The Well-Being of the Elderly in Asia: A Four-Country Comparative Study

642 Pages·2003·40.532 MB·English

by  Albert Isaac Hermalin (ed.)

The Well-Being of the Elderly in Asia

The Well-Being of the Elderly in Asia
A Four-Country Comparative Study
Albert 1. Hermalin, Editor
Ann Arbor
THE UNIVERSITY OF MICHIGAN PRESS
Copyright © by the University of Michigan 2002
All rights reserved
Published in the United States of America by
The University of Michigan Press
Manufactured in the United States of America
§ Printed on acid-free paper
2005 2004 2003 2002 4 3 2
No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form
or by any means, electronic, mechanical, or otherwise,
without the written permission of the publisher.
A elP catalog record for this book is available from
the British Library.
US CIP data applied for.
ISBN 0-472-11280-5
ISBN13 978-0-472-11280-7 (cloth)
ISBN13 978-0-472-02650-0 (electronic)
Contents
List of Figures ix
List of Tables xi
Authors xix
Preface xxi
I Aging in Asia: Facing the Crossroads I
Albert 1. Hermalin and Lora G Myers
The Source and Nature of the Challenges 3
Demographic Responses and Their Limitations 6
Non-Demographic Responses 12
Goals of the Volume 15
Tools and Perspectives 17
History of the Project, Data Collected, and Other Products 18
Impact 21
2 The Demographic, Socioeconomic, and Cultural Context
of the Four Study Countries 25
John Knodel, Mary Beth Ofstedal, and Albert 1. Hermalin
Population Aging and Sociodemographic Change in
World Context 26
Demographic, Socioeconomic, and Cultural Context of the
Four Study Countries 35
Political and Cultural Setting 36
Demographic Change 44
Socioeconomic Change 49
Changing Characteristics of the Elderly 52
Demographic and Social Characteristics ofthe
Sample Elderly 54
Conclusions 59
3 Policies and Programs in Place and under Development 65
Mary Beth Ofstedal, Angelique Chan, Napaporn Chayovan,
Yi-Li Chuang, Aurora Perez, Kalyani Mehta, and Albert 1. Hermalin
Social Security Retirement Programs 68
Health Care Programs 75
Other Programs and Policies Targeted to the Older Population 85
Conclusions 94
vi Contents
4 Theoretical Perspectives, Measurement Issues, and
Related Research 101
Albert l. Hermalin
The Demography of Aging 101
Related Disciplines and Their Perspectives 104
The Conceptual Framework 107
Societal Changes and Their Impact on the Elderly 110
The Effect of Population Aging on Economic Development 114
Asian Interests in Research on Aging 119
Measuring and Understanding Living Arrangements 122
Identifying and Measuring Intergenerational Support
Dimensions 123
Measuring Work and Leisure 128
The Economic Status of the Elderly 129
Health Status and Health Care Utilization 130
Vulnerable Groups and Their Levels of Disadvantage 131
Cross-Cutting Issues, Transitions, and Policy
Recommendations 132
5 Patterns and Determinants of Living Arrangements 143
John Knodel and Mary Beth Ofstedal
Measurement Issues 144
Trends in Coresidence 147
General Patterns of Household Composition 149
Coresidence in Relation to Children's Gender and Marital Status 154
Determinants of Living Arrangements 162
Multivariate Results 170
Conclusions 179
6 Intergenerational Support and Transfers 185
Ann Biddlecom, Napaporn Chayovan, and Mary Beth Ofstedal
Measurement Issues 187
Background 190
Norms and Attitudes about Family Support 194
Availability of Children and Social Contact 196
Current Flows ofIntergenerational Support 197
Conclusions 219
7 Work, Retirement, and Leisure 231
Albert l. Hermalin, Angelique Chan, Ann Biddlecom, and
Mary Beth Ofstedal
Trend and Levels of Labor Force Participation 237
Modeling the Retirement Process 247
