Objectives of the study 2.1 Specific objectives i Systematize theories about living arrangements and the impact of living arrangements on health and working status of the Vietnamese ol
Trang 1THE UNIVERSITY OF DANANG
UNIVERSITY OF ECONOMICS
- -
IMPACT OF LIVING ARRANGEMENTS ON HEALTH AND WORKING STATUS OF THE VIETMAMESE OLDER PERSONS
MAJOR: DEVELOPMENT ECONOMICS
CODE: 62.31.01.05
SUMMARY OF DOCTORAL DISSERTATION
Danang - 2021
Trang 2UNIVERSITY OF ECONOMICS, THE UNIVERSITY OF DANANG
The dissertation can be found at:
- National Library of Vietnam
- Center for Learning Information Resources and Communication - The University of Danang
Trang 3INTRODUCTION
1 Necessity
Vietnam is one of the countries with the fastest population aging, particularly when comparing with other middle-income countries According to the results of the 2019 Population and Housing Census, the proportion of older people (those aged 60 and over) was about 11.9% of the total population (equivalent to 11.4 million people) The population projections by GSO (2016) showed that the proportion of older people would increase to 26.1% by 2050 (equivalent to 27 million people)
Co-residence has been traditionally common in Vietnam, and therefore older people are cared by family members To date, family remains the main security source for older persons – in which they receive support both physically and mentally However, the rapid socio-economic transition and migration have strongly affected households, turning them from multiple-generation families to nuclear families, particularly families where older person lives with his/her spouse Besides, living alone is not desirable arrangement but
it has become an increasingly popular trend among older people Such changes in living arrangements (residential arrangements) provide both opportunities and challenges for care for and promote role of older people
At the same time, most of the older people in Vietnam are still living in rural areas without pensions and having little saving, and many of them do not receive any social protection benefits (UNFPA
2011, Giang Thanh Long and Phi Manh Phong, 2016) and thus many older people are working longer than expected to finance themselves and their families With these, changes in living arrangements where older people do not live with their children will have a significant impact on income security for older people, especially in the Vietnamese socio-economic context
As such, in the context of an aging population under
Trang 4middle-income status, exploration of how living arrangements impact on health and working status of older persons is very important To date, however, at the best of my knowledge, there have been no studies discussing the impact of living arrangements on health (physically and mentally) and working status of older people Therefore, these reasons provide a great motivation for me to pursue the topic “Impact
of living arrangements on health and working status of the Vietnamese older persons” for my Ph.D research
2 Objectives of the study
2.1 Specific objectives
i) Systematize theories about living arrangements and the impact of living arrangements on health and working status
of the Vietnamese older persons;
ii) Analyze the current situation of the living arrangements of older persons in Vietnam;
iii) Analyze the impact of living arrangements on the health and working status of older persons;
iv) Based on the analysis results, propose some policies to improve health and working status of older persons
2.2 Research questions
The research questions to be addressed are:
i) What theories could be used to clarify the relationship between living arrangements and health and working of older people?
ii) What is the situation of living arrangements of older people
in Vietnam?
iii) In the context of Vietnam, how does living arrangements factor affect the health and working status of older people? iv) Based on empirical research results, what policies are needed
to improve the health of older people and promote older people to work?
