Journal of Aging & Social Policy最新文献

The global trend of transferring responsibility for dignified aging from the state to individuals is conducive to a variability of alternative attitudes and strategies. Despite having important implications for both the state and individuals, the variability of old age risk management has not been fully appreciated by social policy. Social policy cannot adapt to every individual, but it can reflect various categories of citizens and their patterns of old age risk management. In this article, we navigate the plethora of individual choices by identifying patterns of strategic behavior in old age risk management in society. Based on our data from the original 2018 survey, representative for the Czech population, we identify four distinctive strategies: risk taking, risk avoiding, risk neglecting, and risk preventing. We conclude by discussing how the data gathered and analyzed through our research may help social policy actors better understand sources of variability and design more effective policy interventions.

Previous research has shown that providing intensive informal care can have a negative effect on an individual's mental health. However, few studies have been able to draw a precise comparison between the experiences of in-home and out-of-home caregivers. This study used data from 16 countries collected from 2011-2019 as part of the Survey of Health, Ageing and Retirement in Europe (SHARE) to conduct asymmetric panel fixed-effects models that examined within-person variation in depression scores after a respondent started providing daily or almost daily personal care either inside or outside of their home. The results substantiated previous findings that in-home caregivers experience more pronounced increases to their reported depressive symptoms after starting to provide daily personal care than do out-of-home caregivers. In addition, in-home caregivers in countries with greater governmental responsibility for long-term care provision (The Northern and Central Clusters) reported fewer increases to their depressive symptoms after starting to provide care than caregivers in countries where long-term care responsibility predominantly rests on families (The Southern and Eastern Cluster). Further, Northern Cluster countries most successfully shrank the pool of out-of-home care providers. Together, these findings underscore the context-specific nature of caregiver wellbeing.

We present new evidence on financial literacy and private long-term care insurance (LTCI) ownership in Singapore, where policy intervention has resulted in a highly standardized marketplace with fixed benefit terms and premiums schedules. Using data from the 2018 Singapore Life Panel (N = 6,151), we document that almost half of the adults aged 50 and above in our large community-based sample have private LTCI coverage. We find that that financial literacy significantly increases LTCI demand, notwithstanding a simple choice environment where consumers cannot customize their policies. Furthermore, the importance of financial literacy was borne out through the knowledge aspect rather than financial skills/experience aspects; specifically, each financial knowledge question answered correctly increased the probability of LTCI ownership by 4.4% points on average. Tests for endogeneity between literacy and LTCI ownership reveal no endogeneity bias in the non-instrumented estimates. Overall, these findings underscore these importance of promoting financial education and literacy among consumers in LTCI markets, especially since financial knowledge is expected to play an even more salient role in markets with little or no product standardization.

Increase in life expectancy around the world puts aging societies with all their challenges on the Global Public Health agenda. In Austria, additional years of life gained are not spent in good health, as healthy life expectancy is far below the European average. Using repeated cross-sectional data from three waves of the Austrian Health Interview Survey (2006, 2014 and 2019), including a total of 10,056 participants aged 65 years and above, this study examined the change in self-reported quality-of-life (QoL) over time and explored associated factors. QoL, estimated by domain scores of the WHOQOL-BREF questionnaire, increased over time but decreased with age in all survey waves. Observed mean scores were significantly higher in males than in females in all QoL domains except the social domain but sex differences disappeared in most domains in the multivariable regression analyses. Instead, factors associated with significantly higher QoL scores included younger age, higher socioeconomic status, living in Western Austria and having no chronic conditions. Statistically significant observed sex differences in QoL in the older-aged Austrian population disappeared when adjusting for income and education. Strategies and measures to increase financial capabilities may have a significant impact on QoL and well-being in this age group.

Home and community-based services are key to an aging society and the aging in place strategies that are preferred by older adults as well as policymakers. But the provision of these kinds of services is often inadequate in territorial terms, raising the question of how to increase their reach and efficiency. This article analyzes the spatial coverage of home support services in the Aveiro Region of Portugal, considering the distribution of their target population and identifying network configurations which would provide these services more efficiently, through a location analysis that minimizes the distance to potential users of these services. This approach showed that, in the Aveiro Region, the spatial coverage of these services is highly uneven and insufficient, considering that the population with difficulties in performing daily tasks exceeds the population benefiting from these services and that the level of coverage differs greatly between territories. It also showed that significant efficiency and equity gains are possible by optimizing the service providers' location at the supra-municipal scale, decreasing the distances to be covered and reducing territorial inequalities.

