Relevant studies on ageing – related issues

Gender
 

Chia, N. C., En, S. L. S., & Chan, A. (2008). Feminization of Ageing and Long Term Care Financing in Singapore (SCAPE Policy Research Working Paper Series). National University of Singapore, Department of Economics, SCAPE. Retrieved from http://econpapers.repec.org/paper/scascaewp/0806.htm  
Feminization of ageing leads to issues relating to long term healthcare financing since females are more susceptible to chronic illnesses. This paper assesses the current provision of long-term care (LTC) in Singapore by first examining the health status of elderly female; and then estimates the present value of LTC expenses. We calibrate the LTC costs for institutional nursing homes, community homes and informal home-based care with domestic helper. We next evaluate the comprehensiveness of a private disability insurance scheme in Singapore (Eldershield) in capturing the expected share of LTC expenditures. We compare the policy comprehensiveness of Eldershield payouts for different utilizations of LTC at different levels of means-tested government subsidies. With subsidies, the LTC cost can be adequately covered by Eldershield; without any subsidies, Eldershield is able to capture 25% to 40% of the LTC costs. We also evaluate the LTC financing implications after an osteoporotic hip fracture surgery.

Lim, L. L., & Ng, T. P. (2010). Living alone, lack of a confidant and psychological well-being of elderly women in Singapore: the mediating role of loneliness. Asia-Pacific Psychiatry, 2(1), 33–40. http://doi.org/10.1111/j.1758-5872.2009.00049.x  
Background: The ‘feminization of aging’ and nuclearization of families calls for research to examine the mental health and well-being of elderly women living alone. This study examined a proposed heuristic model whereby the relationship between living alone and lack of a confidant and psychological well-being is mediated by feeling of loneliness. Methods: Path analysis was performed on data of 1,205 community-living older women aged 55 and above with psychological well-being assessed by depressive symptoms (15-items Geriatric Depression Scale) and SF-12 MCS (mental component summary scale of the 12-item Short-Form Health Survey) quality of life scores assessed at baseline and follow-up 1.5 years later. Results: Goodness-of-fit indices used for the model showed good fits. All of the path coefficients were meaningful in absolute magnitude and significant at P<0.001. Living alone was associated concurrently with lack of a confidant (r=0.11), both of which predicts loneliness (path co-efficient=0.09). Loneliness predicts more depressive symptoms (path coefficient=0.25) and SF-12 MCS (path coefficient=−0.28) at baseline, as well as at follow-up. Conclusion: The findings suggest that loneliness mediates the relationship between living alone, lack of a confidant, and psychological well-being. Living alone becomes detrimental when it leads to loneliness. Social programs directed at elderly women who are living alone should alleviate loneliness through satisfactory interpersonal relationships, and emotional and spiritual support.

Mjelde-Mossey, L. A., & Walz, E. (2006). Changing Cultural and Social Environments: Implications for Older East Asian Women. Journal of Women & Aging, 18(1), 5–20. http://doi.org/10.1300/J074v18n01_02  
The world is aging and the trend is towards a global feminization of aging. In the Asia Pacific region, which already contains approximately 50% of the world’s population over age 60, the number of older women exceeds that of older men in most countries. This article explores the changes that are occurring in East Asian social and cultural traditions for aging and discusses the implications of those changes for women who aged in that culture. In the traditional culture, Chinese, Japanese, and Korean families are influenced by values of family centrality and collective orientation to life that are mostly rooted in Confucian values and ethics. In those traditions, older women assume and maintain a valued status within the family and community through respected roles and productive contributions. However, various factors, such as migration to urban areas and demographic shifts, have precipitated modernization of these societies and alterations of traditional culture. These cultural shifts are relevant to the United States where, according to the 2000 U.S. Census, 71.0% of Asian and Pacific Islander-Americans over the age 65 are foreign-born. Immigration can prompt an immediate cultural shift and create a fast forward insight into the slower cultural evolution currently occurring in East Asian societies.

Mukhopadhaya, P., & Shantakumar, G. (2009). Economics of Gender: Singapore’s Older Generations*. Journal of Interdisciplinary Economics, 21(4), 339–377. http://doi.org/10.1177/02601079X09002100401  
In Singapore, older women (and men) are likely to be ‘marginalized’ by the global labour market. Their higher incidence of disability, smaller savings, short work histories, and lower incomes from less commensurate qualifications and skills contribute to old age insecurity. Widowhood increases their vulnerability and high family dependency, which may not guarantee sustained welfare. Formal old age support by the State is a necessary condition for income security to lessen past inequities and life-course shortcomings. This paper analyses the economic situation of older Singapore women (and men) and focuses on appropriate income security policy, based on two and a half decades of available socio-economic data (1980–2005). Universal suffrage and widespread education, and the Women’s Charter (1961) should translate into women development, but there are gaps through inadequate social security (which is employment-based), exemplifying lack of concerted government effort amidst globalization policies manifested through labour market discrimination and segmented wage systems, unequal benefits and increasing old age disability, calling for long-term healthcare financing and management. JEL classification: I18, I28, I31, H53, H55

