Marital Dissolutions and the Health of Older Individuals in a Rural African Context

Work status among middle-aged and older individuals in China: the effects on physical and mental health

Objective

China's middle-aged and older population is a rich source of human capital. Therefore, considering the health of this group is important when creating and using human resources.

Methods

Using data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 baseline survey of 19,000 adults ages 45 years and older, this study was an objective investigation of the effects of work on the physical and mental health of middle-aged and older adults. We conducted several types of analyses using details of participants' lifestyles and demographic characteristics (living environment, education, financial level, and access to medical services) with work (i.e., employment or volunteer work) as a primary input component of health production to examine their effects on the health status of middle-aged and older individuals.

Results

Six primary outcomes were identified: (1) Employment positively affects both the physical and mental health of middle-aged and older people; (2) Employment can influence the physical and mental health of middle-aged and older people through income, cognitive level, and social support networks; (3) Compared to non-self-employment, self-employment dramatically worsens physical health but has no apparent detrimental effects on mental health. Compared to non-agricultural employment, agricultural labor affects both physical and mental health. (4) Employment has more positive physical and mental health effects in Individuals with higher rather than lower levels of education. (5) Employment opportunities in the eastern region are more likely to promote better physical health than those in the central and western regions of China, although the effects on mental health are negative. (6) When considering groups at different ages of the lifespan, the 60-65-year-old group, who are just entering retirement probably benefit more from continuing work.

Conclusion

We provide some recommendations to encourage middle-aged and older people to work and utilize their experience, which will enhance their physical and mental well-being and help them in realize their own value and social integration.

Marital Disruption and Disparity in Tobacco Use in Reproductive-Aged Women: Evidence from India

Marital disruption defined as widowhood, divorce, or separation, has adverse consequences for women’s health and wellbeing. Extant evidence, however, is primarily available for older women or in developed country settings. Consequences of marital disruption for younger women in the developing countries is relatively less visited. The aim of this cross-sectional study is to assess whether maritally disrupted women of reproductive age (18–49 years) had differential risk of tobacco-use compared to their married counterparts. Using nationally representative data from India, we estimated multivariable logistic regressions to obtain the odds in favor of tobacco-use for maritally disrupted women. We found that compared to women remained in marriage, maritally disrupted women were 1.5 times (95% CI: 1.4–1.6) more likely to consume tobacco. The higher risk of tobacco-use of maritally disrupted women was evident in both younger (age 18–34) and older (age 35–49) cohorts. The results were robust across urban and rural areas, high- and low- education groups, and poor- and non-poor households. The higher odds of tobacco-use among maritally disrupted women persisted even after accounting for household fixed effects. The study findings thus, have implications for strengthening targeted tobacco control policies and health promotion among maritally disrupted women in low-and-middle income countries.

Who is at Risk? Social Support, Relationship Dissolution, and Illness in a Rural Context

This study focuses on a cohort of adults (40-plus) in rural South Africa to unpack associations between physical health and receipt of social support, and the extent to which these associations were moderated by marital status. We use logistic regression to estimate the odds of having received emotional, physical, or financial support separately for men (N = 2247) and women (N = 2609). Our results suggest having an Activity of Daily Living (ADL) limitation or having at least one chronic condition was not significantly associated with social support receipt for women, but having an ADL limitation was associated with reduced odds of receiving financial support among men. Although marital status was strongly and significantly associated with receipt of social support for both men and women, marital status moderated the relationship between health indicators and social support receipt only for men. Our findings suggest that when men, but not women, experience a marital dissolution and are suffering from a disability or a chronic condition, their networks respond by providing needed social support.

PROTOCOL: The association between marital transitions and physical and mental health in late life: A systematic review

This is the protocol for a Campbell systematic review. The objectives are as follows: What is the association between marital transitions and physical health among people older than 60? What is the association between marital transitions and mental health among people older than 60? What is the role of gender, age, and education on the association between marital transitions and health among people older than 60? What is the influence of geographical region, housing, neighborhood, and social support on the association between marital transitions and health status among people older than 60?

Support in times of need: How depressive symptoms can impact receipt of social support among aging adults in rural South Africa

The relationship between mental health and receipt of social support is not well understood in low- and middle-income countries. In this paper, we focus on a cohort of older adults (40-plus) in rural South Africa to unpack associations between mental health and receipt of social support, and the extent to which marital status modifies these associations. We use baseline data from a population-based study, Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), conducted between 2014 and 2015. Our results suggest that men and women who report depressive symptoms are less likely to receive social support: women are less likely to receive emotional and financial support, and men are less likely to receive physical and financial support. Both men and women who are married or partnered are more likely to receive social support than their non-married counterparts. The association between depressive symptomology and receipt of social support differs for women who are separated/divorced and for men who are widowed. Specifically, the association between having depressive symptoms and receiving physical or financial support is more positive for separated/divorced women than their married/cohabiting counterparts; for men, the association between having depressive symptoms and receiving physical support is more positive for widowed men than their married/cohabiting counterparts. Our findings speak to the complicated associations between social support, marriage and mental health in later life and the different experiences that men and women may have.

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We estimate links between mental health and receipt of social support among a cohort of aging adults in rural South Africa.

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Having depressive symptoms is negatively associated with odds of receiving some types of social support for men and women.

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Married men and women have greater odds of receiving all types of social support relative to non-married counterparts.

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Depressive symptoms are more positively associated with receipt of physical support for widowed vs. married men.

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Depressive symptoms more positively linked with receipt of physical or financial support for divorced vs. married women.

The Psychological Benefits of Marriage and Children in Rural Malawi

Despite an extensive literature on the psychological rewards of marriage and children in high-income countries, research on these relationships in low-income countries remains limited. This paper draws on data from 4,133 adult women and men interviewed in the Malawi Longitudinal Study of Families and Health to examine how marital status, categorized as never, formerly, monogamously, and polygynously married, and number of children are associated with psychological well-being. With respect to marital status, we find that women in polygynous unions fare worse than monogamously married women and this detrimental effect is stronger for women than for men. Formerly married men and women of reproductive age experience the worst psychological outcomes, although this association wanes with age. In contrast, the benefits of having children is only evident among older Malawian women. These findings offer novel insights into the patterns of nearly universal marriage and high fertility that characterize Malawi and much of sub-Saharan Africa.

Health Selection, Migration, and HIV Infection in Malawi

Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts.