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The need for community care among older people in China

Published online by Cambridge University Press:  03 June 2015

JUNSHAN ZHOU
Affiliation:
School of Criminology, People's Public Security University of China, Beijing, China.
ALAN WALKER*
Affiliation:
Sociological Studies, University of Sheffield, UK.
*
Address for correspondence: Alan Walker, Sociological Studies, University of Sheffield – Elmfield, Northumberland Road, Sheffield S10 2TU, UK E-mail: [email protected]

Abstract

The social care system of China has come under close scrutiny from policy makers due to the rapid ageing of China's population. Unfortunately, there is very little Chinese research evidence that might be used to plan future service developments. This article is a contribution to filling that gap and it provides essential new information on the expressed demand among older people in China for various community care services. The data are from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey. According to the characteristics of the dependent variables, we used Binary Logistic Regression Analysis to analyse the need for community care among older people in China. The results show considerable need for such care, but China is still a developing country and there are insufficient resources to fund a Western-style social care system (even if that was desirable). Thus, it is argued that the development of social care in China should emphasise community-based care, in partnership with families, with institutional care as a last resort. In addition, it is argued that China (and other countries) should introduce measures to prevent the demand for social care.

Type
Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Abarshi, E., Echteld, M. A., Van den Block, L., Donker, G., Deliens, L. and Onwuteaka-Philipsen, B. 2010. The oldest old and GP end-of-life care in the Dutch community: a nationwide study. Age and Ageing, 39, 6, 716–22.CrossRefGoogle ScholarPubMed
Andersen, R. M. 1995. Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 36, 1, 110.Google Scholar
Andersen, R. M. and Newman, J. F. 1973. Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly – Health and Society, 51, 1, 95124.Google Scholar
Asis, M. M., Domingo, L., Knodel, J. E. and Mehta, K. 1995. Living arrangements in four Asian countries: a comparative perspective. Journal of Cross-cultural Gerontology, 10, 1/2, 145–62.Google Scholar
Banerjee, S. and Macdonald, A. 1996. Mental disorder in an elderly home care population: associations with health and social service use. British Journal of Psychiatry, 168, 6, 750–6.CrossRefGoogle Scholar
Barrett, A. E. and Lynch, S. M. 1999. Caregiving networks of elderly persons: variation by marital status. Gerontologist, 39, 6, 695704.Google Scholar
Bayley, M. 1977. Mental Handicap and Community Care. Routledge and Kegan Paul, London.Google Scholar
Bornat, J., Johnson, J., Pereira, D., Pilgram, D. and Williams, F. (eds) 1997. Community Care: A Reader. Second edition, Macmillan, Basingstoke, UK.Google Scholar
Broese van Groenou, M., Glaser, K., Tomassini, C. and Jacobs, T. 2006. Socio-economic status differences in older people's use of informal and formal help: a comparison of four European countries. Ageing & Society, 26, 5, 745–66.Google Scholar
Calsyn, R. J. and Winter, J. P. 2000. Predicting different types of service use by the elderly: the strength of the behavioral model and value of interaction terms. Journal of Applied Gerontology, 19, 3, 284303.Google Scholar
Calver, J., Holman, C. D. A. J. and Lewin, G. 2004. A preliminary casemix classification system for home and community care clients in Western Australia. Australian Health Review, 27, 2, 2739.CrossRefGoogle ScholarPubMed
Cangping, Wu and Peng, Du 2012. Ageing Society and Harmonious Society. China Population Publishing Housing, Beijing.Google Scholar
