Albert I. Hermalin

The Well-Being of the Elderly in Asia: A Four-Country Comparative Study

The past two decades have witnessed rapid social, economic, and demographic change in East and South-East Asia. The older populations in these regions have been increasing faster than in the West, and the proportions of people over sixty will more than double over the next thirty years. Increased urbanization and educational levels and a strong shift to professional, technical, manufacturing, and service occupations are changing the social and economic landscape, leading to concern for the well-being of the elderly, who traditionally have relied on the family for support. Governments are attempting to preserve these traditions while taking into account widespread family change and new expectations for pension, health insurance, and other public programs.The contributors to this volume use survey and other data collected over ten years to examine the well-being of the current older population in four Asian countries: The Philippines, Singapore, Taiwan, and Thailand. Each major analytic chapter looks at a key dimension of well-being--economic, physical and mental health, work and leisure--and how these are affected by the familial and social support arrangements, as well as age, gender, education, and urban-rural residence. Where possible, changes over time are traced.Explicit attention is given to the policies and programs in place and under development in each country and to the cultural accommodations underway. The contributors also look ahead to the implications of the large numbers of elderly with very different characteristics who will predominate in the coming years and to the policy implications of this coming transformation. The book will be important for scholars and policymakers whose work involves population in Asia, including demographers, sociologists, and economists.Albert I. Hermalin is Research Scientist at Population Studies Center, Institute for Social Research, and Professor Emeritus, Department of Sociology, University of Michigan.

Educational attainment and transitions in functional status among older Taiwanese

Despite considerable research examining the influence of socioeconomic status on health, few studies have considered this relationship as it pertains to older adults in non-Western societies. We attempt to ascertain the influence of education on changes in physical functioning in a rapidly developing country. Data come from the 1989 Survey of Health and Living Status of the Elderly in Taiwan and a follow-up interview in 1993 (N = 4,049, age = 60+). Individuals are conceptualized to be in a state of functional independence or functional limitation at the time of origin, based on their ability to perform three physical functioning tasks. The outcome at the follow-up interview is categorized as functionally independent, limited, or dead, allowing for six probabilities, one from each state of origin to each outcome. These are calculated using a multinomial logit model, controlling for other factors often thought to be associated with health transitions. High levels of educational attainment result in a decreased incidence of functional limitation for those originating in a state of independence. Contrary to expectations, however, education has little influence on those who originate functionally limited. Thus, higher education plays a substantial role in primary prevention of morbidity, delaying the onset of disability, but other factors are more important once limitations begin. We speculate on the reasons behind these findings, including that the results may be culturally dependent.

DO STATEMENTS ABOUT DESIRED FAMILY SIZE PREDICT FERTILITY? THE CASE OF TAIWAN, 1967-1970

The predictive accuracy of respondents’ statements about their future fertility is examined, using interview data from a longitudinal study conducted in Taiwan. Two measures of preference are found to be highly intercorrelated; and regardless of which one is used, Taiwanese women are shown to predict their subsequent fertility at least as well as U.S. women. The preference measures are also predictive of rates of contraceptive use and abortion. While demographic and social characteristics are correlated with fertility in expected directions, statements about wanting more children prove to be highly predictive of subsequent fertility for both modern and less advanced segments of the population.

CHANGES IN SUBJECTIVE AND OBJECTIVE MEASURES OF ECONOMIC WELL-BEING AND THEIR INTERRELATIONSHIP AMONG THE ELDERLY IN SINGAPORE AND TAIWAN

Cet article examine les changements de statut economique des personnes âgees de Singapour et de Taiwan et les determinants de ces changements. A travers cela, les AA. ont observe les niveaux et les changements operes dans les mesures subjectives et objectives du bien etre economique, et les associations entre ces deux types de mesures. Ils ont egalement cherche a savoir si certaines transitions telles que le veuvage, le decin de la sante ou la retraite, affectent chez ces personnes la perception du niveau de leur revenu

THE MULTILEVEL DEPENDENCE OF CONTRACEPTIVE USE ON SOCIOECONOMIC DEVELOPMENT AND FAMILY PLANNING PROGRAM STRENGTH

Using World Fertility Survey data for 15 developing countries, we estimate an equation in which the dependent variable—whether the respondent has ever used an efficient contraceptive method—depends on the respondent’s education and location of childhood residence. All of the coefficients of this equation, including the intercept, vary over countries. Analysis based on new methodology shows that the intercept and education effects vary as a function of national family planning program efforts and that none of the parameters of the equation depend on gross national product per capita. The results demonstrate the efficacy of multilevel analysis, provide a partial test of the theory underlying the analysis, and refocus discussion of the contributions of development and policy variables to fertility reduction.

