Family Members' Abuse of Older Adults, Psychological Well-Being, and Sleep Quality Among Older Women and Men in China.

Despite the well-documented detrimental health effects of elder abuse, scholars have rarely considered whether and how family members' abuse of older adults is associated with sleep. Data from the 2018 China Longitudinal Aging Social Survey (N = 8110) were used to assess the association between elder abuse committed by family members and sleep quality, and how psychological well-being (depression and loneliness) mediates and gender moderates the above association. Results indicated that those who experienced family members' abuse were more likely to report poor sleep quality than their non-abused counterparts. Depression and loneliness partially mediated the elder abuse-sleep relationship. Furthermore, among those who experienced one elder abuse, older women had a higher risk of poor sleep quality than their male counterparts. However, two or more elder abuse experiences had similar negative effects on older women and men. Preventing elder abuse and improving psychological well-being is critical to promoting late-life sleep.

Life Course Risk and Protective Factors of Multimorbidity Resilience Among Older Adults in Rural China: A Longitudinal Study in Anhui Province Before and During COVID-19.

OBJECTIVES: Multimorbidity resilience reflects older adults' ability to cope with, adapt to, and rebound from its adverse effects through mobilizing resources. This study revised the multidomain Multimorbidity Resilience Index based on the Lifecourse Model of Multimorbidity Resilience referring to the life situations of older adults in rural China to measure the multimorbidity resilience from 2018 to 2021 and to explore factors influencing multimorbidity resilience from the perspective of Life Course theory. METHODS: This study used the seventh and eighth waves of longitudinal data (2018-2021) collected in Anhui, China. Older adults (945) with 2 or more chronic diseases were selected, and 1,201 (person-year) observations were collected and studied. A mixed linear model examined the effects of early- and later-factors on multimorbidity resilience. RESULTS: Multimorbidity resilience was negatively correlated with age and decreased faster with age after the outbreak of the coronavirus disease-2019 (COVID-19) pandemic. Married older adults have higher multimorbidity resilience. Exposure to hunger was associated with lower multimorbidity resilience when later factors were considered. Self-reported health before age 15, access to medical resources, and multimorbidity resilience were positively correlated. In addition, this study verified the relationship between multimorbidity resilience and the number of chronic diseases, exercise frequency, religious beliefs, self-reported health, and economic satisfaction, among other factors. DISCUSSION: The associations between life course factors and multimorbidity resilience emphasize the long-term impact of early-life experience and the adverse effects of increasing age, especially after the outbreak of the COVID-19 pandemic. The findings will drive policy development from a life course perspective encompassing prevention and follow-up treatment to promote active aging.

Potential factors associated with resilience among older adults in rural China: a multilevel analysis.

BACKGROUND: Resilience is crucial for older adults who experience adversities, but research on the issue in rural China remains limited. This study aims to examine factors associated with resilience among older adults in rural China, as related to different types of resilience, and under different levels of adversity. METHODS: Data were taken from the eight-wave (2001-2021) Longitudinal Study of Older Adults in Anhui Province, China. We used data from the eighth wave (2021) for the outcome variables and lagged predictors (2018) to avoid reverse causal effects. The study sample included individuals 60 years and above, excluding new participants from 2021, those without any adverse events, and any respondents with incomplete analytic data. Resilience was operationalized as residuals of the regressions of life satisfaction (Life Satisfaction Scale) and depressive symptoms (CES-D) on adversity, referred to as Type-1 and Type-2 resilience respectively. These two types of resilience were then treated as the outcome variables in subsequent multilevel regressions, with the predictors focusing on individual, social, and environmental characteristics and resources. This study adheres to STROBE guidelines. RESULTS: 43% of rural older adults exhibited both Type-1 and Type-2 resilience, whereas 18% exhibited only Type-1 resilience and 7% exhibited only Type-2 resilience. Common factors associated with both types of resilience included self-rated health, satisfaction with one's own financial situation, and the prestigiousness of social networks. Predictors for higher levels of Type-1 resilience included higher levels of financial and emotional support and more options for places of leisure. Predictors for higher levels of Type-2 resilience included greater access to medical care. The prestigiousness of social networks, higher levels of emotional support and instrumental support, access to medical care, and more options of places of leisure were positively associated with resilience in the low-adversity group (first tertile of adversity), only satisfaction with financial situation was positively correlated with the resilience of the middle-adversity group (second tertile), while better self-rated health, satisfaction with financial situation, and financial support yielded greater resilience in the high-adversity group (third tertile). CONCLUSIONS: We examined two types of resilience among older adults in rural China, and found that they have shared and unique associated factors. In addition, the potential factors influencing resilience varied with the level of adversity.

