Health and Living Arrangement Transitions Among China’s Oldest-old

1. Health and Living Arrangement TransitionsAmong China’s Oldest-old Zachary Zimmer Population Council

2. Introduction Because of health problems, the oldest-old require high levels of support In China, support is often facilitated through coresidence So, household composition is particularly important for the oldest-old • This paper looks at household composition by comparing the living arrangement transitions of those in good versus poor health

3. Perspective • Filial piety plays an important function in coresidence • Coresidence may also be a practical decision given lack of alternative support structures • This suggests coresidence decisions are in part altruistic and in part rational.

4. Hypotheses The oldest-old with health problems are most likely living with others 2) Moving in and remaining with others is a function of poor health 3) Relationships are stronger for those not married

5. Measuring Living Arrangement • Lives with • othersa 1) Lives with children 3a) Alone Those not married IF NO • Lives • independently Those married 3b) With spouse a Spouse not included as ‘other’

6. Measuring Health ADL functional limitation 1= yes 0=no 2. Health condition 1=yes 0=no 3. Mini-Mental State Exam (MMSE) Scored 0 to 19

7. Model Living Arrangement At Follow-Up Married With spouse only With children With Others Not married Alone With children With Others

8. Model Health ADL limitations Health conditions MMSE score Living Arrangement At Follow-Up Covariates Age, Sex, Education, Occupation, Marital status at origin Rural/Urban residence, number living children, has a son Married With spouse only With children With Others Not married Alone With children With Others

9. Model Health ADL limitations Health conditions MMSE score Living Arrangement At Follow-Up Covariates Age, Sex, Education, Occupation, Marital status at origin Rural/Urban residence, number living children, has a son Married With spouse only With children With Others Not married Alone With children With Others + Living arrangement at origin

10. Model Health ADL limitations Health conditions MMSE score Women Men Living Arrangement At Follow-Up Covariates Age, Sex, Education, Occupation, Marital status at origin Rural/Urban residence, number living children, has a son Married With spouse only With children With Others Not married Alone With children With Others + Living arrangement at origin

11. Living Arrangement Distributions at Origin and Follow-Up With others With children Spouse only Alone

12. Living Arrangement Distributions at Follow-up By Living Arrangement at Origin At follow-up Living arrangement at origin

13. Percent in Different Living Arrangement at Follow-up by Living Arrangement at Origin

14. Log Odds Ratios for Living Arrangement Transitions, Showing Health Effects by Marital Statusb *** p < .01 ** p < .05 * p < .10 a Reference category is living with spouse only b Controls for age, sex, education, occupation, rural/urban residence, number of children, having a son, marital status at origin and living arrangement at origin

15. Log Odds Ratios for Living Arrangement Transitions, Showing Health Effects by Marital Statusb *** p < .01 ** p < .05 * p < .10 a Reference category is living with spouse only b Controls for age, sex, education, occupation, rural/urban residence, number of children, having a son, marital status at origin and living arrangement at origin

16. Log-Odds for Men Versus Women

17. Log-Odds for Men Versus Women

18. Summary 1. There is a fair degree of fluctuation in and out of living arrangements over a two-year period 2. Effects of health on living arrangements differ by gender For example: Married men with health problems are less likely to move in with others Married women with health problems are more likely to move in with others

19. Some Possible Explanations - Wives are expected to care for husbands - Older men are likely to be living with others even when their health is good - Men are likely to receive help from non-coresident family