Napaporn Chayovan

A cross-national examination of the determinants of self-assessed health.

Self-assessed health measures are often utilized in surveys of older adults, and these have been found to be powerful predictors of other health indicators and future health. However, there is still much that is puzzling about the measure. Few studies use comparative techniques to ascertain the determinants of self-assessed health across diverse settings. Using recent data from the Philippines, Taiwan, and Thailand, the current study tests whether determinants of self-assessed health are similar across samples and whether there are distinct country effects acting upon the association. Ordered probit models reveal that, on the one hand, the determinants of self-assessed health are relatively similar across the three countries, while, on the other, the overall probabilities of reporting favorable self-assessed health remain differentiated even when controlling for a broad series of determinants. The results suggest that cultural variation in the interpretation of health may be a factor and that more subtle measures should be included in future studies of this nature.

Intergenerational support and gender: a comparison of four Asian countries.

We examine patterns of intergenerational support, with a key focus on the gender of the providers, in four countries in East and Southeast Asia: Philippines, Singapore, Taiwan and Thailand. These countries make an interesting set for comparison because they are characterized by varying levels of social and economic development and different family systems, with the Philippines and Thailand having bilateral family systems, Taiwan having a strong patrilineal family system, and Singapore having a mix of the two systems across ethnic groups. Our analyses are based on a recent round of national surveys of older persons that were conducted in each country. The results reveal distinctive patterns and varying levels of flexibility across countries with respect to the gender of coresident married children, but only modest gender patterning in the provision of financial and material support and visiting patterns.

The impact of fertility decline on familial support for the elderly: an illustration from Thailand.

The recent and substantial reduction in the number of children among couples in Thailand is commonly perceived to be one of the most important social changes likely to reduce the extent to which future generations of Thai elderly will be supported by their families. This analysis suggests that the impact of fertility decline per se will be relatively moderate with respect to coresidence the most crucial aspect of familial support....Notwithstanding the very substantial fertility decline few elderly are likely to be childless or to have only one child and elderly parents with at least two children are still quite likely to live with one of them. An important implication of the study is that in settings similar to Thailand the negative effect of lower fertility on familial support for the elderly need not be an overriding concern when deciding whether or not to implement policies to reduce fertility. (SUMMARY IN FRE AND SPA) (EXCERPT)

How Indicators of Socioeconomic Status Relate to Physical Functioning of Older Adults in Three Asian Societies

The relationship between socioeconomic status and physical functioning is tested among older adults in Taiwan, Thailand, and the Philippines. Socioeconomic indicators are limited to education and income, and these are linked to several measures of functioning that are constructed using four specific items—having difficulties crouching, climbing stairs, lifting things, and walking. Depending on the outcome measure, samples are treated separately or pooled. Education is found to be associated with functional health in Taiwan but is a weaker predictor in Thailand and the Philippines. Income has strong associations in Taiwan and Thailand and only a moderate association in the Philippines. Interaction effects based on pooled data confirm that differences in associations exist across settings. These results lead to questions about the universality of the relationship. Explanations for differential effects are discussed, including the impact of national levels of development on health outcomes.

Measuring accessibility to family planning services in rural Thailand.

There are a variety of ways to conceptualize and measure accessibility to contraceptive services and supplies. Using detailed data for rural Thailand, a multiplicity of reasonable measures are developed that reflect time and/or distance to various government program outlets. Many of these are only moderately correlated with one another, and to an important extent, different measures show different associations with levels of contraceptive prevalence. Clearly there is a general need in this area of investigation to pay more attention to the measurement of accessibility as a community characteristic and to consider the sensitivity of results to alternate measures.

