Jung-Hwa HaSeoul National University

Presentation at NYU Aging IncubatorNovember 8, 2018

Dr. Bussarawan Teerawichitchainan, Singapore

Management University

Dr. John Knodel, University of Michigan

Collaborators

Study background and objectives Conceptual framework Data and measures Results Implications and Conclusion

Overview

4

Does childlessnessaffect older adults’

social and psychological well-beingin East and Southeast Asia?

Dramatic decline in fertility across E and SE Asia

7

Total fertility rates in East and SE Asia, 1960-65 and 2010-15

2.0

5.66.2

5.1

6.16.7 6.4 6.4

6.15.6

7.0

6.0

7.0

1.4 1.21.6

1.21.5

1.9 2.0 2.1 2.32.5 2.7

3.0 3.1

0

1

2

3

4

5

6

7

8

9

Japa

n

Sout

h Ko

rea

Chin

a

Sing

apor

e

Thai

land

Brun

ei

Viet

Nam

Mal

aysia

Mya

nmar

Indo

nesia

Cam

bodi

a

Lao

PDR

Phili

ppin

es

East Asia Southeast Asia

1960 - 1965 2010 - 2015

8

Source: UNESCAP (2018)

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Number and Percent of Migrants in China, 1982–2010 (Lu & Xia, 2016)

Smaller family size and increased migration resulted in changing living arrangements of older persons

10Sources: 1986-2017 Surveys of Older Persons in Thailand

Percent of older adults 65+ residing with their adult children

11(Yasuda, Iwai, Yi, & Xie, 2011, p.704)

Research Questions

What are the prevalence and dimensions of childlessness in S. Korea, China, Thailand, Vietnam, and Myanmar? Actual childlessness (elderly without children) De-facto childlessness (elderly whose all children migrated

elsewhere)

Does childlessness contribute to the wellbeing of older persons in East and Southeast Asia? Specifically, we examine the extent to which actual and de-

facto childlessness are associated with (a) social isolation and (b) loneliness

Are these effects moderated by gender and wealth? 12

Conceptual framework

Childlessness as a source vulnerability Children often provide emotional, instrumental, and

financial support to older parents Alternative sources of support are often not present or under-

developed in study countries Lack of children may be linked to limited access to other

social resources or fewer social networks Geographic distance to children may limit the extent to

which children can provide emotional and instrumental support

Negative effects of both actual and de-facto childlessness on older adults’ psychological and social well-being

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Alternative hypotheses Childless older adults may have accumulated more

financial resources and social networks outside their immediate family no effect of actual childlessness on social isolation

Improved technology may help older adults maintain contact with their children (intimacy at distance), and it may have minimal effects on older adults’ loneliness. Older adults may also have more time to interact with others. no effect of de-facto childlessness on social isolation or loneliness

Conceptual framework

Moderating effects of gender and Wealth

Gender Given greater stigma of childlessness (especially infertility)

and fewer opportunity to engage in labor force, women may be more negatively affected by childlessness

Alternatively, older women’s stronger informal social networks may mitigate the negative effect of childlessness

Wealth Those who have greater financial resources may be less

negatively influenced by childlessness.

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Why these five countries?

Similarities Filial piety emphasized as cultural and social norm High rates of migration especially in Southeast Asian

countries and China

Differences Age structure and fertility rate Stage of economic development Availability of social security and other policy

measures for older adults 16

Country settings S. Korea China Thailand Vietnam Myanmar

% 60+, 2015

18.4 15.4 15.6 10.3 8.9

% 60+,2050

41.6 35.1 35.1 28.3 18.5

TFR,2010-15

1.23 1.60 1.53 1.96 2.30

GDP per capita, 2016

$27,539 $8,123 $5,908 $2,186 $1,275

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Data sources

Samples of persons aged 60 and over 2012 Korean Longitudinal Study of Aging (KLoSA)

2011 China Health and Retirement Longitudinal Study (CHARLS)

2011 Survey of Older Persons in Thailand (SOPT)

2011 Vietnam Aging Survey (VNAS)

2012 Myanmar Aging Survey (MAS)

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Measures - Dependent variables

Social isolation index Assessed with social participation/activity data Sum of [whether or not participated (1/0) in each activity x

frequency of participation (4 = did not participate, 0 = almost everyday)] was used.

Activities differed across countries so we converted the scores into percentiles. (higher score = higher social isolation)

Loneliness Assessed with question asking the extent to which older

persons felt lonely during the past month prior to the survey. Responses were dichotomized (1= always ~ some of the time, 0 = never)

Measures - Independent variables

Childlessness Reference category: older adults living with or close to (same village,

city, ward, or county) their children De-facto childlessness (older adults whose all children migrated elsewhere) Actual childlessness (older adults without children)

Moderating variables: gender (1= female) and wealth(higher=greater wealth)

Control variables: age, marital status, education, pension and work status, place of residence (urban/rural), self-rated health, living arrangement

Prevalence of childlessness

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Prevalence of childlessness

22

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Multivariate analysesDV: social isolation (Main effects)

*** p<0.001, ** p<0.01, * p<0.05Notes: OLS regression models are used. Standardized coefficients are presented. The analyses control for socio-demographic characteristics.

