Journal of Aging & Social Policy最新文献

Middle-aged and older adults who are employed in precarious, high-strain jobs may face challenges to continued work, risking economic insecurity and poor wellbeing in retirement. Technology in the workplace, an under-studied aspect of work environments, could accommodate aging workers or could add stress to their jobs. This study examines how technology in sales and surveillance at work are related to job satisfaction and planned job exits among approximately 6,000 workers aged 50-69 employed in the low-wage service sector (e.g. retail, pharmacy, grocery, hardware, fast food, casual dining, delivery, and hotel). On-the-job surveillance was related to lower job satisfaction and higher reports of looking for a new job, especially when combined with sanctioning for slow speed of work. However, rewards for speed, and to a lesser extent the use of leaderboards, were associated with higher job satisfaction, demonstrating the potential of technology to enhance the work experience for older employees. The use of sales technologies was not associated with job satisfaction or intentions to look for a new job. These results provide a uniquely detailed portrait of prevailing labor market conditions for aging workers in the service sector and demonstrate how certain kinds of technology matter for older workers' employment.

Rural China has been experiencing a significant rise in empty nesters among older adults, a mixed consequence of contemporary social issues such as population aging, urbanization, and migration. Focusing on rural older populations who have traditionally relied on private transfers from adult children as well as public assistance, this study used data from the China Health and Retirement Longitudinal Study 2018 and the propensity score matching method to investigate the crowding-out effect of China's primary public assistance program, Dibao, on financial transfers from adult children to their empty-nest older parents and older parents' relationship satisfaction with their adult children. Our findings reveal that Dibao significantly reduced financial transfers from adult children to their empty-nest older parents but enhanced older parents' relationship satisfaction with their adult children. Furthermore, this crowding-out effect was more significant in irregular and cash transfers, and among those with lower capability of engaging in grandchild caregiving. These results suggest a complex dynamic wherein Dibao reduced financial contributions from adult children to their older parents in rural China. This study contributes to understanding the mixed effects of social assistance programs on intergenerational transfers and relationships in the context of the rapidly changing social structure in China.

Older adults are staying in the labor market longer. As the workforce ages, occupational health policies for older workers are required to reduce the burden on occupational safety and health management and maintain workers' health. This study examined the sociodemographic characteristics and health problems of older adults working beyond pension age. Network analysis was used to identify the central health problems reported in the 2017 and 2020-2021 Korean Working Conditions Survey. Results reveal that most older workers belong to blue-collar occupations; they had lower incomes, less education, and worked in ergonomic hazard postures compared to white-collar occupations. The central health problem of the networks in general and blue-collar workers was muscular pain in the upper limbs, which had the highest-strength centrality and showed significant relationships with lower limb pain, backache, and fatigue. In the comparison by occupation types, the central health problem of pink-collar workers in the service and sales sector was lower limb pain. Occupational safety and health systems should consider the relationships of health problems amongst occupation types and determine interventional priorities. The study findings thus hold implications for the establishment of health programs for older workers.

The evolution of long-term care policy in China is a complex response to the nation's demographic shift and socioeconomic changes. Despite extensive policy development, discrepancies between policy intentions and real-world demands of older adults persist. This commentary dissects the dynamics that have shaped China's aging policies from the 1950s to the present, identifying gaps between policy formulations and market response and the challenges of navigating a fragmented regulatory landscape. A misalignment has emerged between an undersupply of home and community-based services and overstocked institutional care capacity, resulting in resource underutilization and diverging from intended policy outcomes. This commentary further explores the regulatory fragmentation within China's long-term care sector, finding that fragmented supervision is a significant barrier to achieving cohesive governance and effective policy implementation. It illustrates the critical need for adaptive policy mechanisms that better align with demographic realities and consumer expectations. This commentary contributes to the discourses on long-term care policy by offering insights into the effectiveness of China's strategic initiatives in recent years and suggesting directions for future policy refinement.

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.

