Journal of Aging & Social Policy最新文献

In November 2020 an outbreak of ethnically and politically motivated armed conflict started in Tigray and expanded to the Amhara and Afar regions of Ethiopia, bringing a devastating impact upon civilians and disadvantaged groups. Persons living in those areas, including older adults, were forced to flee and seek refuge at internal displacement centers. Given the lack of scholarship on aging and humanitarian contexts, this study investigated the challenges faced by older individuals fleeing the war zone and settling in internal displacement centers during Ethiopia's armed conflict. A qualitative descriptive study was used in this cross-sectional investigation. Data from the in-depth interviews with 13 older adults were supplemented with key informant interviews and observations. Interview data was analyzed using thematic analysis. Findings revealed that the older adults escaping their homes and staying in the displacement center faced food shortages; inadequate shelter, clothing and bedding; lack of sanitation and hygiene supplies; inaccessible health services; social network destabilization; family disintegration; lack of care and support; and psychological stress, all of which negatively impacted their physical and psychosocial well-being. The findings call attention to the need for practical access to social and economic integration of older adults in the aftermath of the war as well as ongoing psychosocial intervention.

The need to optimize supports of Alzheimer's disease and related dementias (ADRD) care partners through policy innovation is high. This study sought to frame the care and support needs of multiple historically underrepresented populations who may be underserved and/or have difficulty accessing culturally specific services and determine specific policies that may reduce ADRD care partner burden and improve wellbeing. Qualitative data were gathered through interviews (N = 24) with leaders of organizations that support people living with ADRD and focus groups (N = 5) with dementia care partners from four communities historically underserved in the United States (Asian, Black, Indigenous, and Latinx). Organizational leaders also participated in a modified Delphi process to identify priorities for supporting care partners. Multiple themes were identified including: information resources; navigation and coordination within and across systems; access to clinicians, care teams, health/personal records; legal and financial issues; in-home and respite care; psychological and physical health support for care partners; and flexibility of schedules. Policy-related priorities for supporting care partners informed development of specific policy recommendations related to financing, supports, and respite. State and national policies can be enhanced to address these priorities across populations in ADRD care partner supports, especially for historically underserved groups.

Lower socioeconomic status (SES) is linked to earlier nursing home admission, but it is unclear if this remains true after accounting for health needs. This study examines SES-related inequalities in nursing home admission, controlling for health needs in an area of Switzerland with universal home-based care for older adults. Data were from the Lausanne Cohort 65+ study, including 3650 participants. SES was measured by education level, occupational class, and receiving means-tested benefits (a proxy for low income). Health needs were assessed with a set of physical and mental health variables. Cox proportional hazard models are controlled for demographics and health needs. Over 6 years, 115 (3.2%) participants were admitted to a nursing home. Lower education and receiving means-tested benefits were linked to earlier nursing home admission. However, after adjusting for all SES variables and health needs, associations between socioeconomic inequalities and nursing home admission did not remain significant. Lower SES is initially associated with earlier nursing home admission, but this is substantially explained by functional and cognitive impairment. The study suggests that access to long-term care in Switzerland is horizontally equitable but emphasizes the importance of preventing functional and cognitive decline in lower SES groups.

Little is known about the effect of implementing a long-term care insurance (LTCI) program on long-term institutional care admissions. This study employs a quasi-experimental design to examine the impact of China's LTCI pilot program on institutional care admissions among older adults. Using four waves (2013, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study with 8,005 observations, difference-in-differences was applied to compare institutional care utilization between pilot and non-pilot cities before and after the 2016 policy implementation. Results demonstrate that LTCI significantly increases institutional care admission probability by 0.5%, indicating a profound behavioral impact despite modest absolute changes. The magnitude and direction of effect varies considerably across population subgroups. Age emerges as a key moderating factor, with older individuals showing stronger policy responsiveness. Functional disability presents a more complex pattern: while insurance coverage facilitates access for those with moderate care needs, the effect diminishes among severely disabled individuals for whom institutional care represents an unavoidable necessity. Metropolitan areas demonstrate substantially greater policy effectiveness compared to rural regions. The findings provide crucial evidence on how enabling factors in healthcare utilization operate within different demographic and geographic contexts, offering insights for policymakers designing LTCI systems in aging societies.

