Gender and Aging in the Developing World: Where Are the Men?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73312/1/j.1728-4457.2003.00677.x.pd

Characteristics of physical measurement consent in a population-based survey of older adults

BACKGROUND: Collecting physical measurements in population-based health surveys has increased in recent years, yet little is known about the characteristics of those who consent to these measurements. OBJECTIVE: To examine the characteristics of persons who consent to physical measurements across several domains, including one’s demographic background, health status, resistance behavior toward the survey interview, and interviewer characteristics. RESEARCH DESIGN, SUBJECTS, AND MEASURES: We conducted a secondary data analysis of the 2006 Health and Retirement Study, a nationally-representative panel survey of older adults aged 50 and older. We performed multilevel logistic regressions on a sample of 7,457 respondents who were eligible for physical measurements. The primary outcome measure was consent to all physical measurements. RESULTS: Seventy-nine percent (unweighted) of eligible respondents consented to all physical measurements. In weighted multilevel logistic regressions controlling for respondent demographics, current health status, survey resistance indicators, and interviewer characteristics, the propensity to consent was significantly greater among Hispanic respondents matched with bilingual Hispanic interviewers, diabetics, and those who visited a doctor in the past 2 years. The propensity to consent was significantly lower among younger respondents, those who have several Nagi functional limitations and infrequently participate in “mildly vigorous” activities, and those interviewed by black interviewers. Survey resistance indicators, such as number of contact attempts and interviewer observations of resistant behavior in prior wave iterations of the HRS were also negatively associated with physical measurement consent. The propensity to consent was unrelated to prior medical diagnoses, including high blood pressure, cancer (excl. skin), lung disease, heart abnormalities, stroke, and arthritis, and matching of interviewer and respondent on race and gender. CONCLUSIONS: Physical measurement consent is not strongly associated with one’s health status, though the findings are somewhat mixed. We recommend that physical measurement results be adjusted for characteristics associated with the likelihood of consent, particularly functional limitations, to reduce potential bias. Otherwise, health researchers should exercise caution when generalizing physical measurement results to persons suffering from functional limitations that may affect their participation

Gender Differences in Economic Support and Well-Being of Older Asians

This report provides a comprehensive analysis of gender differences in economic support and well-being in eight countries in Southern and Eastern Asia (Bangladesh, Malaysia, Indonesia, Singapore, Thailand, Vietnam, Philippines, and Taiwan). We examine multiple economic indicators, including sources of income, receipt of financial and material support, income levels, ownership of assets, and subjective well-being. Results show substantial variation in gender differences across indicators and provide an important qualification to widely held views concerning the globally disadvantaged position of older women. Whereas men tend to report higher levels of income than women, there is generally little gender difference in housing characteristics, asset ownership, or reports of subjective economic well-being. Unmarried women are economically advantaged compared to unmarried men in some respects, in part because they are more likely to be embedded in multigenerational households and receive both direct and indirect forms of support from family members.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42986/1/10823_2004_Article_487430.pd

Comparing Models of Frailty: The Health and Retirement Study

To operationalize and compare three models of frailty, each representing a distinct theoretical view of frailty: as deficiencies in function (Functional Domains model), as an index of health burden (Burden model), and as a biological syndrome (Biologic Syndrome model). DESIGN : Cross-sectional analysis. SETTING : 2004 wave of the Health and Retirement Study, a nationally representative, longitudinal health interview survey. PARTICIPANTS : Adults aged 65 and older (N=11,113) living in the community and in nursing homes in the United States. MEASUREMENTS : The outcome measure was the presence of frailty, as defined according to each frailty model. Covariates included chronic diseases and sociodemographic characteristics. RESULTS : Almost one-third (30.2%) of respondents were frail according to at least one model; 3.1% were frail according to all three models. The Functional Domains model showed the least overlap with the other models. In contrast, 76.1% of those classified as frail according to the Biologic Syndrome model and 72.1% of those according to the Burden model were also frail according to at least one other model. Older adults identified as frail according to the different models differed in sociodemographic and chronic disease characteristics. For example, the Biologic Syndrome model demonstrated substantial associations with older age (adjusted odds ratio (OR)=10.6, 95% confidence interval (CI)=6.1–18.5), female sex (OR=1.7, 95% CI=1.2–2.5), and African-American ethnicity (OR=2.1, % CI=1.0–4.4). CONCLUSION : Different models of frailty, based on different theoretical constructs, capture different groups of older adults. The different models may represent different frailty pathways or trajectories to adverse outcomes such as disability and death.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66063/1/j.1532-5415.2009.02225.x.pd

Changes in Subjective and Objective Measures of Economic Well-Being and Their Interrelationship among the Elderly in Singapore and Taiwan

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43698/1/11205_2004_Article_392943.pd

Reciprocal effects of health and economic well-being among older adults in Taiwan and Beijing

The objectives of this Population Council study are threefold: 1) to examine whether socioeconomic status disparities in health are found in non-Western settings; 2) to assess whether socioeconomic status gradients in health endure into older ages; and 3) to evaluate the direction of causality between health and socioeconomic status. Findings provide evidence for reciprocal effects of economic well-being and health among older adults in both Taiwan and Beijing. Those with higher levels of economic well-being have lower levels of functional limitation over time, and those with higher levels of functional limitation have lower levels of economic well-being over time. Consistent with studies based in the United States and Europe, findings from Asia indicate economic differentials in functional health among older adults, highlighting the wider applicability of these associations across settings with very different systems of health care and stratification. Results underscore the importance of considering reciprocal influences in studies of socioeconomic status and health