Ofstedal, M. B., Reidy, E., & Knodel, J. (n.d.). Gender Differences in Economic Support and Well-Being of Older Asians. Journal of Cross-Cultural Gerontology, 19(3), 165–201. http://doi.org/10.1023/B:JCCG.0000034218.77328.1f  
This report provides a comprehensive analysis of gender differences in economic support and well-being in eight countries in Southern and Eastern Asia (Bangladesh, Malaysia, Indonesia, Singapore, Thailand, Vietnam, Philippines, and Taiwan). We examine multiple economic indicators, including sources of income, receipt of financial and material support, income levels, ownership of assets, and subjective well-being. Results show substantial variation in gender differences across indicators and provide an important qualification to widely held views concerning the globally disadvantaged position of older women. Whereas men tend to report higher levels of income than women, there is generally little gender difference in housing characteristics, asset ownership, or reports of subjective economic well-being. Unmarried women are economically advantaged compared to unmarried men in some respects, in part because they are more likely to be embedded in multigenerational households and receive both direct and indirect forms of support from family members.

Russell, C. (2007). What Do Older Women and Men Want? Gender Differences in the ‘Lived Experience’ of Ageing. Current Sociology, 55(2), 173–192. http://doi.org/10.1177/0011392107073300  
Issues of gender have always been at the heart of the sociology of ageing but their construction has undergone a remarkable transformation over the past half century. From an initial focus on retirement (for men) as the defining characteristic of the ‘problem of old age’, the demographic feminization of the aged population has more recently been mirrored in sociological research by a focus on the circumstances and experiences of the numerically larger group of older women. Researchers with an interest in older women, particularly those who approach the issue from a feminist perspective, have concluded that ageing is a gendered phenomenon that has special meanings for women. Some recent commentators have drawn attention to the ‘invisibility’ of older men, though relatively little systematic research has been conducted on any aspect of their lives. While it is well known that women live longer and are more likely to use formal care services than men, other more subtle differences in their experiences of ageing have been less well documented and their implications remain largely unexamined. This article draws on findings from qualitative research to explore gender differences in the ‘lived experience’ of growing old.

Tabloski, P. A. (2004). Global Aging: Implications for Women and Women’s Health. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33(5), 627–638. http://doi.org/10.1177/0884217504268655  
The world’s older population has been growing for centuries; however, the pace of this growth is accelerating rapidly. According to the U.S. Census Bureau, by 2030, more than 60 countries will have 2 million or more older people. Population aging represents a ‘success story,’ with increasing numbers of people worldwide enjoying additional years of life. However, the sustained increase in numbers of older people (usually defined as persons over the age of 65) poses many challenges to policy makers and health care providers around the world. As the world population ages, we are just beginning to understand the social, economic, and political implications of the ‘age wave.’ The majority of older people are women, thus the implications of population changes for women and women’s health are astounding. Nurses can take a national and world leadership role to adequately address the health care needs of increasing numbers of older women.

Yong, V., Saito, Y., & Chan, A. (2011). Gender Differences in Health and Health Expectancies of Older Adults in Singapore: An Examination of Diseases, Impairments, and Functional Disabilities. Journal of Cross-Cultural Gerontology, 26(2), 189–203. http://doi.org/10.1007/s10823-011-9143-0  
Using a nationally representative sample of 4,511 Singaporeans aged 55+ from the 2005 National Survey of Senior Citizens (NSSC), this paper examines gender differences in specific diseases, impairments, and disabilities, and computes health expectancies for these health dimensions. Results show that women have higher prevalence for hypertension, bone/joint, eye/vision, and walking problems, while heart diseases and stroke are more common among men, particularly at younger ages. At ages 75+, women have more disabilities related to basic activities of daily living (bathing, dressing, toileting, transferring, and feeding) than men. Health expectancies computations by the Sullivan method reveal that while women live longer than men, they can also expect more years of life both without and with diseases, impairments, and disabilities. At age 65, a larger proportion of women’s remaining life is with hypertension, bone/joint problems, vision impairments, walking difficulties, and functional disabilities compared to same-aged men. The findings largely support the gender health-survival paradox found in Western countries—that women have higher morbidity rates despite longer life expectancy. The morbidity differences between men and women, however, vary depending on the particular health dimension and measure examined. Older women in Singapore tend to be advantaged in prevalence of diseases and disease-free life expectancy, but have more impairments and functional disabilities, and a larger proportion of remaining life with these difficulties compared to older men. Health policies and programs in Singapore will need to cater to these gender differences in specific health dimensions and measures.