Fertility behaviors and mid-late-life health status in China: From a life-course perspective

Despite extensive research on the impact of fertility behaviors on mid-late-life health, conclusions remain inconsistent, and understanding is limited regarding the role of fertility-correlated life events in this causality. This study uses the 2018 wave and life-history information of the China Health and Retirement Longitudinal Study (CHARLS) dataset to explore how the number of children born (NCB) and age at first birth (AFB) influence later-life health. It also examines the effects of early-life educational attainment and mid-late-life caregiving on later-life health from a life-course perspective. Health measures include the Health Deficit Index (HDI), Activities of Daily Living (ADL), and Mini-Mental State Examination (MMSE). Results from the instrumental variables (IV) approach indicate that higher NCB predicts worse health, while later AFB predicts better later-life health. These findings remain robust with different measures of fertility behaviors, and in models that control for cohort and community fixed-effects. However, introducing education variables could disrupt the causality between fertility behaviors and later-life health, but not with caregiving variables. This suggests a potential "horse race" effect between education and fertility behaviors, both of which significantly influence later-life health. Therefore, understanding this causality and formulating policy for an aging society from a life-course perspective is essential.

The Health Impacts and Life Challenges Caused by the COVID-19 Pandemic on Hong Kong Chinese Women

The COVID-19 pandemic has caused a massive global crisis. The adverse impacts on Asian women, including Hong Kong Chinese women, have been considerable. The pressure on Hong Kong women is immense due to cultural, social, familial, and personal responsibilities. This study aims to illustrate the health impacts and life challenges for Hong Kong Chinese Women during the pandemic. An interpretive phenomenological approach with purposive sampling was adopted. Semi-structured, face-to-face, in-depth interviews were conducted from August 2020 to January 2021. Twenty-five women participated in the interviews, lasting an average of 48 min. The transcribed interviews were analyzed using interpretative phenomenological analysis. The core theme identified was “Perceived family caregiving as paramount self-obligation in times of the pandemic”, in the context of the role of daughter, wife, or mother (or a combination). Three interconnected themes have been identified in individual, relational, and external contexts: deterioration of personal health, unfavorable to family relationships, and adaptation to social challenges. Eight subthemes have emerged related to health impacts and life challenges. The pandemic has increased women’s perception of their caregiver roles in the family, but it has diminished their quality of life. The promotion of strategies and activities that could enhance women’s physical, psychological, emotional and social quality of life is recommended.

Parental caregiving trajectories and Metabolic Syndrome: A longitudinal study among Chinese women

Caregiving stress may play a role in the pathogenesis of Metabolic Syndrome (MetS). However, few studies have investigated the consequences of caregiving on this objectively measured health outcome. This study used population based longitudinal data to examine the causal relationship between caregiving trajectory and MetS among Chinese women. This is a retrospective analysis of 741 women using three waves of data from the Ever-Married Women Survey component of the China Health and Nutrition Survey (2004, 2006, and 2009). Group-based trajectory analysis was used to examine the caregiving trajectories among women in China. Three caregiving trajectories were identified. In multivariate analyses adjusting for potential covariates, 'rising to high-intense' caregivers (Odds Ratio (OR) = 3.78; 95% Confidence Interval (CI): 1.10, 12.93) and 'stable low-intense' caregivers (OR = 2.07; 95% CI: 1.09, 3.92) were associated with higher risk of MetS compared with non-caregivers. Moreover, caregivers who provided 'stable low-intense' parental care were found to be associated with hypertension, high glucose and high triglycerides than those awho did not provide caregiving for their parents. Our results demonstrate that the caregiving trajectories were significantly associated with the risk of MetS. Findings from the study can be used to develop future stress management interventions to decrease MetS risk among women who provide care to their parents.

Are volunteering and caregiving associated with suicide risk? A Census-based longitudinal study

BACKGROUND

Opposing risks have been identified between different prosocial activities, with volunteering having been linked to better mental health while caregiving has been associated with higher prevalence and incidence of depression. This study explored suicide risk of people engaged in prosocial activities of caregiving and/or volunteering.

METHODS

A Census-based record linkage study of 1,018,000 people aged 25-74 years (130,816 caregivers; 110,467 volunteers; and 42,099 engaged in both) was undertaken. Caregiving (light: 1-19; intense: ≥20 h/week), volunteering and mental health status were derived from 2011 Census records. Suicide risk (45 months follow-up) was assessed using Cox models adjusted for baseline mental health.

RESULTS

Intense caregiving was associated with worse mental health (OR_adj = 1.15: 95%CI = 1.12, 1.18) and volunteering with better mental health (OR = 0.87: 95%CI = 0.84, 0.89). For those engaged in both activities, likelihood of poor mental health was determined by caregiving level. There were 528 suicides during follow-up, with those engaged in both activities having the lowest risk of suicide (HR = 0.34: 95%CI = 0.14, 0.84). Engaging in either volunteering or caregiving was associated with lower suicide risk for those with good mental health at baseline (HR = 0.66: 95%CI = 0.49, 0.88) but not for their peers with baseline poor mental health (HR = 1.02: 95%CI = 0.69, 1.51).

CONCLUSIONS

Although an increased risk of poor mental health was identified amongst caregivers, there was no evidence of an increased risk of suicide.