Children's Divorce and their Financial Support to Older Parents in Rural China.

This study examined how adult children's divorce affected their financial support to older parents in rural China and how that relationship was dependent on children's gender. The sample was from rural Anhui Province and the working sample included 1629 older parents who reported their interactions with 6210 children across six waves of observations in 14 years (2001-2015). Generalized Estimating Equations showed that divorced sons provided less financial support to their parents than married sons. In contrast, divorced daughters did not necessarily provide less financial support than married daughters. This gender difference was statistically significant. The findings were discussed in the context of changing rural Chinese families, where the norm of filial piety is still strong but patrilineal tradition and gender ideology have experienced desynchronized changes.

Reconfiguring Social Disconnectedness and Its Link to Psychological Well-Being among Older Adults in Rural China.

Using data from 2015 to 2018 waves of the Longitudinal Study of Older Adults in Anhui Province, China, this study investigated associations between different forms of social disconnectedness (social isolation, loneliness, living alone) and psychological well-being of older adults longitudinally. The results showed that social isolation and loneliness were independently associated with psychological well-being, whereas living alone was not. Different forms of social disconnectedness had additive and interactive effects on psychological well-being of older adults. Those who were exposed to all three forms of social disconnectedness suffered from the lowest level of psychological well-being. Moreover, the adverse effects of social disconnectedness on psychological well-being were found to be stronger for older women than for older men. The results underscore the necessity to consider multiple forms of social disconnectedness as well as their different combinations in explaining psychological well-being in later life.

What Could Interfere with a Good Night's Sleep? The Risks of Social Isolation, Poor Physical and Psychological Health among Older Adults in China.

This study provides one of the first population-based investigations of the longitudinal association between social isolation and sleep difficulty among older adults in China. We analyzed three waves of longitudinal data from the China Longitudinal Aging Social Survey (2014-2018), in which 8456 respondents contributed 16,156 person-year observations. Results from multilevel logistic regression models showed that social isolation was related to a higher risk of sleep difficulty. We also found that socially isolated older adults were more likely to report higher levels of depressive symptoms, a greater prevalence of loneliness and pain, and more chronic diseases compared to their socially integrated counterparts, which in turn increased their risks of sleep difficulty. Moreover, socially isolated older adults with chronic diseases were particularly vulnerable to the risk of sleep difficulty. These findings provide helpful guidance for policymakers and practitioners to design effective intervention strategies to help older adults with sleep problems.

Factors Associated with Death Anxiety Among Rural Chinese Older Adults: The Terror Management Perspective.

OBJECTIVES: The aim of this study was to examine how the factors suggested by the Terror Management Theory are associated with death anxiety among rural Chinese older adults. METHOD: Data were derived from a longitudinal survey of older adults aged 60 and above, had at least one living child, and were living in rural areas of Anhui Province. The working sample included 1,362 older adults. Two-level random effects models were used. RESULTS: Children's financial support was negatively related to death anxiety, whereas emotional closeness with children was positively related to death anxiety. Older women reported more death anxiety than older men. Functional limitations were positively associated with death anxiety, and the widowed reported less death anxiety than the married. We did not find a significant association between religious belief and death anxiety. DISCUSSION: The study highlights the importance of culture in shaping death anxiety among older adults in rural China.

Socioeconomic Status, Institutional Power, and Body Mass Index among Chinese Adults.