With rapid population aging in the U.S. a greater number of older adults now experience economic insecurity, a situation disproportionately affecting older people of color. The COVID pandemic, rising inflation, and increasing economic inequality have reduced the purchasing power of both wages and fixed incomes. Compared with prior cohorts, the current cohort of adults at or nearing retirement age faces higher levels of secured and unsecured debt burden from mortgages, home equity loans, student loans, credit cards, and out-of-pocket medical costs. Long-standing disparities in opportunities and generational wealth have resulted in more outstanding debt for Black older adults than their white counterparts. This "financial fragility" may result in older people foregoing proper nutrition, doctor's visits, needed medications, or home or car repairs, while stress about finances may contribute to chronic health and mental health conditions. Along with programs to educate and advise older adults on their pressing financial concerns, practitioners who interact with older people in many settings should incorporate needed financial assessment and referrals into their work with this population. Professional and continuing education should ensure financial literacy and awareness of financial fragility for those working with older adults.

Policies aimed at increasing employment among older people often focus on the statutory retirement age. Taking into account the characteristics of workers and work-related factors, we examine the impact of reaching the statutory retirement age on continuing employment. In addition to the use of survival trees, we propose a novel method to predict the probability of staying in employment based on an ensemble of survival trees. We focus on Poland as an example of a European country with a particularly low share of older workers in the labor force. Moreover, reform was carried out in Poland in 2017, lowering the previously raised pension eligibility age. Like other EU countries, pension eligibility in Poland starts after reaching the statutory retirement age. Our results suggest that the timing of retirement is determined by the statutory retirement age to a limited extent compared to other factors. In the case of women, a match of education and occupation, the employment sector, and holding a managerial position had a greater impact on continuing employment than reaching retirement age. In the case of men, the type of job contract had the greatest impact on continuing employment. Our findings indicate that the policies and initiatives aimed at extending working life should pay more attention to work-related factors and gender differences in employment.

The social phenomenon of extended working age has been subject to broad scholarly and social policy interest, as part of such trends as the aging of the population, increased life expectancy, shortage of the labor force, and policy debates on pension reforms. A major question about extending working age, or working after retirement, is whether it is a matter of choice, taking control of one's later life, or is coerced, part of entering the precariat. This study provides a nuanced examination of the social processes that direct labor market participation among older workers by conducting an analysis of in-depth interviews with 42 low-income older workers in Israel. The study exposed several institutional constraints that increase their economic vulnerability, demonstrating how interrelated structural factors related to the labor market, gender, and immigration shape the precarity of the life of older workers and coerce their continuous labor market participation. We conclude by emphasizing the responsibility of governments to ensure that older workers' labor market participation truly represents their "choice and control," rather than being a matter of coercion.

Rural populations in the U.S. and many other countries are aging rapidly, which creates challenges for policymakers and local leadership. Therefore, this study explored what makes rural communities a good place for older adults to live in and why. Data were primarily derived from in-depth interviews with 25 older adults living in four small rural towns in Iowa, and information provided by local stakeholders. All these communities are aging but differ in perceptions about the quality of age-based services. The findings show that such services are important but not a necessary condition for a rural community to be perceived as age-friendly. A strong and supportive social environment appears to offer some compensation when local services are lacking and local infrastructure is underdeveloped. Both older adults and local stakeholders' perceptions of an age-friendly community are mostly related to social networks, informal support, and a local "culture of caring." Recognizing and strengthening these aspects of community life is within reach of rural communities and their leaders, without the need for large-scale interventions or infrastructure investments.

Home and community-based services (HCBS) enable frail patients to remain at home. We examined whether there were neighborhood-deprivation, racial, or rural disparities in HCBS utilization provided to Veterans by the Department of Veterans Affairs (VA) or Medicare by comparing the adjusted utilization rate of a historically disadvantaged group with the predicted utilization rate had it been treated as the historically dominant group. Among the 2.7 million VA patients over 66 years old in 2019, 11.0% were Black, 39.2% lived in rural settings, 15.3%/29.2%/30.9%/24.7% lived in least/mild/moderate/most-deprived neighborhoods. On average, 11.2% received VA or Medicare HCBS. Veterans residing in more deprived neighborhoods had 0.11-0.95% higher adjusted probability of receiving HCBS than expected had they resided in the least deprived neighborhoods. Veterans residing in rural areas had 0-0.7% lower HCBS rates than expected had they been treated like urban Veterans. Black Veterans were 0.8-1.2% more likely to receive HCBS than expected had they been treated like White Veterans. Findings indicate that VA resources were equitably employed, aligning with probable HCBS needs, suggesting that VA's substantial and long-standing investment in HCBS for care of frail Veterans could serve as a model for other payers and providers in the U.S.