China has implemented national essential public health services (NEPHS) to strengthen its primary health care system. These services are continuously adjusted in accordance with factors such as public health service requirements. Previous research has indicated significant variability in the prevalence and patterns of multimorbidity. This study utilizes the Electronic Health Records in 2021 (N = 4,045,684) to describe the prevalence of major chronic diseases and explore common patterns of multimorbidity among older adults in Zhejiang, China. Results show that the prevalence of multimorbidity was 36.04%, with the most common pattern of multimorbidity being hypertension and dyslipidemia (12.66%), followed by hypertension and diabetes (5.46%), and hypertension, dyslipidemia, and diabetes (3.95%). The NEPHS should consider embracing the strategic management framework of the Guided Care Model, shifting the focus from a purely disease-oriented to a more holistic patient-oriented model.

In an era where urban environments increasingly grapple with the challenges of an aging population, the necessity for age-friendly neighborhoods (AFNs) has never been more acute. This study investigates the implementation and effectiveness of AFN initiatives in Hong Kong, examining the alignment between policy intentions and their actual impact on the ground. Utilizing a strengths-based perspective, documentary and thematic analysis for gray literature, semi-structured interviews, and focus groups are employed to bridge existing research gaps by highlighting the subjective agency of older adults. The findings reveal that while policies are robustly designed, their execution often fails to align with older adults' actual demands and expectations. Although public policies are generally well-intentioned, they often lack specificity and fail to accommodate the unique needs of the older population fully. Serving as active agents, older adults have the potential to contribute significantly to the making of AFNs, challenging the traditional view of them as mere beneficiaries.

Consumer-directed care (CDC) programs for older people aim to optimize health outcomes by offering clients control and flexibility regarding service arrangements. However, policy design features may differ due to heterogenous sociostructural systems. By operationalizing a framework with three dimensions of CDC, i.e. control and direct services, variety of service options, and information and support, we analyzed how countries vary in their policy designs to achieve consumer direction. Using an expert survey (n = 20) and cross-national document analysis, we analyzed 12 CDC programs from seven selected countries: the United States, the United Kingdom, Germany, the Netherlands, China, Australia, and Spain. Among the three dimensions, CDC programs placed more emphasis on and displayed more homogenous performance of policy designs that achieve consumer direction in the dimension of control and direct services, while less emphasis was placed on and more heterogenous performance displayed in the dimensions of variety of service options and information and support. We offer a systematically operationalized framework to investigate CDC policy designs. Findings advance our understanding of CDC policy features from a cross-national perspective. Policymakers could incorporate these findings to empower older people in their respective societies.

Preventing infections in nursing homes is highly challenging, given the ambiguous nature of nursing homes as care institutions and places to live. Yet, little is known about how care workers experience preventing infections in this context. Understanding the ambiguities experienced by care workers in nursing homes when enacting infection prevention is crucial to preparing for future health crises. This study investigates and identifies the ambiguities care workers faced and experienced when preventing infections during the COVID-19 pandemic. Interviews and observations were combined to capture narratives and behaviors related to infection prevention and care work. By using thematic analysis, three types of ambiguity were identified: (a) an Ambiguous sense of purpose, (b) Environmental ambiguity, and (c) Information ambiguity. The findings provide a nuanced understanding of the ambiguities care workers face and experience in nursing homes when preventing infections and indicate that such ambiguities impact their behaviors and attitudes. From this study, it is possible to conclude that policymakers must consider nursing homes' ambiguous characteristics in infection prevention programs.

Older migrants face special difficulties in the access and use of long-term care services and supports (LTSS). Our study was designed to examine how older persons with limited English proficiency (LEP) in two groups of migrants (Spanish or Chinese speaking) interact with the LTSS system. Focus groups were used to elicit information from members of these groups. We discovered Chinese elders were likely to believe that the LTSS services could, if managed properly, meet their needs, while the Spanish speakers were more skeptical. These differences were associated with the presence of trusted intermediaries among the Chinese elders who could represent their interests, while most Spanish speakers did not report having such intermediaries. In this way, trust, or lack of it, was uncovered as the key element defining older adults' interactions with the formal health and social service systems. Findings will be used to develop a modeling method that will allow us to analyze results in a manner that can be extended to use with other migrant groups.