Despite the vast literature on the socioeconomic status (SES) gradient of obesity among adult people, no study has investigated the relationship between institutional power and body mass index. Using national survey data from the "China Labor-force Dynamics Survey 2016" (CLDS 2016), multistage cluster-stratified probability proportional to size (PPS) sampling was employed to select cases from 29 provinces, cities, and autonomous regions in China. This study adopts an institutional approach to explore the influences of SES and institutional power on the state of being overweight or severely overweight (obese) among Chinese adults. It is shown that SES has a non-linear influence on being overweight or obese, higher education has a negative effect on being overweight or obese, income has an inverted U-shaped effect on being overweight or obese, and having a managerial or administrative job has a positive effect on being overweight but less so on obesity. These findings reveal that disparities in health outcome and risks are due to inequality in SES. The work unit is a stronger predictor of adults being overweight or obese than occupation. Working in the public sector has a positive effect on being overweight relative to working in the private sector, and only state institutions and government departments have a positive association with obesity. Our results indicate that institutional structure still has effects on individuals' life chances in the era of China's market transition.

Marriage, Health, and Old-Age Support: Risk to Rural Involuntary Bachelors' Family Development in Contemporary China.

In the traditional system of Chinese families, individuals are embedded in the institution of the family with defined obligations to enhance family development. As a consequence of the male-biased sex ratio at birth in China since the 1980s, an increasing number of surplus rural males have been affected by a marriage squeeze becoming involuntary bachelors. Under China's universal heterosexual marriage tradition, family development of rural involuntary bachelors has largely been ignored, but in China's gender-imbalanced society, it is necessary to adopt a family-based approach to identify and study the plight of rural involuntary bachelors. Studies on gender imbalance indicate that these men face multiple risks from the perspectives of their life course, the family life cycle, and the family ethic. To a certain extent, these risks are caused by a conflict between the individual's family life and family ethics and are mainly reflected in problems concerning marriage, health, and old-age support. Not only do these vulnerabilities affect the individual and family development across the whole life cycle but also pose major risks to social development in the face of strong gender imbalance. In order to deal with risks faced by rural involuntary bachelors, core ethical principles, including autonomy, beneficence, and justice, need to be adopted. Through adjustments to informal support provided by the family and formal support provided by policy-makers, risk of uncertainty in family development faced by rural involuntary bachelors could be reduced.

Internal Migration and the Health of Middle-Aged and Older Persons in China: The Healthy Migrant Effect Reconsidered.

This study investigates associations between internal migration and health among middle-aged and older adults in China, including variations associated with type of migration (rural-to-urban, urban-to-rural, rural-to-rural, urban-to-urban). Data were drawn from China's Health and Retirement Longitudinal Study (2011, 2013, 2015). Lagged panel and fixed-effect regression models address associations between migration and health outcomes (self-rated health, depression) while controlling for pre-migration and post-migration selection effects. The results reveal the positive implications of rural-to-urban migration for the self-rated health of middle-aged but not older adults. They also point to the positive effects of migration within and to rural areas for the self-rated and mental health of older adults. Overall, although migration may be beneficial to the health of internal migrants in China, complexities associated with age, type of migration, and the health outcome involved need to be taken into account.

Widowhood and depression: a longitudinal study of older persons in rural China.

Using six waves of longitudinal data (2001-2015) collected in Anhui, China (N = 2,131) and generalized estimating equations (GEE) models, this study fulfilled several objectives. First, the study compared the widowed to the married to examine if the transition to and duration of widowhood contributes to changes in depression. Second, the study examined if the bereavement-depression relationship is a process that precedes widowhood or is an abrupt change following the death of a spouse. Third, the study examined if social resources influence the bereavement-depression relationship. The study found that there is pre-widowhood effect on depression and that the widowhood event also contributes to increases in depression. Levels of post-widowhood depressive symptoms peak during the first six months bereavement and taper off within 25 months. Controlling for social support, contact with children, and living arrangements does not change the bereavement-depression relationship. The findings support Attachment Theory, which suggests that the loss of a spouse leads to emotional isolation that cannot be overcome with kin-based social support and social integration.

Rural Households' Poverty and Relocation and Settlement: Evidence from Western China.

