Journal of Aging & Social Policy最新文献

The prevalence of dementia is rising rapidly across the European Union, necessitating comprehensive national and international responses. National Dementia Strategies serve as key policy instruments, outlining priorities for dementia care across European countries. While numerous organizations have proposed ethical principles to guide dementia policy, limited knowledge exists on ethical priorities in EU dementia policies. This study examines the ethical principles embedded in European national dementia strategies, analyzing their definitions, contexts of application, and relative emphasis. Using framework analysis, this study systematically analyzed 17 European national dementia atrategies, identifying commonalities and variations in ethical priorities. Findings reveal a broad spectrum of ethical principles present across national dementia strategies throughout the EU. However, findings also suggest significant variations in how principles are interpreted.

China's September 2024 proposal to raise the statutory retirement age prompted online debate over its implications. This study examines how the policy proposal was discussed and framed on Zhihu, a Chinese question-and-answer online community primarily composed of young users (a relevant but underexamined group whose contributions to the pension system and perspectives may shape policy legitimacy and feasibility). 1298 posts were collected over the six days following the proposal announcement and analyzed using thematic and framing analysis. Five key themes emerged from the posts: barriers to extending working life (e.g. ageism), reduced autonomy in everyday life (e.g. unmet family caregiving duties), structural disparities in pension schemes (e.g. occupation- and gender-based differences), rationales for the policy proposal, and intergenerational tensions. Five frames were identified: risk, inequality, compromised well-being, conflict, and opportunity. The findings suggest that the online discourse is predominantly critical and grievance-laden and is intertwined with broader societal and institutional issues. Multiple coexisting frames articulate the diverse experiences and structural conditions of different social groups across age, gender, occupation, and other intersecting identities. The findings suggest that policymakers in labor, health, and social welfare should engage more cautiously with issues raised within the online community, particularly concerns about structural inequalities and disadvantages affecting different social groups.

Following the judicial overhaul enacted by the Israeli government in early 2023, a wave of unprecedented protests surged in the streets. This study aims to understand the experiences of older activists who participated in the initial protests against the judicial overhaul. It explores why some continued protesting, while others disengaged after the October 7 massacre and the subsequent war, using a life course perspective with an emphasis on the concept of linked lives. Between February and May 2025, 22 older activists who had been involved in the initial protests in 2023 were interviewed. Thematic analysis was employed. Results show diverging viewpoints: some activists believe protests remain vital, while others have ceased due to fears of societal division, perceived ineffectiveness, and prioritizing national unity during wartime. Ambivalence was a common thread, especially regarding the legitimacy of protests amid ongoing war. The findings highlight how historical events, personal experiences, and social contexts influence activism. The socioemotional selectivity theory and the concept of linked lives illuminate the reasons behind continued or discontinued protest engagement.

In aging societies, contributory pension systems play a critical role in ensuring income security for older adults. While many countries have reformed these systems to enhance sustainability - by tightening the link between employment histories and benefit eligibility - such changes can unintentionally exacerbate existing inequalities. This study examines the case of Spain's 2011 pension reform, which increased the required contribution period and introduced a dual statutory retirement age. Drawing on administrative microdata from the Continuous Sample of Working Lives (MCVL), this work analyzes over 100,000 newly retired individuals between 2010 and 2020. Results show that women, whose careers are more often shaped by caregiving and part-time work, were disproportionately affected: many postponed retirement to avoid benefit penalties. The reform also halted the prior trend toward narrowing the gender pension gap. These findings underscore how formally neutral institutional rules can reinforce structural disadvantage. Addressing such inequities requires pension designs that incorporate compensatory measures - such as care credits and flexible contribution pathways - to ensure fair and sustainable retirement outcomes for all.

The growing prevalence of dementia is a significant public health concern in the context of dramatic population aging worldwide. Nutrition is related to cognitive outcomes over the life course and dementia risk. This study examines the cognitive consequences of perceived food deprivation in the United States and India. A novel harmonized data set was developed to evaluate differences in the cognitive consequences of perceived food deprivation using data drawn from the U.S. Health and Retirement Study (HRS) and the Longitudinal Aging Study in India (LASI). OLS regression was used to evaluate the association between three domains of cognitive function and perceived food deprivation and to examine whether these effects are dependent on country context. Results show significant cognitive consequences across all three cognitive domains in association with perceived food deprivation, but based on moderation analyses, these effects are significant only among food-deprived individuals in the United States who have approximately one-third of a standard deviation lower cognitive function than their non-food-deprived counterparts (p < .001). Future research is needed to identify mechanisms of these effects and identify specific food policies that could reduce cognitive risks related to perceived food deprivation in the United States.