Chen, Z. 2011. Knowledge and perceptions: Chinese older adults’ willingness to use institutional elder care. Unpublished masters thesis, Georgia State University, Atlanta, Georgia. Available online at http://digitalarchive.gsu.edu/gerontology_theses/22 [Accessed 21 December 2011].Google Scholar
Cheng, S. T. and Chan, A. C. M. 2006. Filial piety and psychological well-being in well older Chinese. Journals of Gerontology: Psychological Sciences and Social Sciences, 61B, 5, 262–9.Google Scholar
Cheung, C. K. and Kwan, A. Y. H. 2009. The erosion of filial piety by modernisation in Chinese cities. Ageing & Society, 29, 2, 179–98.CrossRefGoogle Scholar
China National Committee on Ageing 2008. Theory and Practice of Ageing in Place in China. Ageing Publisher, Beijing.Google Scholar
China National Committee on Ageing, National Development Commission, Ministry of Civil Affairs, Ministry of Education, Ministry of Human Resources and Social Security, Ministry of Finance, Ministry of Construction, Ministry of Health, National Population and Family Planning Commission and State Administration of Taxation. 2009. Views of Promoting Home Care Services. 29 January.Google Scholar
Choi, N. G. 1994. Patterns and determinants of social service utilization: comparisons of the childless elderly and elderly parents living with or apart from their children. Gerontologist, 34, 3, 353–62.Google Scholar
Croll, E. J. 2006. The intergenerational contract in the changing Asian family. Oxford Development Studies, 34, 4, 473–91.CrossRefGoogle Scholar
Cvitkovich, Y. and Wister, A. 2001. The importance of transportation and prioritization of environmental needs to sustain well-being among older adults. Environment and Behavior, 33, 6, 809–30.CrossRefGoogle Scholar
Daatland, S. O. 2001. Ageing, families and welfare systems: comparative perspectives. Zeitschrift für Gerontologie und Geriatrie, 34, 1, 1620.Google Scholar
Delgado, M. and Tennstedt, S. 1997. Making the case for culturally appropriate community services – Puerto Rican elders and their caregivers. Health and Social Work, 22, 4, 246–55.Google Scholar
Department of Health 2005. Independence, Wellbeing and Choice. Department of Health London.Google Scholar
Gill, T. M., Robison, J. T. and Tinetti, M. E. 1998. Difficulty and dependence: two components of the disability continuum among community-living older persons. Annals of Internal Medicine, 128, 2, 96101.Google Scholar
Gu, D. 2008. General data assessment of the Chinese Longitudinal Healthy Longevity Survey in 2002. In Zeng, Y., Poston, D., Vlosky, D. and Gu, D. (eds), Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions. Springer, Dordrecht, The Netherlands, 3959.Google Scholar
Gu, D. and Dupre, M. E. 2008. Assessment of reliability of mortality and morbidity in the 1998–2002 CLHLS waves. In Zeng, Y., Poston, D., Vlosky, D. and Gu, D. (eds), Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions. Springer, Dordrecht, The Netherlands, 99115.CrossRefGoogle Scholar
Gu, D., Zhang, Z. and Zeng, Y. 2009. Accessibility to healthcare services makes a difference in healthy longevity among older Chinese adults. Social Science and Medicine, 68, 2, 210–9.Google Scholar
Herzog, A. R. and Wallace, R. B. 1997. Measures of cognitive functioning in the AHEAD study. Journals of Gerontology: Social Sciences, 52B, Special issue, S37–48.CrossRefGoogle Scholar
Heumann, L. F. and Boldy, D. P. (eds) 1993. Aging in Place with Dignity: International Solutions Relating to the Low-income and Frail Elderly. Praeger Publishers, Westport, Connecticut.Google Scholar
James, K., Holder-Nevins, D., Morris, C., Eldemire-Shearer, D., Powell, J. and Laws, H. 2008. Ageing in place: implications of morbidity patterns among older persons – findings from a cross-sectional study in a developing country. Australasian Journal on Ageing, 31, 3, 170–5.Google Scholar
Jorm, L. R., Walter, S. R., Lujic, S., Byles, J. E. and Kendig, H. L. 2010. Home and community care services: a major opportunity for preventive health care. BMC Geriatrics, 10, 1, 2634.CrossRefGoogle Scholar
Joseph, A. E. and Phillips, D. R. 1999. Ageing in rural China: impacts of increasing diversity in family and community resources. Journal of Cross-cultural Gerontology, 14, 2, 153–68.Google Scholar
Kosloski, K. and Montgomery, R. J. 1993. The effects of respite on caregivers of Alzheimer's patients: one year evaluation of the Michigan Model Respite Programs. Journal of Applied Gerontology, 12, 1, 417.CrossRefGoogle Scholar
Lagergren, M. and Johansson, P. A. 1998. Are there differences in standard of care for the elderly? A comparative study of assistance decisions in Stockholm. Scandinavian Journal of Social Welfare, 7, 4, 340–9.CrossRefGoogle Scholar
Lai, O. K. 2008. The enigma of Japanese ageing-in-place practice in the information age: does digital gadget help the (good) practice for inter-generation care? Ageing International, 32, 3, 236–55.Google Scholar
Larsson, K. and Thorslund, M. 2002. Does gender matter? Differences in patterns of informal support and formal services in a Swedish urban elderly population. Research on Aging, 24, 3, 308–37.Google Scholar
Lei, J. and Walker, A. 2013. The Big Society in China: a failed experiment. Social Policy and Society, 12, 1, 1730.Google Scholar
Leung, J. C. B 2000. Community building in China: from welfare to politics. Community Development Journal, 35, 4, 425–7.Google Scholar
McDonald, J. T. and Condea, H. 2010. Does geography matter? The health service use and unmet health care needs of older Canadians. Canadian Journal on Aging, 29, 1, 2337.Google Scholar
Meinow, B., Kåreholt, I. and Lagergen, M. 2005. According to need? Predicting the amount of municipal home help allocated to elderly recipients in an urban area of Sweden. Health and Social Care in the Community, 13, 4, 366–77.Google Scholar
Milne, A., Hatzidimitriadou, E. and Wiseman, J. 2007. Health and quality of life among older people in rural England: exploring the impact and efficacy of policy. Journal of Social Policy, 36, 3, 477–95.Google Scholar
Ministry of Civil Affairs 2011. The China Statistics Report of Civil Affairs. Ministry of Civil Affairs, Beijing.Google Scholar
Morris, J. 1997. Community Care: Working in Partnership with Service Users. Venture Press, London.Google Scholar
Nelson, T., Fernandez, J. L., Livingston, G., Knapp, M. and Katona, C. 2004. Does diagnosis determine delivery? The Islington study of older people's needs and health care costs. Psychological Medicine, 34, 1, 147–55.CrossRefGoogle ScholarPubMed
Nihtilä, E. and Martikainen, P. 2007. Household income and other socio-economic determinants of long-term institutional care among older adults in Finland. Population Studies: A Journal of Demography, 61, 3, 299314.Google Scholar
Oberski, I. M., Carter, D. E., Gray, M. and Ross, J. 1999. The community gerontological nurse: themes from a needs analysis. Journal of Advanced Nursing, 29, 2, 454–62.Google Scholar
Palmer, E. and Deng, Q. 2008. What has economic transition meant for the well-being of the elderly in China. In Gustafsson, B. A., Li, S. and Sicular, T. (eds), Inequality and Public Policy in China. Cambridge University Press, Cambridge, 182203.Google Scholar
Penning, M. J. 1999. Health, social support, and the utilization of health services among older adults. Journals of Gerontology, 50B, 5, 5330–9.Google Scholar
Phillipson, C., Bernard, M., Phillips, J. and Ogg, J. 2001. The Family and Community Life of Older People. Routledge, London.Google Scholar
Quach, A. S. and Anderson, E. A. 2008. Implications of China's open-door policy for families: a family impact analysis. Journal of Family, 29, 8, 1089–103.Google Scholar
Qureshi, H. and Walker, A. 1989. The Caring Relationship: Elderly People and Their Families. Macmillan Education, London.Google Scholar