Based on survey data collected from five counties across southern Shaanxi, China, the present study employs a multinomial logistic model to explore the main factors related to the type of poverty of rural households, particularly focusing on the role of relocation time, reason for relocation, and type of relocation. The results showed that three types of poverty, "voluntary poverty", "transient poverty", and "chronic poverty", are distinguished by combining income and consumption criteria. Moreover, relocation and settlement programs contribute to a certain degree to these three kinds of poverty, and the effects vary according to the relocation characteristics. Specifically, those relocated long-term were more likely to be trapped in "voluntary poverty" and "chronic poverty", whereas those relocated short-term were less likely to fall into "voluntary poverty" and "transient poverty". The poverty alleviation and disaster-related resettlers were less likely to be trapped in "chronic poverty", whereas centralized resettlers were less likely to be trapped in "voluntary poverty" and "chronic poverty". Additionally, demographic characteristics, capital endowment variables, and geographical features are all important factors affecting rural households' type of poverty. This study can serve as a reference for further resettlement practice in China and other developing countries.

The decline in China's fertility level: a decomposition analysis.

Many factors have contributed to the decline in China's fertility level. Using China's population census data from 1990, 2000 and 2010, the present study investigates the factors causing the decline in China's fertility rate by decomposing changes in two fertility indices: the total fertility rate (TFR) and the net reproduction rate (NRR). The change in the TFR is decomposed into the change in the marital fertility rate (MFR) and the change in the proportion of married women (PMW). Four factors contribute to the change in the NRR. The following are the main findings. A drop in the MFR caused a decrease in the TFR and the NRR between 1989 and 2000. However, the change in MFR increased TFR and NRR between 2000 and 2010. Marriage postponement caused a decline in the fertility level between 1989 and 2000 as well as between 2000 and 2010. The effect of the MFR and marriage postponement varied with age and region and also between urban and rural areas.

Marriage Aspiration, Perceived Marriage Squeeze, and Anomie Among Unmarried Rural Male Migrant Workers in China.

Using data from a survey of rural-urban migrants conducted in Xiamen City, China, during 2009, this study explores determinants of anomie among unmarried rural male migrant workers in the context of China's gender imbalance. Results indicate that the perceived marriage squeeze has exerted direct effects on anomie, and marriage aspiration has indirect effects on anomie among rural male migrant workers. The perceived marriage squeeze also has a mediating effect between marriage aspiration and anomie among unmarried rural male migrant workers. Social integration in the destination city is also a determinant of anomie among these unmarried migrant workers.

Understanding Bachelorhood in Poverty-stricken and High Sex Ratio Settings: An Exploratory Study in Rural Shaanxi, China.

Coupled with the social practice of female hypergamy, the male surplus within the never-married population means that today's Chinese marriage market is extremely tight in particular for men from a rural background and the least privileged socio-economic categories. Drawing on quantitative data from a survey conducted in 2014-2015, this article sheds light on the situation of single men who are past prime marriage age in three rural districts of Shaanxi particularly affected by this phenomenon. It compares single men's characteristics to those of their married counterparts and offers insights into the heterogeneity of single men with the aim of challenging some commonly accepted assumptions about bachelorhood in rural China. Results suggest a strong internalization of the various characteristics, centred on being able to offer social mobility to a potential wife, that a man is expected to have to be attractive to women in a context where women have more choice in mate selection. We conclude that mate selection is highly marked by class, social norms, social interactions, health, generation and age, and requires the mobilization of certain amounts of individual, social and economic resources. Unwanted bachelorhood would thus be better understood using an intersectional approach rather than mainly in numeric terms.

Female fertility history and mid-late-life health: Findings from China.

China's middle-aged and older women suffer from poorer health than men. Using national baseline data from the China Health and Retirement Longitudinal Study (CHARLS), a survey conducted from 2011 to 2012, this article applies logistic models to investigate the association between female fertility history (parity, early childbearing, late childbearing) and middle-aged and late-life health. We find that parity is related to the mid-late-life health of women. Women with four children or more are more likely to suffer from activities of daily living (ADL) impairment and poorer self-rated health than those with one to three children. Early childbearing is associated with ADL impairment; however, the correlation is mediated by socioeconomic status. Early childbearing is related to self-rated health in later life by an indirect-only mediation effect via educational attainment and personal income.