Trang 53 Object and scope of the research
3.1 Object of the research:
The objects of this research were living arrangements (residential arrangements) of older people in Vietnam, health and working status of older people, and the impact of living arrangements
on health and working status of the Vietnamese older persons
3.2 The scope of the research:
- Content: The author focused on building quantitative models
to analyze the impact of older people’s living arrangements on their health (both physical and mental health) and working status
- Space: Over Vietnam with a nationally representative dataset
- Period:
+ Changes in living arrangements of older people from 2002
to 2016 based on the Vietnam Household Living Standards Survey (VHLSS) data of the General Statistics Office
+ Impact of living arrangements on health and working status
of older people based on the data of the Vietnam Aging Survey 2011 (VNAS 2011) since at the time that this dissertation was completed, VNAS 2011 was the only nationally representative database on older persons with the most comprehensive data which could be fully used
to pursue research questions of this dissertation
4 New contributions to the research
- This dissertation analyzed various research methods and respective results from a number of literatures in Vietnam and other countries From which, the research gaps were explored to have further studies
- Clarify the concepts and classify different types of living arrangements in order to adapt with the research contexts
- Quantify the impact of living arrangements on health (both physical health and mental health) and working status of older people
- This has been the first study in Vietnam analyzing such impact
Trang 6- The dissertation’s results showed that living arrangements of the Vietnamese older people have changed Among different types, living with children was the best for health and wellbeing of older people
- The dissertation provide various recommendations to policy makers in formulating appropriate policies to improve health and wellbeing for older people
5 Structure of the dissertation
Include the opening, the conclusion and 5 chapters as follows: Chapter 1 Literature review
Chapter 2 Theoretical foundations of the effect of living arrangements on the health and working of older people Chapter 3 Research design
Chapter 4 Research results
Chapter 5 Policy implications
CHAPTER 1 LITERATURE REVIEW 1.1 Studies on living arrangements of older people
1.1.1 Research situation in the world
1.1.2 Research situation in Vietnam
Studies of the world and Vietnam on living arrangements of older people show that the living arrangements model of older people
in different countries and regions is different Living alone or living with a spouse is the most common form of living arrangements found
in developed countries, and living with children is the most common form in developing countries However, empirical evidence shows that, in developing countries like Vietnam, along with socio-economic changes, the traditional living arrangements model is also changing rapidly The percentage of older persons living with children has decreased while living alone or with wife/husband has increased
Trang 71.2 Studies on the impact of living arrangements on health of older people
* Living arrangements positively affect the health of older people
* Living arrangements negatively affect the health of older people
From the review of the above studies, some important results can be drawn as follows:
- Living arrangements of older people is one of the important factors determining the health of older people There is ample evidence, including in developed and developing countries, that living arrangements are likely to affect older people's health - represented by various measures such as self-assessment health, difficulty in daily activities, depression, cognitive impairment, disease situation, and risk of death
- In general, studies have shown that living in a generational family will contribute to improving physical and mental health due to the material and non-physical benefits it brings (such as supporting internal family transfer, health care, a healthy lifestyle, help with daily activities, pride, and emotional support, etc.)
multi Older people living alone often have poor health and are at higher risk for depression as well as less satisfied with life
- Several studies have found the opposite effect that living together does not improve the health of older people but makes the health of them worse Due to the sharing of resources from parents to children, or living together makes older people too dependent on others, leading to a decline in some motor functions, and further, the generation gap leads to conflicts about ideological values These are the causes that make a living together between parents and children lead to health deterioration of older people
Trang 81.3 The research on the impact of living arrangements on working status of older people
From the review of the above studies, some significant results can be drawn as follows:
- The majority of older people still work, and this participation
is very different for each type of living arrangement
- Living arrangements of older persons are one of the important factors determining older people's work In both developed and developing countries, there is much research evidence showing that living arrangements may affect the working status of older people
- The research results are heterogeneous, in which some studies affirm that the working probability of older people living with spouses and children is higher than in other older people groups (for example, Croda and Gonzalez 2005, Paul and Verma 2016, Raymo et
al 2018) In contrast, there is a study revealing that older people living with their children have a lower probability of working than other older people groups (for example, Tong, Chen and Su 2018)
1.4 Scientific gaps
- In the studies on the relationship between living arrangements and health, and working of older people, the research results are not apparent Hence, in the context of Vietnam, it is necessary to examine this relationship
- Vietnam is a developing country, but the aging process is happening very fast The studies on aging, in general, are quite large, but the research on the current situation of living arrangements, health, work as well as the effect between these factors of older people in Vietnam has not been studied
- Research on the effect of living arrangements on the health, and working of older people in Vietnam as a basis for social policy planning
Trang 9CHAPTER 2 THEORETICAL BASIS OF THE IMPACT OF LIVING ARRANGEMENTS ON HEALTH AND WORKING STATUS
OF OLDER PEOPLE 2.1 General issues about older people and living arrangements of older people
2.1.1 Some related concepts
2.1.1.1 Population aging
Population aging also called the "aging population" period: When the proportion of people aged 65 and older accounts for 7% to 9.9% of the total population or more (According to the classification