Rechel, B., Doyle, Y., Grundy, E. and McKee, M. 2009. How can health systems respond to population ageing? World Health Organisation Policy Brief 10, World Health Organisation Regional Office for Europe, Copenhagen.Google Scholar
Seal, J., McCreadie, C., Turner-Smith, A. and Tinker, A. 2002. Older people as partners in assistive technology research: the use of focus groups in the design process. Technology and Disability, 14, 1, 21–9.Google Scholar
Seeborg, M. C., Jin, Z. and Zhu, Y. 2000. The new rural–urban labor mobility in China: causes and implications. Journal of Socio-economics, 29, 1, 3956.Google Scholar
Sixsmith, A. and Sixsmith, J. 2008. Ageing in place in the United Kingdom. Ageing International, 32, 3, 219–35.Google Scholar
Spitze, G. and Logan, J. 1990. Sons, daughters, and intergenerational social support. Journal of Marriage and the Family, 52, 2, 420–30.Google Scholar
State Council 2006. The views of promoting the community care services. State Council, Beijing, 9 April.Google Scholar
Themessl-Huber, M., Hubbard, G. and Munro, P. 2007. Frail older people's experiences and use of health and social care services. Journal of Nursing Management, 15, 2, 222–9.Google Scholar
Tian, Q. 2010. Community care for the elderly: comparative study based on welfare pluralism. Doctoral dissertation, East China Normal University, Shanghai, China.Google Scholar
Toseland, R. W., McCallion, P., Gerber, T. and Banks, S. 2002. Predictors of health and human services use by persons with dementia and their family caregivers. Social Science and Medicine, 55, 7, 1255–66.Google Scholar
United Nations 2011. World Population Prospects. Available online at http://esa.un.org/wpp/unpp/panel_population.html. [Accessed 15 April 2012].Google Scholar
Walker, A. (ed.) 1982. Community Care: The Family, The State and Social Policy. Blackwell, Oxford.Google Scholar
Walker, A. 1991. The relationship between the family and the state in the care of older people. Canadian Journal of Aging, 10, 2, 94112.Google Scholar
Wang, F. and Mason, A. 2005. Demographic dividend and prospects for economic development in China. United Nations Expert Group Meeting on Social and Economic Implications of Changing Population Age Structure, 31 August to 2 September, Mexico City.Google Scholar
Wang, J., Chen, T. and Han, B. 2014. Does co-residence with adult children associate with better psychological well-being among the oldest old in China? Aging & Mental Health, 18, 2, 232–9.Google Scholar
Winship, C. and Radbill, L. 1994. Sampling weights and regression analysis. Sociological Methods Research, 23, 2, 230–57.Google Scholar
Wister, A. and Dykstra, P. A. 2000. Formal assistance among Dutch older adults: an examination of the gendered nature of marital history. Canadian Journal on Aging, 19, 4, 508–35.Google Scholar
Wolinsky, F. 1994. Health services utilization among older adults: conceptual, measurement and modeling issues in secondary analysis. The Gerontologist, 34, 4, 470–75.Google Scholar
Yan, Y. 2006. The Changes in Private Lives. Shanghai Bookshop Publisher, Shanghai, China.Google Scholar
Zavoretti, R. 2006. Family-based care for China's ageing – a social research perspective. Asia Europe Journal, 4, 2, 211–28.Google Scholar
Zeng, Y., Poston, D., Ashbaugh Vlosky, D. and Gu, D. (eds) 2008. Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions. Springer, Dordrecht, The Netherlands.Google Scholar
Zhan, H. J., Liu, G. and Guan, X. P. 2006. Availability and willingness: compare attitudes toward institutional care between Chinese elderly parents and their adult children. The Journal of Aging Studies, 20, 3, 279–90.Google Scholar
Zhang, Z., Gu, D. and Hayward, M. D. 2010. Childhood nutritional deprivation and cognitive impairment among older Chinese people. Social Science & Medicine, 71, 5, 941–9.Google Scholar
Zhao, Baige 2007. Vice Minister for China's National Population and Family Planning Commission, “90 m Chinese grow up as ‘only’ children”. China Daily, 22 January.Google Scholar