The impact on rural livelihoods and ecosystem services of a major relocation and settlement program: A case in Shaanxi, China.

China's largest-ever resettlement program is underway, aiming to restore ecosystems and lift ecosystem service providers out of the poverty trap and into sustainable livelihoods. We examine the impact of the relocation and settlement program (RSP) to date, reporting on an ecosystem services (ES) assessment and a 1400-household survey. The RSP generally achieves the goals of ES increase and livelihood restore. In biophysical terms, the RSP improves water quality, sediment retention, and carbon sequestration. In social terms, resettled households so far report transformation of livelihoods activities from traditional inefficient agricultural and forest production to non-farm activities. Increased income contributes to decrease the poverty rate and improve resettled households' living condition and standard. Meanwhile, the RSP decreases households' dependence on ES in terms of provisioning services. Difficulty and challenge also showed up subsequently after relocation. A major current challenge is to enable poorer households to move, while providing greater follow-up support to relocated households. While the program is unique to China, it illuminates widespread opportunities for addressing environmental and poverty-related concerns in a rapidly changing world.

On the Relationship Between the Marriage Squeeze and the Quality of Life of Rural Men in China.

China is facing a male marriage squeeze, as there are more men in the marriage market than potential female partners. As a consequence, some men may fail to ever marry. However, while some studies have suggested that most unmarried men affected by the marriage squeeze in rural China feel a sense of failure, the quality of life of the men who remain unmarried against their will remains largely unexplored. Using data collected in rural Hanbin district of Ankang City (Shaanxi, China), this study analyzes the relationship between the marriage squeeze and the quality of life among rural men. Descriptive analyses indicate that the quality of life of unmarried men aged 28 years and older tends to be worse than for both younger unmarried men and married men. Also, the quality of life of men who perceive the marriage squeeze appears to be worse than that of those who do not. Regression analyses reveal that the perceived marriage squeeze and age independently have a significant negative relationship with the quality of life of rural men.

China's marriage squeeze: A decomposition into age and sex structure.

Most recent studies of marriage patterns in China have emphasized the male-biased sex ratio but have largely neglected age structure as a factor in China's male marriage squeeze. In this paper we develop an index we call "spousal sex ratio" (SSR) to measure the marriage squeeze, and a method of decomposing the proportion of male surplus into age and sex structure effects within a small spousal age difference interval. We project that China's marriage market will be confronted with a relatively severe male squeeze. For the decomposition of the cohort aged 30, from 2010 to 2020 age structure will be dominant, while from 2020 through 2034 the contribution of age structure will gradually decrease and that of sex structure will increase. From then on, sex structure will be dominant. The index and decomposition, concentrated on a specific female birth cohort, can distinguish spousal competition for single cohorts which may be covered by a summary index for the whole marriage market; these can also be used for consecutive cohorts to reflect the situation of the whole marriage market.

Relocation and Social Support Among Older Adults in Rural China.

OBJECTIVES: China's economic reforms have led to millions of citizens being relocated to support infrastructure development, reduce poverty, and address ecological, disaster-related and other concerns. This study expands on previous research on the implications of relocation in China by examining the impact of rural elders' relocation on the perceived availability of emotional, instrumental, and financial support. METHODS: Data were drawn from the Ankang Study of Aging and Health conducted with a representative sample of 1,062 rural residents aged 60 and over living in Ankang, China. Two-stage probit and least squares regression models assessed the impact of relocation on familial and nonfamilial emotional, instrumental, and financial support. RESULTS: Relocation was negatively associated with the number of social support resources that older adults perceived as being available. Although this was the case with regard to both familial and nonfamilial support, it was particularly evident with regard to family support and, within families, with regard to instrumental rather than financial or emotional support. DISCUSSION: Relocation has negative implications for the number of social support resources perceived to be available by older adults in rural China. China will need to come to terms with how to provide for the instrumental support needs of an aging society.