge: high level regional workshop. Dr. Kenneth Thorpe. Jakarta, Indonesia

ASEAN Experience: Initiative for ASEAN Integration (IAI) and Narrowing the Development Gap in Health

ECONOMIC AND FINANCIAL ANALYSIS

Update on the Dengue situation in the Western Pacific Region

Help seeking behavior among Malaysian international students in Australia

WORLD HEALTH ORGANIZATION

POTENTIAL TECHNOLOGIES TO SOLVE COMMON HEALTH PROBLEMS IN SOUTH EAST ASIA COUNTRIES

ASEAN Health Supplements Regulatory Harmonisation Update

Update on the Dengue situation in the Western Pacific Region

Understanding Today s Probiotics Regulations in South East Asia. Wai Mun Poon Regulatory Affairs Consultant

2015 KUALA LUMPUR DECLARATION ON THE ESTABLISHMENT OF THE ASEAN COMMUNITY

WCPT COUNTRY PROFILE December 2017 JAPAN

PROJECT DOCUMENT. Cooperative Agreement for Preventing the Spread of Communicable Diseases through Air Travel (CAPSCA)

Transcription:

Jung-Hwa Ha Seoul National University Presentation at NYU Aging Incubator November 8, 2018

Collaborators Dr. Bussarawan Teerawichitchainan, Singapore Management University Dr. John Knodel, University of Michigan

Study background and objectives Conceptual framework Data and measures Results Overview Implications and Conclusion

4

Does childlessness affect older adults social and psychological well-being in East and Southeast Asia?

Dramatic decline in fertility across E and SE Asia Total fertility rates in East and SE Asia, 1960-65 and 2010-15 9 8 7 6 5 5.6 6.2 5.1 6.1 1960-1965 2010-2015 6.7 6.4 6.4 6.1 5.6 7.0 6.0 7.0 4 3 2 1 2.0 1.4 1.2 1.6 1.2 1.5 1.9 2.0 2.1 2.3 2.5 2.7 3.0 3.1 0 Japan South Korea East Asia China Singapore Thailand Brunei Viet Nam Malaysia Myanmar Southeast Asia Indonesia Cambodia Lao PDR Philippines 7

Source: UNESCAP (2018) 8

Number and Percent of Migrants in China, 1982 2010 (Lu & Xia, 2016) 9

Smaller family size and increased migration resulted in changing living arrangements of older persons Sources: 1986-2017 Surveys of Older Persons in Thailand 10

Percent of older adults 65+ residing with their adult children (Yasuda, Iwai, Yi, & Xie, 2011, p.704) 11

Research Questions What are the prevalence and dimensions of childlessness in S. Korea, China, Thailand, Vietnam, and Myanmar? Actual childlessness (elderly without children) De-facto childlessness (elderly whose all children migrated elsewhere) Does childlessness contribute to the wellbeing of older persons in East and Southeast Asia? Specifically, we examine the extent to which actual and defacto childlessness are associated with (a) social isolation and (b) loneliness Are these effects moderated by gender and wealth? 12

Conceptual framework Childlessness as a source vulnerability Children often provide emotional, instrumental, and financial support to older parents Alternative sources of support are often not present or underdeveloped in study countries Lack of children may be linked to limited access to other social resources or fewer social networks Geographic distance to children may limit the extent to which children can provide emotional and instrumental support Negative effects of both actual and de-facto childlessness on older adults psychological and social well-being 13

Conceptual framework Alternative hypotheses Childless older adults may have accumulated more financial resources and social networks outside their immediate family no effect of actual childlessness on social isolation Improved technology may help older adults maintain contact with their children (intimacy at distance), and it may have minimal effects on older adults loneliness. Older adults may also have more time to interact with others. no effect of de-facto childlessness on social isolation or loneliness

Moderating effects of gender and Wealth Gender Given greater stigma of childlessness (especially infertility) and fewer opportunity to engage in labor force, women may be more negatively affected by childlessness Alternatively, older women s stronger informal social networks may mitigate the negative effect of childlessness Wealth Those who have greater financial resources may be less negatively influenced by childlessness. 15

Why these five countries? Similarities Filial piety emphasized as cultural and social norm High rates of migration especially in Southeast Asian countries and China Differences Age structure and fertility rate Stage of economic development Availability of social security and other policy measures for older adults 16

Country settings % 60+, 2015 % 60+, 2050 TFR, 2010-15 GDP per capita, 2 016 S. Korea China Thailand Vietnam Myanmar 18.4 15.4 15.6 10.3 8.9 41.6 35.1 35.1 28.3 18.5 1.23 1.60 1.53 1.96 2.30 $27,539 $8,123 $5,908 $2,186 $1,275 17

Data sources Samples of persons aged 60 and over 2012 Korean Longitudinal Study of Aging (KLoSA) 2011 China Health and Retirement Longitudinal Study (CHARLS) 2011 Survey of Older Persons in Thailand (SOPT) 2011 Vietnam Aging Survey (VNAS) 2012 Myanmar Aging Survey (MAS) 18