Throughout the COVID-19 pandemic, the Centers for Medicare and Medicaid Services and state health agencies implemented numerous regulations for nursing homes addressing infection control and data reporting. This study explores interviews (n = 156) with administrators of 40 nursing homes across the U.S. between July 2020 and December 2021 to better understand their experiences with governmental agencies amid shifting regulatory standards, frequent inspections, and possible enforcement actions. Administrators highlighted confusion due to the evolving and sometimes conflicting guidance between state and federal agencies, although some states offered valuable COVID-19-specific assistance. They also described challenges in understanding and implementing new, frequently changing requirements, resulting in potential inspection deficiencies. Although enforcement actions, including financial penalties, are intended to deter noncompliance, administrators expressed concerns about added resource strain. Recommendations included increasing collaboration and data collection between regulatory agencies; reducing administrative burden during outbreaks and incorporating feedback from centers during regulatory changes; and increasing reimbursement to support compliance. Continued changes to oversight, including increased penalization and risk-based survey prioritization, should be evaluated to determine differential impacts on nursing home operations and resident care.

Nursing homes are under immense pressure to improve quality. The purpose of this study was to determine if there is a relationship between registered nurse (RN) skill mix (proportion of RN hours among all nursing staff hours) and higher quality measure (QM) star ratings. Data sets from 2021-2022 were utilized from the American Community Survey, Centers for Medicare and Medicaid Services (CMS), Medicare Cost Reports, Payroll-Based Journal, and Care Compare. The final analytic sample was 14,556 unique nursing homes. Ordered logistic regression was used to examine the relationship between RN skill mix (independent variable) and QM star ratings (dependent variable). The study found that RN skill mix is positively associated with QM star ratings. For a 1% increase in RN proportion, the odds of being in a higher QM star rating category increase by 4% (OR = 1.04, p < .001). This study fills two significant gaps in prior literature by relying on more accurate nurse labor hours through electronic payroll records vs. self-reported data, and by using the government standard of 15 quality measures vs. a few selected metrics. The results have implications for policymakers to incentivize improved quality, and for nursing home administrators to improve QM star ratings.

House, land and asset ownership are crucial indicators of economic security in old age. Food security recognized as a robust social determinant of health and well-being among the older population, ranks highly in the UN's Sustainable Development Goals. This study aimed to examine the association between house, land, and asset ownership, and food insecurity among middle-aged and older adults in India. Data came from a nationally representative survey, the Longitudinal Aging Study in India (LASI) - (2017-18) wave 1. Bivariate and multivariate logistic regression models were used to examine the associations of housing and land and asset ownership with food insecurity. Further, to assess the endogeneity, we used instrumental variable probit model. Housing, land and asset ownership were significantly associated with food. Older adults residing in a rental house were more likely to report food insecurity, particularly the association was stronger in urban areas (aOR = 1.92, 95%CI 1.27, 2.90, p < .001. Also, participants in rural households who did not have agricultural land and farm property were more likely to report food insecurity. Public policy must consider the role of housing, land and asset ownership in reducing food insecurity and improving the overall well-being of the growing older population in India.

China's social medical insurance system has long focused on reducing the risk of catastrophic health expenditures from serious illnesses, overlooking the economic burden of common diseases brought by population aging. To address this problem, China implemented the outpatient mutual-aid security (OMAS) policy for covering outpatient services under its basic medical insurance system for the employed. Using panel data from the China Health and Retirement Longitudinal Study between 2011 and 2018, this study aimed to investigate whether the OMAS policy changed the middle-aged and older adults' utilization pattern of health services by utilizing the difference-in-differences (DID) approach. The results indicated that the implementation of the OMAS policy increased the number of outpatient visits (Coefficient = 0.240, p < .05) and reduced the number of inpatient visits (Coefficient = -0.117, p < .05) without increasing financial risk among middle-aged and older adults. The OMAS policy was also found to be associated with improvements in self-rated health (Coefficient = 0.234, p < .05) and a reduction in the number of ADL limitations (Coefficient = -0.103, p < .05) over the course of its extended implementation. Our study demonstrated that the OMAS policy has led to changes in health-care utilization patterns and enhancements in health outcomes in the long term.