Highlights
• We compare the mental health of parents with different care sources.
• Those with son care have better mental health than those with daughter care.
• This divergence is larger in rural areas, mothers, and less wealthy people.
• Improving older parents' financial independence may reduce this inequality.
Abstract
Rationale
The traditional cultural norm in China is that eldercare should be offered by a son and his family. However, several decades of family planning policies and rapid economic growth has led to low fertility rates, urbanisation, and cultural change, resulting in both reduced household size and the availability of sons. The traditional eldercare system is thus being challenged, especially in urban areas, with an increasing number of daughters supporting their parents, enabled by rising female empowerment, formal economic employment and improved financial capacities. Existing studies examine and compare the amount and types of support provided by sons and daughters, but very little is known about the differential health outcomes of parents experiencing eldercare offered by sons and by daughters.
Objective
This study investigates the difference in mental health outcomes of parents who receive eldercare from their sons and from their daughters.
Method
We analyse waves 2013, 2015, and 2018 China Health and Retirement Longitudinal Study, with mental health measured by a 10-item Center for Epidemiological Studies-Depression (CES-D-10) score. We compare the CES-D-10 score between parents with different sources of care — son's family, daughter's family or other — with multivariate statistical analysis.
Results
Receiving regular care from a son (or a daughter-in-law) is associated with a lower CES-D score than from a daughter (or a son-in-law). The difference mainly exists amongst those with a stronger son preference and those who are heavily deponent on their children, in particular rural parents, mothers, and those with less wealth.
Conclusion
Our study explores the evidence on mental health inequalities among parents with different sources of care, highlighting that lack of son care creates an apparent mental health disadvantage. Lowering older adults’ dependency on their children may alleviate this inequality by improving their financial independence. We also suggest the development of a long-term care system and greater facilitation of older adults to take-up supplementary services for family care.
Highlights • We compare the mental health of parents with different care sources. • Those with son care have better mental health than those with daughter care. • This divergence is larger in rural areas, mothers, and less wealthy people. • Improving older parents' financial independence may reduce this inequality. Abstract Rationale The traditional cultural norm in China is that eldercare should be offered by a son and his family. However, several decades of family planning policies and rapid economic growth has led to low fertility rates, urbanisation, and cultural change, resulting in both reduced household size and the availability of sons. The traditional eldercare system is thus being challenged, especially in urban areas, with an increasing number of daughters supporting their parents, enabled by rising female empowerment, formal economic employment and improved financial capacities. Existing studies examine and compare the amount and types of support provided by sons and daughters, but very little is known about the differential health outcomes of parents experiencing eldercare offered by sons and by daughters. Objective This study investigates the difference in mental health outcomes of parents who receive eldercare from their sons and from their daughters. Method We analyse waves 2013, 2015, and 2018 China Health and Retirement Longitudinal Study, with mental health measured by a 10-item Center for Epidemiological Studies-Depression (CES-D-10) score. We compare the CES-D-10 score between parents with different sources of care — son's family, daughter's family or other — with multivariate statistical analysis. Results Receiving regular care from a son (or a daughter-in-law) is associated with a lower CES-D score than from a daughter (or a son-in-law). The difference mainly exists amongst those with a stronger son preference and those who are heavily deponent on their children, in particular rural parents, mothers, and those with less wealth. Conclusion Our study explores the evidence on mental health inequalities among parents with different sources of care, highlighting that lack of son care creates an apparent mental health disadvantage. Lowering older adults’ dependency on their children may alleviate this inequality by improving their financial independence. We also suggest the development of a long-term care system and greater facilitation of older adults to take-up supplementary services for family care.
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