Sexual activity among older Thais: The influence of age, gender and health

This study examines sexual activity among thepopulation aged 50 and over in Thailand inrelation to age, gender and health status. Itis the first study of older persons based on alarge nationally representative survey in anynon-Western or developing country. The resultsindicate substantial proportions of oldermarried Thais remain sexually active, but atlower levels than found in Western countries. Sexual activity and desire decline steadilywith age for both married men and women but atany given age both are lower for women. Overall, the sexual desire of husbands is a farmore important determinant of marital sexualactivity than that of wives. Poor healthdepresses activity and desire but does notaccount for the decline of either with age. Forthe majority of older married Thai men andwomen behavior and desires are concordant. Discordance levels for married women exceedthose for men, however, and arise primarilyfrom being active but lacking desire. Possiblereasons for lower sexual activity relative toWestern countries are considered. Implicationsfor the quality of life of older persons andthe AIDS epidemic are discussed together withmethodological lessons for research on olderage sexual behavior.

Gender and wellbeing among older people: evidence from Thailand

Researchers and international organisations frequently suggest that older women are disadvantaged in comparison with older men. This analysis of census and survey data from Thailand, however, indicates a far more complex association between gender and various aspects of ageing. Through an examination of various demographic, economic, psychosocial and health variables, it is found that older Thai women do face certain disadvantages compared to their male counterparts, including lower education and literacy, far higher levels of widowhood and living alone, and a lower likelihood of receiving formal retirement benefits. Older Thai men, however, also face relative disadvantages, including worse survivorship, a lower likelihood of receiving money from adult children, a greater probability of debt and other financial problems, and lower satisfaction with their financial situation. Many other demographic, psychosocial and economic measures are not significantly associated with gender. Our analysis provides some support for a lifecourse perspective, that relates gender differences in old age to differences in earlier life experiences, roles and reward structures, particularly access to retirement pensions and the type of support older men and women provide for their co-resident children. Marital status often mediates gender differences in wellbeing among older people. The study concludes with research and policy recommendations.

Inter‐generational family care for and by older people in Thailand

Purpose – The purpose of this study is to examine inter‐generational arrangements in Thailand for personal care provided to older members and provided by them as grandparents to young children.Design/methodology/approach – Results are based on analysis of the 2007 Survey of Older Persons in Thailand. Consideration focuses on persons aged 60 and older.Findings – The results document the primary role of the family, especially adult children and spouses, in providing personal care to older members. For those with only one or two adult children compared to those with four or more, spouses are considerably more likely and children less likely to be the main care provider. At the same time, older family members, as grandparents, make significant contributions to the care of young children, especially for those whose parents migrated. In most such situations, however, the grandchilds parents cover the main financial support.Social implications – Trends towards smaller family size and increased migration of adul...

Infant feeding practices in Thailand: an update from the 1987 Demographic and Health Survey.

Data from the Thai Demographic and Health Survey, conducted in 1987, confirm evidence from earlier surveys that the decline in the duration of breastfeeding evident during the 1970s came largely to a standstill in the 1980s. In addition, the proportion initiating breastfeeding, while high throughout the period, has increased to the point where, at the national level, it is now close to universal. These changes coincide with efforts, primarily undertaken or coordinated by the Ministry of Public Health, to promote breastfeeding and discourage use of breast milk substitutes. While substantial socioeconomic differentials in the duration of breastfeeding exist, initiation is common even among the groups that breastfeed for the shortest period of time. Breastfed children are generally given supplemental foods or liquids at very early ages. It is common to breastfeed children relatively frequently during the day and evening. Bottles with nipples are used to provide supplementary food to breastfed children by a substantial proportion of mothers. Most use of bottles with breastfed children is not for the provision of infant formula but for other types of supplemental food.

Contraceptive Initiation Patterns in Thailand

Data from the Thailand Demographic and Health Survey permit a detailed examination of the pattern of contraceptive initiation in terms both of first post-marital contraceptive use and initiation of use following childbirth. A clear trend towards beginning contraception earlier in the family-building process over the course of the fertility transition is evident. During the earliest stage, contraception was first used mainly after a couple had already achieved their desired family size, but later on couples increasingly began use in order to space births, and most recently it has become common to begin use to delay the start of childbearing. There are two distinctive patterns of contraceptive initiation following childbirth. For women who chose sterilization, initiation occurs during the immediate post partum period, while for those who used other methods, use most commonly began shortly after the return of menses. As a result, few Thai women are at present unprotected against unplanned pregnancies for any...