Correlates of Labor Force Participation 251
Contents vii
Attitudes and Preferences Related to Work and Retirement 265
Leisure Activities of the Elderly 275
Conclusions 283
8 Economic Well-Being: Insights from Multiple Measures
of Income and Assets 295
Albert 1. Hermalin, Ming-Cheng Chang, and Carol Roan
Measurement Issues Related to Economic Well-Being 296
Levels of Income in Absolute and Relative Terms 301
Major Sources of Income 306
Factors Affecting Levels of Income 308
Household Income and Indirect Sources of Support 319
Subjective Measures of Economic Well-Being 324
Assets and Home Ownership 327
Changes in Economic Well-Being over Time 344
Conclusions 348
9 Physical and Mental Health of the Elderly 361
Zachary Zimmer, Josejina N Natividad, Mary Beth Ofstedal,
and HUi-Sheng Lin
Methodological Issues 362
Health Risk Behaviors 366
Physical Health 371
Emotional and Cognitive Health 385
Self-Assessed Health 388
Conclusions 398
10 Patterns of Health Care Utilization 413
Mary Beth Ofstedal and Josejina N Natividad
Health Insurance Coverage 417
Health-Seeking Behaviors 425
Use of Specific Medical Services 429
Unmet Need for Health Services 450
Conclusions 455
11 The Vulnerable and Their Potential Disadvantages 461
Albert 1. Hermalin, Mary Beth Ofstedal, and Kalyani Mehta
Methods and Measurement Issues 462
Research Findings 469
Cross-Country Profiles of Relative Risks 486
Multivariate Results 492
Summary of Disadvantages Faced by the Sociodemographic
Groups 499
Policy and Programmatic Implications 503
Conclusions 508
viii Contents
12 Capturing Change: Transitions at Older Ages and
Cohort Succession 519
Albert 1. Hermalin
Cohort Succession and Its Implications for Population Aging 521
Transitions over the Later Life Course 532
Conclusions 539
l3 Making the Choices: Policies and Research for the
Coming Years 543
Albert 1. Hermalin
Major Findings and Their Implications 544
Anticipating the Future: Demographic, Social, and Economic
Trends and Their Interconnections 555
Policy Strategies in an Uncertain World 563
Developing a Research Agenda 574
Looking Backward and Looking Forward 577
Appendix A: Survey Design Information and Methodological Notes 583
Appendix B: Guide to Archived Data 590
Appendix C: Project-Related Publications 592
Index 599
Figures
1.1. Factors Affecting the Well-Being of the Older Population,
Policy Developments, and Their Interrelationships 7
4.1. Conceptual Framework of Factors Affecting Well-Being of
the Elderly and Others, and Policy Formation 108
7.1. Labor Force Participation Rates for the Philippines, Thailand,
Taiwan, and Singapore: 1970-1990 238
7.2. Percent of Older Males and Females in Labor Force, by Age
and Country: 1980s and 1995-1996 242
8.1. Interrelationships among Various Dimensions of Economic
Well-Being 300
8.2. Ratio of Mean Income in Sociodemographic Groups to
Overall Mean Income, by Country 312
8.3. Sufficiency ofIncome for the Cohort 60 and Older, 1989
and 1996 346
8.4. Distribution of Sufficiency of Income in 1996 by Level of
Sufficiency in 1989 347
10.1 Determinants of Health Services Utilization 415
ILIA. Philippines: Relative Risks of Economic Disadvantages
for Sociodemographic Groups 471
11.1B. Philippines: Relative Risks of Health Disadvantages
for Sociodemographic Groups 472
11.1 C. Philippines: Relative Risks of Social Disadvantages for
Sociodemographic Groups 473
11.2A. Thailand: Relative Risks of Economic Disadvantages for
Sociodemographic Groups 475
11.2B. Thailand: Relative Risks of Health Disadvantages for
Sociodemographic Groups 477
1l.2C. Thailand: Relative Risks of Social Disadvantages for
Sociodemographic Groups 478