Effects of birth rank, maternal age, birth interval, and sibship size on infant and child mortality: evidence from 18th and 19th century reproductive histories.

There has been long-standing interest in the effects of maternal age, birth rank, and birth spacing on infant and child mortality. Contradictory inferences about the role of these factors have arisen on occasion because of the absence of adequate controls, the use of cross-sectional or incomplete reproductive histories, and inattention to the effect of family size goals and birth limitation practices. This study analyzes completed reproductive histories for German village populations in the 18th and 19th centuries, a period when deliberate fertility control was largely absent. Our results confirm previous studies of the association of infant mortality with maternal age, although in the present data these differentials are largely limited to neonatal mortality. They also confirm the importance of birth interval as a factor in infant mortality. Sibship size is positively related to infant mortality even when birth rank is controlled. However, once sibship size is controlled, there are no systematic differences in infant and child mortality by birth order. The mechanisms relating sibship size and mortality are explored.

A MULTILEVEL MODEL OF FAMILY PLANNING AVAILABILITY AND CONTRACEPTIVE USE IN RURAL THAILAND

This paper assesses the ways in which the availability of family planning program outlets influences the likelihood of contraceptive use in rural Thailand. It focuses on a village-level measure of actual availability of sources rather than respondent perceptions of availability. Individuallevel and village-level data collected as part of the second Thailand Contraceptive Prevalence Survey are used to test three hypotheses about the effects of actual availability: that (a) availability of family planning outlets increases the likelihood of contraceptive use; (b) it enhances the effect of a desire for no more children on the likelihood of use; and (c) it weakens the positive relationship between education and the likelihood of use.

Do intentions predict fertility? The experience in Taiwan, 1967-74.

Are responses to survey questions about desire for additional children useful in predicting future fertility? Data from Taiwan covering the years 1967--74, a period of rapid fertility decline and increasing contraceptive practice, indicate that reproductive intentions and contraceptive use were very good predictors of subsequent fertility. Whether more children were wanted was itself the most important determinant of contraceptive use. Aggregate consistency between attitudes and behavior was higher than found in US surveys during the same period. Similar studies are needed to determine whether statements of intentions have predictive value in other settings as well.

THE 1960s: A DECADE OF PROGRESS FOR BLACKS?

Between 1960 and 1970 blacks, as well as whites, improved their socioeconomic status. Among both races, educational attainment increased, the occupational distribution was upgraded, and real purchasing power rose markedly. In almost every comparison, the gains were somewhat greater among blacks than among whites and thus most indicators of racial differentiation declined. Nevertheless, the changes of this decade failed to eliminate racial differences with regard to socioeconomic status. In all comparisons, except for the income of certain groups of women, blacks were at a disadvantage when compared to whites both at the start and at the end of this decade, and very large racial differences remain. Further socioeconomic progress by blacks during the 1970s will probably not eliminate racial differences. The article concludes by relating the socioeconomic trends to such other aspects of race relations as integration, governmental policy, and the attitudes of whites and blacks.

The Impact of Family Planning Clinic Programs on Adolescent Pregnancy

During the 1970s, there was a decline in adolescent childbearing in the United States and, among teenagers who were sexually active, there was a decline in pregnancy rates as well. To what extent was increased enrollment by teenagers in federally funded family planning clinics responsible for these declines? Areal multivariate analysis reveals that adolescent birthrates were reduced between 1970 and 1975 as the result of enrollment by teenagers in family planning clinics, independent of the effects of other factors also affecting fertility, such as poverty status, education and urbanization. Using a model which controls for differences in adolescent sexual activity in different areas in 1970 and 1975, the analysis found that for every 10 teenage patients enrolled in family planning clinics in 1975, about one birth was averted in 1976. Other multivariate models, which did not control for differences in sexual activity, showed changes in the same direction, though of smaller dimension. Since the family planning program averts not only births but also pregnancies that result in abortions and miscarriages, an estimate was made of the total number of pregnancies averted by the program. Based on the proportion of unintended pregnancies among adolescents that resulted in live births in 1976 (36 percent), it was estimated that for every 10 teen patients enrolled in 1975, almost three pregnancies were averted in the following year. Over the 1970s, an estimated 2.6 million unintended adolescent pregnancies were averted by the program--944,000 births, 1,376,000 abortions and 326,000 miscarriages. In 1979 alone, an estimated 417,000 unintended pregnancies were prevented by the program.