Changes in policies that restrict early retirement have raised the retirement age for many low-skilled older workers in Denmark. This study examines the prevalence of adversities among these workers and their impact on mental well-being. Using latent class analysis on Danish survey data from 5,453 low-skilled workers aged 57-62 years, five distinct adversity profiles were identified: "poor health" (17%), "adverse working conditions" (11%), "dire financial situation" (11%), "poor health and adverse working conditions" (8%), and "no adversities" (52%). Workers facing adversities report significantly lower mental well-being, with a higher risk of depression and increased stress levels, compared to those without adversities. The risk of poor mental well-being is highest among those experiencing both health and work-related adversities. Additionally, "job lock" - when workers wish to retire but cannot afford to - emerges as a key factor associated with reduced mental well-being across all adversity profiles. The findings suggest that efforts to extend working lives by limiting early retirement opportunities could have unintended implications for the mental well-being of low-skilled older workers. Notably, the findings indicate that firms actively engaging in supportive practices can mitigate some adverse effects, underscoring the critical role employers play in safeguarding the mental well-being of older employees.

Long-term care insurance (LTCI) serves as a pivotal policy instrument in addressing long-term care needs globally, yet its impact on spousal caregiver's burdens remains underexplored. This study investigates China's LTCI pilot policy, focusing on its influence on co-residential spousal caregivers. Using data from four periods of the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011-2018, LTCI pilots are employed as a natural experiment to evaluate changes in caregivers' emotional, physical, and social burdens. The quantitative results indicate that LTCI significantly reduces emotional and physical health burdens among spousal caregivers of people with disabilities in China, along limited effect on social burdens. Heterogeneity tests reveal that LTCI's effects are most pronounced in rural areas and among spouses with lower education levels. These findings underscore the need for policy refinements targeting spousal caregivers, with particular emphasis on socioeconomically disadvantaged groups.

Older formerly incarcerated individuals (OFIIs) face unique reentry challenges, particularly concerning housing and family reunification. Using in-depth, semi-structured interviews with 19 individuals released from prison after the age of 50, the study explored their reentry experiences focusing on how they navigated housing and social support systems post-release. Results showed housing challenges are compounded by age-related barriers, stigma, and weakened social support networks. Targeted interventions are needed, including eliminating discriminatory housing policies, expanding Medicaid-funded supportive housing, and developing family-focused reentry programs. By highlighting the interconnectedness of housing and social support, this research emphasizes the need for age-specific policies and community-based assistance to improve reentry outcomes for older returning citizens.

Understanding how digital literacy affects the quality of life (QoL) of older adults is crucial in the context of growing digitization. Drawing on data from a survey of 2,238 community-dwelling older adults in Hunan province, China, this study investigated the association between digital literacy and QoL, including mediating mechanisms and the threshold effects of this relationship. The results indicate that digital literacy was positively correlated with QoL of older adults, and these findings remained robust after using double/debiased machine learning and instrumental variable approach. Moreover, the QoL-enhancing effect was more pronounced above a digital literacy score of 27, reflecting a threshold effect. Mediation analysis revealed that digital literacy indirectly improved QoL through two pathways: community participation and health checkup. Overall, the findings suggest developing targeted digital literacy policies for older adults, which should prioritize comprehensive digital literacy training that goes beyond basic skills. Furthermore, promoting digital literacy as a means to enhance social participation and health engagement can help support the well-being of older populations and foster active aging in an increasingly digital world.

With the expected rise in unpaid caregiving, many caregivers will have to combine care with employment. While most research finds negative spillovers between caregiving and employment, it is crucial to understand the factors under which caregiving has positive spillover effects. Analyzing Dutch retrospective data from the Longitudinal Internet Studies for the Social science (3,543 caregiving situations of 2,042 caregivers), this study examined how factors from the work environment and the caregiving situation are related to two positive spillovers, namely learned skills from caregiving for paid work and employment being a relief from caregiving. Results from multilevel models show that a working environment with high flexibility compared to no flexibility was related to more skill learning and relief. Further, we found that more understanding of managers and colleagues was related to learning skills, while managers and colleagues knowing about caregiving was linked to feeling relief. More diverse caregiving tasks were associated with more skills learned for paid work and more relief felt. These findings can guide state or firm-based policies to not only prevent negative but also foster positive spillovers.

Aging well has become a critical topic among scholars and policymakers in the context of global population aging. In Australia, the growing aging population underscores the need for a comprehensive index to measure successful aging. However, challenges such as data limitations, contextual constraints, and the lack of a unified social consensus have hindered efforts to establish nationwide measurements. Inspired by the European Union's Active Aging Index and employing a consistent theoretical framework and calculation method, this paper develops an Australian aging well index comprising 21 indicators across four domains. The constructed index offers valuable insights into Australia's strengths and weaknesses in supporting older adults, while also enabling comparative evaluations across nations. Australia demonstrates strong performance in the domains of Independent, Healthy and Secure Living, and Capacity and Enabling Environment; however, improvements are needed in Employment and Social Participation and Relationships. Targeted policy interventions are recommended to enhance employment opportunities and promote social engagement, thereby fostering a more comprehensive approach to aging well.