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DV: social isolation (interaction effects)

*** p<0.001, ** p<0.01, * p<0.05Notes: OLS regression models are used. Standardized coefficients are presented. The analyses control for socio-demographic characteristics.

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DV: loneliness (main effects)

*** p<0.001, ** p<0.01, * p<0.05Notes: Binomial logistic models are used. Odds ratios are presented. The analyses control for socio-demographic characteristics.

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DV: loneliness (interaction effects)

*** p<0.001, ** p<0.01, * p<0.05Notes: Binomial logistic models are used. Odds ratios are presented. The analyses control for socio-demographic characteristics.

Summary of findings: Social isolation

Actual childlessness increases social isolation in Thailand, Vietnam, and Myanmar but not in S. Korea and China

In all study countries, levels of social isolation among the defacto childless is comparable to those with children living nearby Children’s migration does not have negative influence on older

persons’ social wellbeing Economic support from migrant children may enable older adults

to remain socially active Increased availability and affordability of technology (e.g., mobile

phones, internet, improved roads) likely allow the de-facto childless to be engaged in community activities. 27

Summary of findings: Loneliness

Actual and de-facto childlessness are related to increased odds of loneliness in all study countries except China

Both types of childlessness may have detrimental consequences for older adults’ psychological wellbeing even though they may not have a significant effect on socialwellbeing Adult children and friends of older adults play different roles Social connectedness may be fulfilled by friends but children

may have a unique role which cannot be substituted with other resources.

Asia: Filial piety is considered as both cultural value and social status.

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Discussion

Childless older persons in China are quite resilient. They do not differ from those with children nearby with regards to

loneliness and social isolation

Accustomed to living without children and established ways to maintain social connection beyond parent-child network? Although the current generation of older adults may not have been

directly affected by the one-child policy, dramatic economic growth and subsequent migration of young adults to urban areas may have normalized “childlessness”

Long history of working together as commune members may buffer the effect of childlessness

Alternatively, it may be due to differences in social participation measures

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Discussion

Gender and wealth matter

Being female mitigates the effects of childlessness on social isolation and loneliness

Effects of wealth differ across outcomes and across countries Greater wealth helps defacto childless elderly Thais to be socially

engaged but they feel lonelier than those who are de-facto childless and have less wealth

Wealth does not always lead to greater social embeddedness

More research is necessary to understand the mechanisms through which wealth creates divergent experiences of childless older persons in different settings.

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Lack of data on reasons for actual childlessness Did not account for whether or not childlessness is

voluntary Childlessness may have different meanings for

married vs. never-married older adultsChallenges in harmonization of key variables De-facto childlessness measure doesn’t account for: Frequency of contact Amount of emotional, instrumental, and financial

support exchanged

Limitations

Cause of childlessness(Case of China)

lives nearbyIntimacy at

distanceDefactochildless

Actual childless Total

Married 5,057 204 136 92 5,489Partnered 245 19 15 5 284Separated 45 0 2 3 50Divorced 35 1 5 5 46Widowed 1,419 19 35 33 1,506

Never married 8 0 1 62 71Total 6,809 243 194 200 7,446

Due to infertility or loss of children

Never had children

Specific information on the cause of childlessness is not ascertained in most population-based surveys.

Improved “children availability” typology

Reference group: Elderly coresiding with children or having children nearby

Intimacy at distance: Elderly whose all children migrated elsewhere but remain in frequent (weekly) contact with children

De-facto childlessness: Elderly whose all children migrated elsewhere and have little or no contact with children

Actual childlessness: Elderly without children33

Availability of children

% distribution China Korea Thailand Vietnam Myanmar

Children nearby 91.7 87.7 75.9 85.5 88.9

Intimacy at distance 2.6 3.0 10.7 8.8 1.0

Defacto childless 2.0 7.0 7.0 1.0 3.3

Actual childless 2.7 2.3 6.4 4.7 6.8

Conclusions

Childlessness is associated with greater loneliness in most countries, yet it does not always have a detrimental effect on later-life social well-being.

Childlessness generally take a toll on older persons’ lives through feelings of loneliness

Greater social isolation among childless elders in SE Asia, although similar effects were not found in E Asia

Findings point to the importance of distinguishing between actual and de facto childlessness

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Our contribution: First study to compare the

prevalence an implications of actual and de-facto childlessness across E and SE Asia.

Implications of childlessness will become even more salient in the future, as mid-aged adults with fewer or no children enter old age.

Conclusions

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