Measures - Dependent variables Social isolation index Assessed with social participation/activity data Sum of [whether or not participated (1/0) in each activity x frequency of participation (4 = did not participate, 0 = almost everyday)] was used. Activities differed across countries so we converted the scores into percentiles. (higher score = higher social isolation) Loneliness Assessed with question asking the extent to which older persons felt lonely during the past month prior to the survey. Responses were dichotomized (1= always ~ some of the time, 0 = never)

Childlessness Measures - Independent variables Reference category: older adults living with or close to (same village, city, ward, or county) their children De-facto childlessness (older adults whose all children migrated elsewhere) Actual childlessness (older adults without children) Moderating variables: gender (1= female) and wealth (higher=greater wealth) Control variables: age, marital status, education, pension and work status, place of residence (urban/rural), self-rated health, living arrangement

Prevalence of childlessness 21

Prevalence of childlessness 22

Multivariate analyses DV: social isolation (Main effects) *** p<0.001, ** p<0.01, * p<0.05 Notes: OLS regression models are used. Standardized coefficients are presented. The analyses control for socio-demographic characteristics. 23

DV: social isolation (interaction effects) *** p<0.001, ** p<0.01, * p<0.05 Notes: OLS regression models are used. Standardized coefficients are presented. The analyses control for socio-demographic characteristics. 24

DV: loneliness (main effects) *** p<0.001, ** p<0.01, * p<0.05 Notes: Binomial logistic models are used. Odds ratios are presented. The analyses control for sociodemographic characteristics. 25

DV: loneliness (interaction effects) *** p<0.001, ** p<0.01, * p<0.05 Notes: Binomial logistic models are used. Odds ratios are presented. The analyses control for sociodemographic characteristics. 26

Summary of findings: Social isolation Actual childlessness increases social isolation in Thailand, Vietnam, and Myanmar but not in S. Korea and China In all study countries, levels of social isolation among the defacto childless is comparable to those with children living nearby Children s migration does not have negative influence on older persons social wellbeing Economic support from migrant children may enable older adults to remain socially active Increased availability and affordability of technology (e.g., mobile phones, internet, improved roads) likely allow the de-facto childless to be engaged in community activities. 27

Summary of findings: Loneliness Actual and de-facto childlessness are related to increased odds of loneliness in all study countries except China Both types of childlessness may have detrimental consequences for older adults psychological wellbeing even though they may not have a significant effect on social wellbeing Adult children and friends of older adults play different roles Social connectedness may be fulfilled by friends but children may have a unique role which cannot be substituted with other resources. Asia: Filial piety is considered as both cultural value and social status. 28

Discussion Childless older persons in China are quite resilient. They do not differ from those with children nearby with regards to loneliness and social isolation Accustomed to living without children and established ways to maintain social connection beyond parent-child network? Although the current generation of older adults may not have been directly affected by the one-child policy, dramatic economic growth and subsequent migration of young adults to urban areas may have normalized childlessness Long history of working together as commune members may buffer the effect of childlessness Alternatively, it may be due to differences in social participation measures 29

Gender and wealth matter Discussion Being female mitigates the effects of childlessness on social isolation and loneliness Effects of wealth differ across outcomes and across countries Greater wealth helps defacto childless elderly Thais to be socially engaged but they feel lonelier than those who are de-facto childless and have less wealth Wealth does not always lead to greater social embeddedness More research is necessary to understand the mechanisms through which wealth creates divergent experiences of childless older persons in different settings. 30

Limitations Lack of data on reasons for actual childlessness Did not account for whether or not childlessness is voluntary Childlessness may have different meanings for married vs. never-married older adults Challenges in harmonization of key variables De-facto childlessness measure doesn t account for: Frequency of contact Amount of emotional, instrumental, and financial support exchanged

Cause of childlessness (Case of China) lives nearby Intimacy at distance Defacto childless Actual childless Total Married 5,057 204 136 92 5,489 Partnered 245 19 15 5 284 Separated 45 0 2 3 50 Divorced 35 1 5 5 46 Widowed 1,419 19 35 33 1,506 Never married 8 0 1 62 71 Total 6,809 243 194 200 7,446 Due to infertility or loss of children Never had children Specific information on the cause of childlessness is not ascertained in most population-based surveys.

Improved children availability typology Reference group: Elderly coresiding with children or having children nearby Intimacy at distance: Elderly whose all children migrated elsewhere but remain in frequent (weekly) contact with children De-facto childlessness: Elderly whose all children migrated elsewhere and have little or no contact with children Actual childlessness: Elderly without children 33

Availability of children % distribution China Korea Thailand Vietnam Myanmar Children nearby 91.7 87.7 75.9 85.5 88.9 Intimacy at distance 2.6 3.0 10.7 8.8 1.0 Defacto childless 2.0 7.0 7.0 1.0 3.3 Actual childless 2.7 2.3 6.4 4.7 6.8

Conclusions Childlessness is associated with greater loneliness in most countries, yet it does not always have a detrimental effect on later-life social well-being. Childlessness generally take a toll on older persons lives through feelings of loneliness Greater social isolation among childless elders in SE Asia, although similar effects were not found in E Asia Findings point to the importance of distinguishing between actual and de facto childlessness 35

Conclusions Our contribution: First study to compare the prevalence an implications of actual and de-facto childlessness across E and SE Asia. Implications of childlessness will become even more salient in the future, as mid-aged adults with fewer or no children enter old age.

37