Education of adult children and mortality of their elderly parents in Taiwan

Research shows an older adult’s education is strongly associated with mortality. But in societies such as Taiwan, where families are highly integrated, the education of family members may be linked to survival. Such may be the case in settings where there are large gaps in levels of education across generations and high levels of resource transfers between family members. This Population Council study employs 14 years of longitudinal data from Taiwan to examine the combined effects of education of older adults and their adult children on mortality outcomes of older adults. Results indicate that educational levels of both parent and child are associated with older adult mortality, but the child’s education is more important when a) controlling for the health of the older adult, and b) when examining only those older adults who already report a serious chronic condition, suggesting different roles for education in onset versus progression of a health disorder that may lead to death

Financial Literacy and Planning: Implications for Retirement Wellbeing.

Only a minority of American households feels “confident” about retirement saving adequacy, and little is known about why people fail to plan for retirement, and whether planning and information costs might affect retirement saving patterns. To better understand these issues, we devised and fielded a purpose-built module on planning and financial literacy for the 2004 Health and Retirement Study (HRS). This module measures how workers make their saving decisions, how they collect the information for making these decisions, and whether they possess the financial literacy needed to make these decisions. Our analysis shows that financial illiteracy is widespread among older Americans: only half of the age 50+ respondents could correctly answer two simple questions regarding interest compounding and inflation, and only one-third correctly answered these two questions and a question about risk diversification. Women, minorities, and those without a college degree were particularly at risk of displaying low financial knowledge. We also evaluate whether people tried to figure out how much they need to save for retirement, whether they devised a plan, and whether they succeeded at the plan. In fact, these calculations prove to be difficult: fewer than one-third of our age 50+ respondents ever tried to devise a retirement plan, and only two-thirds of those who tried actually claim to have succeeded. Overall, fewer than one-fifth of the respondents believed they engaged in successful retirement planning. We also find that financial knowledge and planning are clearly interrelated: those who displayed financial knowledge were more likely to plan and to succeed in their planning. Moreover, those who did plan were more likely to rely on formal methods such as retirement calculators, retirement seminars, and financial experts, and less likely to rely on family/relatives or co-workers.Social Security Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/49432/1/wp108.pd

Coresidence choices of elderly parents and adult children in Taiwan.

In recent years, interest in the status of the elderly in Asia has grown tremendously, stemming largely from a convergence of rapid demographic and socioeconomic change. Declines in mortality and fertility during the latter half of the twentieth century have led to an increase in the number and proportion of the population at older ages, a trend that will continue to accelerate well into the twenty-first century. Furthermore, the decline in fertility will eventually lead to a reduction in the number of children available to share responsibility for supporting their parents in old age. During this same time, Taiwan experienced dramatic social and economic change. These changes will likely challenge the persistence and strength of longstanding family and household arrangements that have generally been the source of support for the elderly in Taiwan. Drawing on data from the 1989 Taiwan Survey of Health and Living Status of the Elderly, this study focuses on the living arrangements of the elderly in relation to their adult children, by examining associations between characteristics of older parents and adult children and their patterns of coresidence. The study extends previous research on living arrangements by adopting an alternative methodological approach that allows for simultaneous consideration of characteristics of parents and all of their children in a multinomial logit framework, and provides a mechanism for modelling interdependencies in the coresidence patterns of children within families. Results of the study suggest that, although the prevalence of coresidence with adult children continues to be quite high in Taiwan overall, there is considerable variation in coresidence patterns according to demographic characteristics, socioeconomic and health status, and family composition; many of the findings support hypotheses relating to the impact of life course transitions and the mode of social organization on coresidence choices. The study also finds evidence of substantial interdependency in the coresidence patterns of siblings, which argues for the utility of the simultaneous logit approach in studies of family living arrangements.Ph.D.DemographyGerontologyIndividual and family studiesSocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/129719/2/9610211.pd

InstituteforSocialResearch The Impact of National Health Insurance on Treatment for High Blood Pressure among Older Taiwanese

Sherry Briske,Yan Fu, and Lee Ridley for useful references and insights. We are also indebted to the staff at the Bureau of Health Promotion in Taichung, Taiwan for their work in designing and conducting the survey and making the data available. National Health Insurance and Treatment for High Blood Pressure among Older Taiwanese 2 In 1995, Taiwan implemented a national health insurance program (NHI) to provide equitable, affordable, and universal health care coverage to all its citizens. Prior to this, 43 % of the population was uninsured and 57 % was covered by one of three major insurance programs. In this study, we examine the effect of NHI on the utilization of medical services (physician visits and medication use) for high blood pressure (HBP). We compare utilization before and after the introduction of NHI across three groups—those who were uninsured, covered by government insurance (GI), and covered by non-government insurance (NGI) prior to 1995. Analyses are based on data from the 1993 and 1999 waves of the Survey of Health and Living Status of the Middle-Aged and Elderly in Taiwan (1989-2003). The sample is restricted to persons age 70+ who have HBP. Multivariate logit regressions models are based on Andersen’s behavioral model of health services utilization