of Cowgill and Holmes (1970), cited by (Tsuya and Martin, 1992)
2.1.1.2 Definition of older people
In Vietnam, according to Article 2, the Law on the older people 2009 stipulates: Older people are citizens of the Socialist Republic of Vietnam aged 60 and over In this dissertation, the author will use the term older people under this regulation
2.1.2 Definition of “Living arrangements”
2.1.2.1 Definition of living arrangements
2.1.2.2 Living arrangements of older persons
The term ‘living arrangements’ or ‘co-residential arrangements’ (Palloni, 2000) is used to refer to the household structure of older people
2.2 Classifying living arrangements of older people
From the above analysis, it is suitable for the basic characteristics of Vietnam in terms of demographics, socio-economic situation, and the availability of research data as well as to assess the relationship between living arrangements and health, and working of older people clearly, this dissertation defines living arrangements and classifies living arrangements as follows:
Living arrangements of older people is to show whom the elderly live with and the living arrangements can be divided into the
Trang 10following 4 groups: i) Living alone: consisting of households with only older persons living alone; ii) Living with a spouse only ( households with only 2 elderly spouses living together); iii) Living with at least a child (that is, the elderly living with at least one child, including natural and/or adopted children; and iv) Other (including other ways of living arrangements of older persons not belong to the above 3 groups)
2.4 Living arrangements and health of older persons
2.4.1 Definition and measurement of health
2.4.1.1 Physical health
2.4.1.2 Mental health
2.4.2 Impact of living arrangements on health
The impact of living arrangements on the health of older persons is explained by convoy theory, social support theory, and cultural theory
2.4.2.1 The convoy model of social relations
Living arrangements can be seen as a kind of social convoy of intergenerational relationships because it provides support throughout an individual's life, including both physically and physically support (physical help, financial support, etc.) and emotional support Individuals in this social convoy are closely related within the family, thus the living arrangements of individuals and the change in their living arrangements affect the overall health and well-being of all individuals in the convoy
2.4.2.2 Social support theory
Living arrangements between generations are a kind of social support because living arrangements form the closest and most direct social environment in providing physical and mental social support to individuals The different types of living arrangements are associated with diverse family relationships and different exchange models because the different types of living arrangements will determine the role of individuals in a household and the number and type of various
Trang 11resources that available for individuals Because of these differences, living arrangements may have important effects on health and psychology in later life
2.4.2.3 Cultural theory
2.5 Living arrangements and working status of older people
2.5.1 Definition and classification of older persons' working
2.5.1.1 Definition
To date, there is no definition of working of older persons in Vietnam, so to match the research data, the dissertation approaches the definition of working of the GSO: working is labor activity from1 hour or more to create income sources not prohibited by law
2.5.2 Impact of living arrangements to working status of older persons
2.5.2.1 Theory of supply-demand and labor market participation of older people
2.5.2.2 Living arrangements and the participation of older people in the labor market
The theory of modernization holds that the result of economic development will lead to the breaking of traditional norms and thus weakening the binding relationships between children and parents (Goode, 1963) The change in living arrangements, increasing of the nuclear family not only makes it difficult for children and parents to live together but also weakens the financial and emotional relationship through generations (Thornton, Chang, and Sun 1984), changes in living arrangements will affect working status in older persons
Trang 12CHAPTER 3 RESEARCH DESIGN 3.1 Research context
3.2 Conceptual framework and research model for studying the effect of living arrangements on the health of older people
3.2.1 Conceptual framework
The conceptual framework includes: The health output variable of older people is shown: self-assessed health -representation for physical health and depression - representation for mental health And three independent groups of variables impact on the physical and mental health of older people namely: i) Living arrangements (and this is the main independent variable in the model; ii) group of factors related to individual characteristics of older people; iii) group
of household characteristics variables; iv) variables related to health behaviors
3.2.2 Research model
Based on the approach of previous studies (for example, Chou,
Ho and Chi 2006, Weissman and Russell 2016, Mahapatro, Acharya and Singh 2017), the author examined the relationship between living arrangements to the health of older persons based on the logistic regression model as follows:
Logit (P) = βiXi + εi or Log ( 𝑃
+ i: is the older person i;
+ X: shows different sets of independent variables representing
individual and household characteristics;
Trang 13+ β: is coefficient; and
+ ε: shows the measurement error term
3.2.3 Describe and measure research variables
3.2.3.1 Dependent variable (Health outcomes)
- Self- rated health (SHR) represents for physical health
- Depression represents for mental health
3.2.3.2 Independent variables
❖ Independent variables in SRH logistic regression model
- Living arrangements were main independent variable This
study included four types of living arrangements, respectively: (i) living alone; (ii) living only with a spouse; (iii) living with at least child; (iv) other
Other independent variables are divided into the following three groups:
- Sociodemographic variables: age; gender; marriage status; education; urban/rural residence; religion; ethnicity
- Environment factors were measured by lighting energy; drinking water; toilet
- Health behaviors The environment assessed included tobacco-smoking; alcohol-drinking
❖ Independent variables in depression logistic regression model
- Living arrangements of older people: This is the main independent variable in this study, the living arrangements is described above
Other independent variables are divided into the following three groups:
- Individual characteristics include: age; sex; marital status;
education level; working status; had difficulties with activities of daily living (ADLs), had functional limitations
- Household-related characteristics include financial status;